What are Finger Movements in Childhood?
Finger movements in childhood are repeated flicking, tapping, or unique finger motions commonly associated with a developmental disability like the Autism Spectrum.
These movements may be rhythmic, and it may feel that your child has no control or awareness of their fingers. The movements may increase in the presence of stress, anxiety, or excitement. Often, these movements are referred to as part of the category of RRBs for restricted repetitive behaviors. This behavior is assessed on the ADOS-2, a measure for evaluating autism characteristics.
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Symptoms of Finger Movements in Children
- Wiggling fingers non-functionally: your child is moving fingers in a rolling motion. They may hold their hands on the sides of their body while wiggling or rolling fingers around. Some kids may hold out their fingers out in front of them and watch as their hands and fingers move
- Tapping fingers non-functionally: your child is tapping fingers repeatedly and without a purpose
- Flicking fingers non-functionally: your child is flicking and extending fingers. The child may watch their fingers flick or keep their hands at their sides while moving and flicking
- Holding fingers in rigid position: your child is maintaining a rigid finger posture that may look like a muscle spasm or tensing of the hand
- Watching hands or fingers intently: your child may study hands and moving fingers and seem to be distracted by them
- Rocking or flapping: your child may have other motor behaviors like rocking and flapping along with finger movements
Causes of Finger Movements in Childhood
- Motor overflow is an excess movement that does not serve a function. It is common in infants, older adults, and those with neurological differences. The motor planning part of the brain may not be working smoothly. Movements are controlled by the parts of the brain (parietal lobe and basal ganglia) responsible for planning and executing gross motor movements.
- Motor stereotypies: Motor movements that may include finger movements are often referred to as Complex Motor Stereotypies. These behaviors are patterned, repetitive, and rhythmic involuntary movements . They can occur in children who are otherwise developing typically and are considered part of executive dysfunction.
- Restricted & repetitive behaviors: Finger movements may occur in children with Autism Spectrum Disorders. A neurological difference is present in this context, and the behaviors are referred to as restricted and repetitive behaviors. Restricted and repetitive behaviors are only one of the many symptoms of autism. Thus, if a child has only repetitive behaviors but no social or communication problems, autism would not be diagnosed
Some diagnoses that commonly occur with finger movements
- Developmental coordination disorder: challenges with fine motor or gross motor skills, which may include motor planning and motor overflow. Children with this disorder may have difficulties executing fine motor movements for writing, drawing, or small tasks like stringing beads. Sometimes these issues may result in unique or impaired finger movements 
- Autism spectrum disorder: deficits in social communication and restricted interests or behaviors [1, 2, 3]. The sensory-motor systems in children with ASD may differ in some children, and thus RRBs, including finger movements, can be a part of the diagnosis. Often with autism, special interests are also present
- Cerebral palsy: impacts muscle tone, movement, and coordination (generally is diagnosed around the time of birth)
- Intellectual disability: finger movements may be part of a developmental, neurological, or genetic disorder that also causes intellectual impairment
- Neurological conditions related to motor movement: medical conditions that impact motor movement or medications that cause excess motor movement could lead to unusual finger movements. Parkinson's Disease or Huntington’s Disease, for example, are medical conditions occurring in adults that may result in unique motor movements. Some medications for schizophrenia may cause tardive dyskinesia, which includes motor problems
What to Do about Finger Movements in Childhood
When a child has a movement disorder that is part of a complex medical diagnosis, or neurological condition, it will be important to consult with your treatment team before deciding on any interventions. Typically neurologists, physical therapists, occupational therapists, and psychiatrists treat these symptoms. In most cases, the best outcomes are achieved when the treatment team coordinates and works on common goals.
As psychologists, the authors of this article have worked extensively with children on the Autism Spectrum (ASD). With ASD, it can be a goal to have the child begin to recognize motor overflow behaviors. You can then start to work with them to inhibit and shape the behaviors. Shaping refers to gradually moving toward a more acceptable behavior through reinforcing successive approximations. Stated simply, we decide the behavior we want to teach and then reward every baby step toward that goal.
Many children can be provided with an alternative to occupy their hands, such as a fidget toy for the pocket, something to tap or hold, or a cool-looking textured bracelet. Once your child can recognize the finger movements, they can shift to a less noticeable behavior to meet the sensory need.
“If finger movements are infrequent and not causing teasing or embarrassment, you may decide to do nothing.
If your child does not mind the finger movements, there is no reason to worry. It is okay to let this issue go so long as your child is not suffering any negative impacts.”
However, some kids we work with tell us they want to change these behaviors. They might prefer another way to focus at school rather than drawing attention to themselves. Many kids will make adjustments at school but not worry about making changes at home, where they feel safe and comfortable.
If your child really wants to work on this issue to feel more confident around peers, here are a few ideas.
- DO listen to your child and take their cues for how you can help them
- DO provide a fidget toy to hold when your child encounters stress or excitement
- DO offer a rubber bracelet or band that is stylish and offers something to grab and twist as needed
- DO provide movement breaks regularly for other kinds of motor activity
- DO work on coping strategies for stress like deep breathing, yoga, muscle relaxation, listening to music, taking a walk or water break
When to Seek Help for Finger Movements in Childhood
If your child meets the criteria for autism or another medical diagnosis, they may need an IEP or Section 504 Plan to provide additional support and services at school. It will be important to share any diagnostic information or reports with your School Psychologist to get the ball rolling.
Professional Resources on Finger Movements
- Psychologist or neuropsychologist: to consider symptoms in a mental health and brain-based context. A testing psychologist who knows child development can comprehensively evaluate emotional, cognitive, language, learning, and motor domains to help create a profile of your child’s strengths and needs. This professional can diagnose autism and other neurodevelopmental disabilities
- Neurologist: to consider other neurological causes for finger movements. Can diagnose many genetic or brain-based disorders or medical conditions.
- School psychologist: to consider a 504 plan or IEP based on behaviors and learning in school
- ABA therapist: to treat RRBs and help a child find appropriate replacement behaviors for any problematic finger movements. ABA therapists may come into the home. Many parents find it helpful to have support in the setting where they see these behaviors
- Occupational therapist (OT): to work on fine motor movements with a child in a school or community setting. Occupational Therapists can work on sensory sensitivity and sensory regulation. If your child needs an OT and has a medical condition, a community referral can come from your doctor, and most insurance plans will likely cover services
- Physical therapist: to work on motor skills. Generally, an OT works with the hands, but a child with more motor needs may find regular physical therapy helpful. A medical doctor can make this referral
- Developmental pediatrician: to look at the whole child and identify any genetic conditions or needs related to neurology, behavior, or development. Can prescribe medication as needed. This professional can diagnose any medical or genetic condition, including autism
Similar Conditions to Finger Movements in Childhood
- Motor coordination: finger movements could be related to a general motor control problem
- Executive functions: finger movements are often associated with executive functioning deficits in multiple areas
- Attention challenges: finger movements may be associated with attention deficits
- Social challenges: finger movements may be associated with the social deficits often seen in children with Autism Spectrum Disorder or ADHD
- Sensory sensitivity: finger movements are often seen in children who have sensory sensitivities. In this case, Autism Spectrum Disorder should be considered
Book Resources on Finger Movements in Childhood
 Kroncke, Willard, & Huckabee (2016). Assessment of autism spectrum disorder: Critical issues in clinical forensic and school settings. Springer, San Francisco.
 Fein, Deborah (2011). The Neuropsychology of Autism.
 Mahone, Mark E.; Ryan, Matthew; Ferenc, Lisa; Morris-Berry, Christina; Singer, Harvey, S. (2014). Neuropsychological function in children with primary complex motor stereotypies. Developmental Medicine & Child Neurology.
 Goldman, S., Wang, C., Salgado, M. W., Greene, P. E., Kim, M., & Rapin, I. (2009). Motor stereotypies in children with autism and other developmental disorders. Developmental Medicine & Child Neurology, 51(1), 30-38.
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