1. CMS is short for Complex Motor Stereotypies

2. It is a movement disorder related to repetitive movements and behaviours.

3. CMS is characterized as involuntary, purposeless motion, usually involving the bilateral (left and right) movements of the body and/or hands, face and arms, in a patterned, rhythmic manner.

4. Two Categories:

   1. Primary CMS: Can occur in typically developing children and individuals with no associated neurobiological conditions. Purely physiolgical and can be stopped with distractions.

   2. Secondary CMS: Can occur in children and individuals with associated neurobiological conditions or impairments - CMS presents as a resulting symptom.

   Severity ranges - mild, moderate to severe

A selection of classical CMS movements and patterns include:

1. Hand flapping

2. Arm waving

3. Hand/wrist rotations

4. Hands opening and closing

5. Finger wriggling/waving

6. Facial expressions

7. Open Mouth

8. Body/arms/legs tensing

9. Toe walking

10. Breath holding

11. Body rocking

12. Vocalizations

Often the behaviours can be singular (one) or in combination (multiples).

They can also be combined with pacing and bouncing.

CMS behaviour profile can be beautifully unique - a signature part of the individual.

Complex motor Stereotypies have early childhood onset - around 2 years of age and can last into adulthood.

1. Typically developing children and individuals can have CMS - though still not commonly known (Primary CMS) - See Happy Hands Blog post.

2. Affects Neurodivergent children and adults not on the Autism Spectrum (Secondary CMS - Dyspraxia for example).

3. Affects children and individuals with Autism Spectrum Disorder (ASD) - 44% in this group demonstrate CMS (Secondary CMS).

4. Affects children and individuals with sensory deprivation - hearing and vision loss for example. (Secondary CMS).

5. Affects children and individuals with intellectual disabilities or impairments (Secondary CMS).

6. Affects children and individuals with other psychiatric or neurological disorders (Secondary CMS).

There are many factors that can trigger CMS:

1. Excitement

2. Happiness

3. Boredom

4. Stress

5. Anxiety

6. Fatigue

7. Engrossment (while consumed with a discussion, activity, or topic)

CMS behaviours and patterns vary from individual to individual. Likewise, the severity, the duration, and the frequency of their need to perform their stereotypy (stereotypies) also differs and ranges based on their mood, their environment, social settings and engagement level.

1. CMS sessions can last seconds to minutes (at times longer).

2. Can occur multiple times per day.

3. Does not occur during sleep.

4. Often misdiagnosed for OCD or tics disorder.

5. Has co-morbidity (linked) with other neurobiological conditions - Dyspraxia, ASD, ADHD, OCD for example.

6. Intense Imagery Movements (IIM) and CMS are strongly connected (see link below).

7. CMS can serve to alleviate stress and anxiety, bring calm, and provide a physical release to the entire body.

8. May look painful, but is not (usually).

9. There may be a genetic component.

10. No current medication or treatment.

11. Unless harmful or widely distracting, it would be beneficial if society could learn to accept that CMS is an integral part of an individual’s expression and comfort.