Expert: James Michael Roan - 3/25/2007

Question
I'm a little concerned about two things my 20 month old daughter does. When she's excited, or frustrated (because I'm about to take something away from her), she flaps her hands. The other thing she does is walks on her toes around the house sometimes. I did both the M-CHAT and revised M-CHAT and she was fine on every question. She points at everything, does tons of pretend play, looks when you talk about a toy across the room, looks every time you call her name. This is all comforting. Her language is at about 35-40 words, in three languages. My parents speak my native language to her, I speak English, my husband his native language. Some of the words are super clear and others are harder to understand, like "kuck" for "duck". Her receptive language is amazing. She can understand directions in all three languages. She is very social and follows other children around trying to play with them at the playground. She has friends already and is more interested in people than anything else. She makes great eye contact, and is very affectionate. However, I'm still concerned about the origin of the toe walking and hand flapping. I read a little about how some stereotypic movements can occur in normal children but, 35% of these children had parents with a tic disorder. My husband, his cousins, and his nephew all have tics! Could this be related or should I be concerned???

Answer
Hi Gina;

It sure doesn't sound like autism. Hand flapping is thought as a means of emotional and neurological modulation, whether it occurs in autism or typically developing children. You may want to have the occupational therapist at your school, or a private one, check her out. I'm not concerned.

Kind Regards,
James