Expert: Trey McGowan - 3/16/2008

Question
My 9 year old boy has hand flapped since he was around 2. He is academic and sporty. He tries not to flap at school but often lapses not realising he is doing it. This makes him the focus of ridicule and bullying by his peers. He has been assessed several times from the age of 4 onwards with no conclusion. Apparently he does not tick enough boxes to be diagnosed. However his hand flapping is taking over his life. After school and week-end and holidays he more or less continuously flaps. His favourite flapping tool at the moment is a piece of plastic curved track. He goes from gentle waggling the track in front of his face to a full blown flap where he's skipping back and forth, pulling faces grunting and aggressively flapping.Please help.

Answer
Hi there, Karen!

What I'm looking at here suggests strongly to me that you should consider assessment not under autism, but under a tic disorder. Particularly if your young man is not ticking any other 'autism' boxes, but has difficulty with his flapping. It is not uncommon to mistake the two in some stages, because of the physical sterotypies (and occasionally verbal) that go along with the pair of them!

I'm not saying for sure that this is what it is; as I have declared many a time and will again, I am not a doctor and can't make diagnoses of any sort. However, I can at least make suggestions, and this genuinely makes me wonder if you might be looking at a tic disorder. If so, then it may be that it can be treated and he can work on getting the extent of flapping under some control.

In the meantime, see if you can find out what is causing the flapping. Write down the patterns of it so you can later bring it to the doctor and show them what you are looking at at home. Frequency, severity, controllability, et cetera. In this way, you can be sure you have the details as fresh as the day you wrote them down, rather than trying to remember back two weeks when he had a bad episode, or whatever.

I wish you all the best, and as usual, any comments, feedback, et cetera, can be directed to me!

Trey