Expert: Trey McGowan - 3/31/2008

Question
My daughter has been hand flapping since birth. She does it when she is excited or proud. She is 5 1/2 years old. When she was a baby it was full body shivering/movements and finger flicking. Now it is very obvious and big hand flapping along with her mouth open and sometimes her right leg shaking. She also has selective mutism which she often refuses to speak in social situations. At home she is verbally very advanced and appropriate. She is and has always been great at imaginative play. She plays "school" "tea parties" "baby doll going to the doctor" ect...
My question is could she be on the spectrum when she basically has only one autistic trait (hand flapping).
Thanks.  

Answer
Hi there, Jennifer!

The thing with autism is that it is not a single trait. It is a series of common traits that 'come together' to create a very noticeable issue. And the big issue with autism is social issues.

The reason I bring this up is that simply showing 'hand-flapping' might be an autistic trait, but I would hesitate to try putting it on the spectrum. After all, there are many other situations which can cause hand flapping, other than autism. Treatment for autism does not do anything to stop these 'stereotypies'. Rather, it is generally a form of training for the person: they have to learn what is and isn't appropriate and when.

If this hand flapping is an issue (and I'm assuming it is with the letter coming as it is), maybe you want to try looking into other things it could be.  Your doctor or a child psychologist may know some things. Look into the possibility of neurological issues, particularly if they are on one side. Tic disorders, epilepsy, these both could cause the sort of activity that you're describing. But I am not a doctor, and I am not even beginning to say it is either of these; only that they are something to consider if she is definitely not showing other autistic traits.

As for the 'selective mutism', this could very well be an issue known in the world as 'shyness'. It is possible there is something more than that, but even the most neurotypical child can feel awkward and stressed in a group situation, and not do any talking. For that, try some general social training: get the child used to having more people around, and let them relax at their own pace. It may very well help to eliminate the problem and open her up some with them. Or it may just be that she is introverted, and will never truly be comfortable. While I can't promise that it *isn't* an autistically-triggered trait, I would be considering this first.

Hopefully my letter answered your question satisfactorily. If you have any others, any follow-ups, comments, et cetera, feel free to send them my way!

Trey