Expert: Trey McGowan - 6/18/2007

Question
QUESTION: My granddaughter, who is almost eight months old, does a lot of hand flapping. To your knowledge, is this typical behavior or could it be an indicator of autism for a child of this age group? She does make eye contact and return smiles at her parents.

Thank You,

Dee

ANSWER: Hello, Dee!

The short answer to this is: possibly. I know. I hate answers like that, too.

The long answer, therefore, is as follows: Excessive hand-flapping alone, without any other signs in a child of that age, could indeed be an indication of autism in a child this young. Look for the other common signs: rocking, spinning (herself or other things), other forms of self-stimming and oversensitivity. PDD has a vast slew of symptoms, but those tend to be the ones most commonly noticed by parents in the early years.

Alternatively, it could be a natural self-exploring behavior in a child of this age. She may have learned that the flailing of her hands is a good way to burn off excess energy, or feels good to her. It may well be that in a couple of months or so, it will fade.

I'm not a doctor, so I can't make a diagnosis and wouldn't even attempt it, but for me, I would write it down in her Baby Book (if you have such a thing) and keep it around. Describe the hand-flapping in at least a little detail (is it a twitch? Mad flailing at the wrists? Is it quite literally flapping like she was pretending to be a bird?). This way, if the problem persists, you'll have the proof, signed and dated, of how early it was going on (as many doctors will ask questions about that). And if it turns out to be nothing, it'll be a cute memory you can turn back to later and tell your daughter, 'You used to run around like a little bird....'

If I can help with anything else, don't hesitate to ask!

Trey

---------- FOLLOW-UP ----------

QUESTION: The "hand flapping" is more of a flick of the wrist going back and forth not up and down making it look like a hand wave (Miss America style.) However, she is not waving. She seems to do it when she is nervous or excited. Is this different than the hand flapping? She definetly makes eye contact, and smiles back when smiled at. She notices when her parents leave and cries for them. I will write it down.

Thank You,

Dee

Answer
I'm sure there's a medical definition for what constitutes as 'hand flapping' that I'm not privy to, but for the most part I see it in the definition of a child (or adult) who is shaking their hands loose-wristed from side to side, either lightly or strongly. Thus the definition 'flap' (because they flap like a sheet in the breeze). Essentially, if you'll pardon a graphic description, hold your hands the way a dog begging would hold their paws, then, without tensing the muscles of your wrists, shake your hands to and fro. That loose wriggling is what I tend to see IDed as 'hand flapping', and the strong sensation you get while doing that is often the reason the child does it.

What you are describing sounds more like a rather typical expression of surprise or glee, and while it may be done unusually often, it's very possible that she is just excitable. Maybe you could bring her to the doctor and bring along an object that makes her excited, to give him an example of what it is that you're looking at when you see her 'hand flapping'. It may well be that she is just very very energetic, and thus does a lot of cheering in her own little way! A doctor or psychologist would be more sure. At eight months, though, if this is the only symptom that she is showing, I wouldn't start worrying just yet. Give her time to start developing (or not developing) language and it will become more clear.

Here's some links that might be of interest to you for identifying:

A mother with an 8 month old infant who describes some hand-flapping (if this is you then I hope you'll forgive the rerouting!)
http://www.autism-pdd.net/forum/forum_posts.asp?TID=16541

Pictures of an individual hand-flapping
www.gettingthetruthout.org/pageb006.html (it may be down)

Descriptions from special needs mothers of their children's hand flapping. These are various situations, but the descriptions are probably helpful for you to get an image.
http://www.mothering.com/discussions/showthread.php?p=4835623

Kudos for being such an attentive and loving mother!

Trey