Stereotypic repetitive behaviors, with or without self-injury, variedly manifest in many cultures. Cultural attitudes toward unusual behaviors may result in delayed diagnosis. Overall cultural tolerance and attitudes toward stereotypic movement vary and must be considered.

Culture-Related Diagnostic Issues of Stereotypic Movement Disorder

Diagnostic issues of Stereotypic Movement disorder include:

Culture-related diagnostic issues

Michigan State University

Stereotypic movement disorder is diagnosed when an individual has repetitive, seemingly driven, and apparently purposeless motor behaviors, such as hand flapping, body rocking, head banging, self-biting, or hitting. The movements interfere with social, academic, or other activities. Motor stereotypes are among the diagnostic characteristics of autism spectrum disorder

Stereotypic Movement Disorder

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed., Text revision). https://doi.org/10.1176/appi.books.9780890425596

DSM-5-TR

The essential feature of stereotypic movement disorder is repetitive, seemingly driven, and apparently purposeless motor behavior. These behaviors are often rhythmical movements of the head, hands, or body without obvious adaptive function. The movements may or may not respond to efforts to stop them.


Diagnostic Features of Stereotypic Movement Disorder

The DSM-5-TR outlines a few specifiers to help specify the condition of Stereotypic Movement Disorder for each individual case. These specifiers are as followed: Self-injurious, not self-injurious and severity

Specifiers for Stereotypic Movement Disorder

Young children who are typically developing frequently make simple stereotypical movements (such as rocking; in the US and UK, this ranges from 5% to 18%). Complex stereotypic movements are substantially less frequent (happening in 3%–4% of cases). In samples from high-income nations, between 4% and 16% of people with intellectual developmental disorder (intellectual impairment) engage in stereotypy and self-harm. People with severe intellectual developmental disorders are more at risk. 10% to 15% of people with intellectual developmental disorders who dwell in residential facilities may also self-injure and have stereotypic movement disorder.  In children with severe intellectual developmental disorders, repetitive and constrained behaviors and interests may be risk factors for the onset of self-harm, violence, and destructive conduct.


Prevalence of Stereotypic Movement Disorder 

Onset is in the early developmental period. Stereotypic movements typically begin within the first 3 years of life. Simple stereotypic movements are common in infancy and may be involved in acquisition of motor mastery. In children who develop complex motor stereotypes, approximately 80% exhibit symptoms before age 24 months, 12% between 24 and 35 months, and 8% at 36 months or older. In most typically developing children, the severity and frequency of stereotyped movements diminish over time. Onset of complex motor stereotypies may be in infancy or later in the developmental period. Among individuals with intellectual developmental disorder, the stereotyped, self-injurious behaviors may persist for years, even though the typography or pattern of self-injury may change.


Development and Course of Stereotypic Movement Disorder 

Risk and prognostic factors of Stereotypic Movement disorder include:

Environmental
Genetic and physiological


Risk and Prognostic Factors of Stereotypic Movement Disorder 

Related Diagnostic Issues of Stereotypic Movement Disorder

Differential Diagnoses to Stereotypic Movement Disorder include
Normal development
Autism spectrum disorder
Tic disorders
Obsessive-Compulsive related disorders
Other conditions

Differential Diagnoses to Stereotypic Movement Disorder 

Common comorbidities in children with chronic motor stereotypes include attention-deficit hyperactivity disorder, motor coordination problems, tics/Tourette’s disorder, and anxiety.

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