Repetitive arm and hand movements (complex motor stereotypies) in children.

OBJECTIVE: To characterize clinical features, associated problems, and outcomes for children with complex motor stereotypies who do not have mental retardation or pervasive developmental disorders.

STUDY DESIGN: We performed a record review for 40 children (63% male) aged 9 months to 17 years with complex motor stereotypies between 1993 and 2003.

RESULTS: Age at onset was at or before 3 years in 90% of the sample. Symptoms occurred at least once daily in 90%. Excitement was identified as a trigger in 70%. Movements stopped when cued in 98%, and none had stereotypies during sleep. A total of 25% had comorbid attention deficit hyperactivity disorder (ADHD), and 20% had a learning disability. Family history of stereotypies was identified in 25%, tics in 33%, ADHD in 10%, and mood-anxiety disorder in 38%. Pharmacotherapy to target associated conditions was used in 40%, and behavioral therapy was used in 23%. A total of 53% identified symptoms for more than 5 years. Movements resolved in 5% of the children, improved in 33%, were unchanged in 50%, and worsened in 13%.

CONCLUSIONS: The clinical course of complex motor stereotypies appears chronic. Better understanding of the clinical features of complex stereotypies in primary care settings is essential for early diagnosis and management.