It's Not A Seizure - It's Masturbation!

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After puberty, masturbation is normal, feels good and is good for you – it helps your sex life. What many parents don’t realize is that masturbation occurs down to 9 months of age.

     Infants and toddlers, both males and females, masturbate.  It can look really strange and parents often worry that the child is having a seizure. The child develops a repeated pattern of behavior that may involve crossing the legs, holding the hands in to groin area, breathing irregularity and agitation. It lasts for a few minutes and then resolves with the child becoming relaxed. It may be repeated multiple times a day.

     A true grand mal seizure involves jerking of multiple extremities or different muscle groups on both sides of the body. It always involves some loss of consciousness. If the child is conscious when doing the behavior, it is almost certainly not a seizure. A temporal lobe seizure can involve repeated strange behavior without the jerking of a grand mal seizure, but, again, usually involves some alteration of consciousness. After a seizure, the child will have a period of sleepiness and confusion. The child who is masturbating is awake and alert (although intensely involved in their behavior) and acts normally after the episode.
     Other medical problems can cause jerks, twitches and unusual movements in children. Young infant can normally twitch when falling asleep. However, if a child seems to have pain, has abnormal eye movements or disorientation after a spell, it should be investigated.

     Adults have problems with childhood masturbation because they think of it as a sexual activity and are embarrassed by it. Children under five don’t think in sexual terms and masturbate simply because it feels good. Parents need to avoid overreaction to the behavior. Don’t let grandma’s or the daycare provider’s embarrassment make you feel like the behavior has to be stopped. Help your child understand that masturbation is in the same category as nose-picking, farting and other things that we all do but we learn to do in private.

Stuttering and Speech Problems

   As children develop language between age 2 and age 5, a frequent concern of parents is stuttering. The most common form of stuttering is word stuttering – repeating the first word of the sentence before getting the sentence out: “Mom…Mom…Mom… I’m hungry”. This is normal and probably comes from the child’s brain going faster than his mouth. It usually resolves itself without any treatment. Parents should just relax and give the child time to get out whatever he is trying to say.

     True stuttering is letter stuttering – the first letter of a word is repeated: “M…M…M…Mom, I’m hungry”. This kind of stuttering is more common in males, seems to run in families and needs to be treated by a speech therapist.

     Delay in speech development can have many causes. If a child is not responding to parent’s speech by 4 months, he should be evaluated for possible hearing loss. The most common reason for temporary hearing loss is fluid in the middle ear caused by recurrent ear infection. This usually occurs after 1 year of age and is reversed when the infections stop or the fluid is eliminated.

     A child who does not respond normally to parent’s speech or does not develop language use by 18 months should also be evaluated for developmental delay or autism.  Problems pronouncing words can be associated with cerebral palsy, stroke or brain tumor.

     There are many categories of speech and language problems: articulation disorders, language disorders, expressive disorders and receptive disorders. Parents who have concerns about their child’s speech problems should see a speech therapist.

ADHD Treatment

Medications for ADHD have a negative public image –“I don’t want to drug my kid” – but there is no real reason for this. The basic medication, methylphenidate (Ritalin), has been used since 1937 and we have more experience with it than almost any other drug used today. We know its effects, its side effects and its long-term effects. It is cheap, safe, easy to dose and is effective in treating ADHD. Yet, people continue to be reluctant to use it.

     As with Autism and Downs Syndrome, many alternative therapies (vitamins, diets, etc.) have been tried to treat ADHD. Unfortunately, none of them have had any statistical success. Allergy therapy doesn’t work because ADHD isn’t an allergic disease. Diet therapy doesn’t work because ADHD isn’t a dietary problem. Behavioral therapy has been proven to improve the ability of ADHD children to function with about the same success rate as medication alone. The greatest success rate in ADHD therapy comes from a combination of behavior therapy, improved parenting skills and medication.

     Ritalin and most of the basic ADHD medications fall into the category of “stimulant medication”. It doesn’t seem to make sense to give a stimulant to a child who routinely bounces off the walls, but these medications improve ADHD symptoms without making the child more hyperactive. The current theory about how they work involves the concept of “inhibitory” nerves that cause other nerves to decrease their activity. These medications stimulate inhibitory nerves, which decreases the general neurologic output. The previous ADHD article spoke about external stimuli distracting a child with ADHD from the task he is trying to focus on. The medication helps to decrease this distractibility. It also decreases hyperactivity, inattention and impulsivity. Other ADHD medications do the same things in the brain but are not listed as “stimulants”.  When medications are used, it is best to start with one medication on a low dose and then increase the dose rapidly until the child, parent and teacher notice improvement. Doing a “blind study” where the pharmacy gives the parent both actual medication and sugar pills sounds scientific but I’ve only found that it is a waste of time. I prefer to work on finding the proper dosage as fast as I can. You don’t increase the dose every day because everyone has good and bad days, but, after three days on the medication, the effect the drug has on the child will be obvious. If the dose the child is on doesn’t seem to be having an effect, the morning dose should be increased. If the morning dose seems effective but doesn’t last long enough, the parent can increase the morning dose to see if it will last longer or can begin a dose at noon or when the morning dose wears off. There are also “long lasting” medication which could be tried. I don’t advise giving “drug holidays” on the weekend because children with ADHD don’t only need help at school and I’ve found it is difficult for the child to always be going on or off the medication. Find a dose that works and stick with it. As the child grows, the dose may need to be increased.

     The most common side effect is loss of appetite. Most people drink coffee after a meal because decreased appetite is a common side effect of any stimulant. This may be the cause of the slight decrease in growth that is sometimes seen when children are on these medications. Other side effects include trouble sleeping, headache, upset stomach and a peculiar zombie-like disconnected feeling that occurs when the dose is too high.

     In future articles I will discuss the behavior modification and parenting skills that are needed to give the medication its maximum benefit. What is important for parents to understand is that, when ADHD treatment works for a child, that child’s life is so improved (both short-term and long-term) that small side effects become unimportant.