Expert: Trey McGowan - 1/12/2008

Question
My daughter started twirling her hands and feet as an infant when stimulated with an exciting toy or object. This has progressed to hand flapping and prancing back and forth throughout the day. She does great in preschool, loves to teach the other children and help them, is incredibly empathetic and caring, maintains eye contact, great verbal skills,... She mostly flaps and grunts and prances during free, non-structured play. Her breathing is strained and she does not know what she is doing. We are seeing a neurologist next month. When she was 3, a pediatric neurologist said I shouldn't be concerned and that she would likely grow out of it.

Your thoughts please?

Answer
Hey Christa!

I hope you'll forgive the delay in answering the question, but I've been down with a terrible toothache and only just recently got back into the 'answering questions' thing. Feel free to scold me mightily for taking this one to the wire!

First off, as per my usual, I'm not a doctor. So these thoughts would be only that: thoughts.

Now, in looking at what you say, it looks to me as if this is an example of a child simply finding an eccentric outlet for her energy. It's possible she is showing one or two of the autistic signs, or that it may develop, but to be quite honest with you, it sounds to me as if she is too empathetic with others to have Asperger's Syndrome or autism. The hand-twirling and grunting are signs, yes, but they are not the most important sign.

One thing it could be is a tic disorder, rather than the 'average' ADD. While the best-known example of this is the severe signs of Tourettes that people see on talk shows, 99% of the time, Tourettes expresses itself in a much lesser way: in verbal utterances (grunts, gasps, mumbles, sudden pitches of voice) and in physical reactions (blinking, hand flickering, shifting from side to side). It is also much more likely for a child to end up with only one or the other, rather than both.

I would definitely suggest getting a detailed report of what you are seeing with her, and bring it up with the neurologist when you go to see him. This way, even if it is nothing, you can have the peace of mind that you made sure to bring all the information in. Plus, stress can make people forget even the most important things, so by having them written down, you can be sure nothing at all is forgotten.

Hopefully this (belated) answer will help you out! Luck to you, and if you have any follow-ups, questions, or feedback, don't hesitate to give it!

Trey