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Stereotypic Movement Disorder—Child


Sterr-e-o-tipp-ik Movement Disorder


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).

Causes    TOP

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    TOP

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    TOP

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

Diagnosis    TOP

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.

Treatment    TOP

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.

Prevention    TOP

SMD cannot be prevented.


Family Doctor—American Academy of Family Physicians
Healthy Children—American Academy of Pediatrics


Canadian Pediatric Society


Disorders of childhood: Stereotypic movement disorders. website. Available at: Published February 4, 2008. Accessed July 6, 2017.
Primary (non-autistic) motor stereotypies. Johns Hopkins Medicine website. Available at:
...(Click grey area to select URL)
Accessed July 6, 2017.
Your child’s stereotypies. Evelina London website. Available at:
...(Click grey area to select URL)
Updated August 2016. Accessed July 6, 2017.
Last reviewed August 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 9/20/2017

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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