• Stereotypic Movement Disorder—Child



    Stereotypic movement disorder (SMD) is the rhythmic repetition of body movements called stereotypies. These movements are usually harmless or may result in self-harm or social challenges.
    SMD often starts around age 3 years. It may occur by itself or with other conditions, such as Autism Spectrum Disorder (ASD).


    It is not clear what causes SMD. Some children with SMD have family members who had SMD when they were young, so there may be a genetic link for some.
    SMD may also be associated with neurological conditions or brain injuries in some children. Not all children with SMD have brain injury though.
    Head Injury
    Copyright © Nucleus Medical Media, Inc.

    Risk Factors

    SMD is more common in boys.
    Factors that may increase a child’s risk of SMD include:
    • Having a developmental condition, such as ASD
    • Family history of SMD


    Symptoms are common in children aged 3-5 years of age, but it may last longer in some children. Stereotypic movements have the following features:
    • Affect the arms, hands, head, or entire body
    • Are rhythmic
    • Do not change over time
    • Can be subtle or disrupting
    • Stop when a child’s focus changes
    Symptoms may include:
    • Thumb sucking
    • Biting one’s nails, lips, hands or other body parts
    • Hair twisting
    • Rocking
    • Teeth clenching or grinding
    • Banging the head on objects
    • Nodding
    • Hand or arm flapping
    • Waving
    • Wiggling one’s fingers or opening and closing the hands


    You will be asked about your child’s symptoms and medical history. Understanding the movements, what starts them, and what makes them stop will help the doctor to determine if it is SMD or other disorders that cause similar movements. A physical exam will be done. Psychological testing will also be done.


    Talk with the doctor about the best treatment plan. In some cases, SMD fades over time. Minor movements that do not cause problems may not need treatment. Movements that impact social function or cause self-harm will need to be treated. Options include:

    Behavior Therapy

    The movements are easily stopped with distraction. Therapist- or home-based behavioral therapy can help a child recognize patterns and reduce or stop movements with positive reinforcement.
    Cognitive behavioral therapy (CBT) may also be used to change patterns of thinking that are unproductive and harmful. However, it may not be helpful in very young children.


    There is no specific medication to treat SMD. If therapy is not effective and symptoms are severe, then medication may be chosen on a case by case basis to help symptoms that do not respond to therapy.


    SMD cannot be prevented.


    Family Doctor—American Academy of Family Physicians http://www.familydoctor.org

    Healthy Children—American Academy of Pediatrics http://www.healthychildren.org


    Canadian Pediatric Society http://www.cps.ca

    Health Canada https://www.canada.ca/en/health-canada.html


    Disorders of childhood: Stereotypic movement disorders. MentalHelp.net website. Available at: https://www.mentalhelp.net/articles/disorders-of-childhood-stereotypic-movement-disorder/. Published February 4, 2008. Accessed July 6, 2017.

    Primary (non-autistic) motor stereotypies. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/neurology%5Fneurosurgery/centers%5Fclinics/pediatric-neurology/conditions/motor-stereotypies/index.html. Accessed July 6, 2017.

    Your child’s stereotypies. Evelina London website. Available at: http://www.evelinalondon.nhs.uk/resources/patient-information/your-childs-stereotypies.pdf. Updated August 2016. Accessed July 6, 2017.

    Revision Information

  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.