More or less pleasurable behavior, apparently similar to masturbation, may be seen from infancy onwards, more so in preschool girls, but also in boys (78). Rhythmic hip flexion and adduction may be accompanied by a distant expression and perhaps somnolence thereafter. Manual stimulation of the genitalia does not seem necessary. The diagnosis of infantile masturbation is more difficult when the infant or young child seems unhappy during the rhythmic movements. The relative frequency of events and occurrence in specific circumstances, such as when bored or in a car seat, lends this behavior to home videotape recording. Parents prefer the term gratification (or even benign idiopathic infantile dyskinesia) to infantile masturbation, understandably. Readers are referred to Nechay et al (78) for an extensive clinical review.
Sometimes more difficult to diagnose may be the phenomenon in slightly older children, of the "television in the sky." Affected children may appear to stare into space or have unvocalized speech with imaginary individuals and perhaps seem to twitch or move one or more limbs for several minutes at a time. When there are repeated jerks or spasms, there may be confusion with epileptic infantile spasms.
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