Is arm-flapping in toddlers always a sign of autism?

My daughter, now three and a half years old, has always had a tendency to flap, clap and wave her hands when she gets upset. The more anxious or frustrated she gets, the more dramatic the movements get. A mild frustration might meet with a quick wring of the hands, but she may respond to full-blown panic attack by wildly flailing her arms.

Many parents are understandably concerned when they see their toddlers exhibiting arm-flapping behaviors, since hand-flapping is one of many classic behavioral symptoms of autism. My daughter does exhibit some autism-like behaviors, but is ultimately not considered autistic at this point in her development. If you're worried that arm-flapping may be a sign of autism in your toddler, here are some factors to consider.

1. It is one of many interrelated behaviors. Hand-flapping falls into a category of behaviors known as stereotypy. Stereotypy is one form of self-stimulation, or "stimming," often seen by children with developmental disabilities. Acts of repetitive self-stimulation may also include self-hitting, body-rocking and head-banging. These all accomplish similar tasks to the minds and bodies of toddlers-- they offer a consistent sensory input that, in turn, can provide comfort.

2. Hand-flapping is an extremely common behavior.

Many toddlers with typical development display hand-flapping and other stimming behaviors. In fact, BabyCenter reports that 20% of toddlers engage in the related behavior of head-banging. Stereotypy is an essentially normal behavioral phase. It is not always-- or even often-- a symptom of autism.

3. Hand-flapping peaks among two-year-olds.

My daughter first started flapping her hands at about six months of age. She did it more consistently, and more with more intensity, during the second half of her third year (18 and 24 months of age). She now displays some hand-flapping behavior, but far less often. Stimming behaviors are most common among two-year-olds and less common as a child matures into the preschool years.

4. Some older children continue to engage in arm-flapping. Your child's hand-flapping or arm-flapping behavior may not necessarily evaporate as he gets older. I have seen several preschoolers do the same thing when they feel especially panicked or upset. Even many adults will flick their wrists or wave their hands when feeling intensely stressed. While the behavior may look alarming, it isn't necessarily a sign of autism or any other disability.

5. Get in touch with an expert if you're worried. Any time you are concerned about your child's development, or worry that she may be showing early symptoms of autism, it's best to check with an expert. A pediatrician or early-intervention specialist can evaluate your toddler's behavior for other symptoms of autism or developmental disability. While it's unlikely that arm-flapping would appear as a sole symptom of a disabling condition, your child could benefit from early intervention if he does have an underlying problem. Always seek expert help when you feel concerned about your child's health or well-being.

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