Soft Neurological Signs in Young Children and My Personal Experiment

Dear Dr. Cason,

I have a son who is 4 and also a twin. He twitches his fingers and does this circular motion with his hands when he talks, but mostly when he is excited.(his arms stay at his side).My doctor says its just a nervous thing and that he will learn how to control it, but it worries me. What do you think?- CS

Dear CS-

It sounds like what you are describing is neurological overflow or what others will call "soft" neurological signs". These soft neurological signs are often used to describe signs that are either difficult to obtain or interpret. It is commonly seen in immature nervous systems of very young children. Persistence of these signs beyond a certain age though may indicate a future problem with attention and/or learning disorders or other cerebral dysfunctions.

You can test your child for soft neurological signs a couple of different ways.

1. Ask your child to walk across a room on their tip toes. As they perform this look for tremors and "overflow" involuntary movements that occur with his hands and his face.

2. Ask your child to touch the tip of their finger to the tip of your index finger and then touch the tip of their nose again. Do this three times. As they perform this look for tremors and "overflow" involuntary movements that occur with their other hand and their face.

Remember again, that the presence of these signs may or may not indicate future problems. The best thing you can do is discuss your concern with your pediatrician and if you are still concerned, they can refer you to visit with a pediatric neurologist who can evaluate your child and offer specific recommendations.

I hope this helps. I couldn't find any specific ages in which these soft signs should be gone. Most articles suggested that beyond age 5 or 6 was concerning for other conditions. Now as luck would have it I have a 4 and a 6 year old. They are both full term and otherwise developmentally on target.Tomorrow I shall do my own little experiment and let you know what I found!

*Warning* This is not a true "experiment" and one should take it as an interesting task and not necessarily indicative of how other 4-6 year olds will perform.

*11/18/08 Update*

Standing at the bus stop today I had a chance to test my children. The older 6 year old certainly did well. The four year old splayed her fingers a little as she touched her nose and had difficulty with balancing as she did the tip toe walk.I wouldn't necessarily call this a soft sign but she did show less coordination. I would expect her to get better at this and have no worries about her development overall.

I'd be curious what other people found out! Let me know by leaving me a comment.