Hand flapping is perhaps one of the most commonly known “stims” engaged in by children with autism spectrum disorder. So it’s understandable that a parent who sees their toddler flapping their hands will be concerned. However, as our Akron ABA therapists can explain, hand flapping is actually a common behavior that all toddlers behave in. It could be a sign of developmental or neurological conditions, such as autism, but it might also simply be a self-soothing mechanism.

Many toddlers engage in hand flapping as a way to release energy, express excitement or cope with different emotions. It’s important to note that repetitive behaviors, like hand flapping, are often part of typical development in toddlers.

Pediatricians, psychiatrists, pediatric behavior specialists, and our own Akron ABA therapists are going to look at the totality of the evidence when thinking about whether an autism diagnosis is appropriate. Hand flapping alone won’t be enough to justify one.

Many typically-developing toddlers engage in hand flapping when they don’t know what to do with all the big emotions they’re feeling – happy, frustrated, angry, elated, scared, etc. For the most part, a toddler will outgrow this by the time they turn 2 or 3, as they are able to better master big, unexpected emotions and express themselves. A child who is on the autism spectrum may not outgrow this.

However, that doesn’t mean you have to wait until a child’s 3rd birthday to dig a little deeper if you have concerns. In fact, “wait and see” is not a great approach when it comes to autism because it’s a well-verified fact that early intervention therapies are associated with the best possible outcomes for children who have autism. The earlier you as a parent get the ball rolling, the sooner you can get your child the critical early care they need to forge new neural pathways that can help them overcome their developmental deficits in speech, language, sensory, and social skills. Autism can be diagnosed as early as 14 months, though the stability of the diagnosis is higher at 18 months.

If your child is flapping their hands but also exhibiting other symptoms of ASD or you have additional concerns about their development, it’s appropriate to have them evaluated by a healthcare provider who offers ADOS testing. The ADOS (Autism Diagnostic Observation Schedule) test is a commonly used assessment tool for diagnosing ASD, though there are others.

The ADOS test will go beyond the hand flapping behavior to examine whether other areas of development are not progressing as they should. Some of the red flags ADOS testing helps identify include (as noted by the CDC):

• Delays in speech.
• Delays in social interaction. (Avoids eye contact, doesn’t respond to their name, doesn’t use hand gestures, doesn’t show many facial expressions, doesn’t initiate play with others, doesn’t notice when others are upset/hurt or doesn’t seem bothered by it, doesn’t play pretend, doesn’t sing or dance, etc.).
• Restricted or repetitive behaviors or interests. (Hand flapping is just one of these.)
• Gastrointestinal issues.
• Hyperactive, impulsive, or inattentive behavior.
• Delayed movements.
• Unusual sleeping or eating habits.
• Extreme sensitivity (or lack of sensitivity) to sensory stimuli (tactile, taste, sound, sight, etc.).

Your pediatrician can help evaluate your child and provide guidance on any necessary next steps.

In summary, while hand flapping alone is not always a cause for concern, if you have other concerns about your child’s development, it is always best to discuss them with your child’s pediatrician.

Therapy & Wellness Connection – your connection to a life without limitations – provides ABA therapy to children in Akron, Cleveland, Brecksville-Broadview Heights and surrounding communities. We also offer occupational therapy, speech therapy, physical therapy, summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

Neurodivergent, Cleveland Clinic

More Blog Entries:

What We Look for When Hiring Registered Behavior Technicians for Akron ABA Therapy, Feb. 11, 2023, Akron ABA Therapy Blog