Direct genital manipulation is rare a manifestation of childhood gratification behaviour below 5 years of age: A case series

Abstract

Childhood masturbation/self-gratification behaviour means self-stimulation of the genitals by an immature child. Literature on this topic is scarce and scattered. Though most of the paediatricians seem to know about this entity, precise knowledge on spectrum of different behavioural patterns these children may show is lacking. Masturbatory activity in infants and young children is difficult to recognise because it often does not involve manual stimulation of the genitalia at all. We hereby report a series of 3 cases of childhood masturbation where direct genital manipulation, a very rare manifestation, was evident during gratification spells.

Childhood gratification syndrome: Demystifying the clinical conundrum with a narrative literature review of the past 5 decades

“…[ 25 , 26 , 27 , 28 , 49 ] Direct stimulation of the genitalia using hands or rubbing against hard surfaces was observed in others. [ 5 , 49 , 50 ] The playful genital manipulation along with contractions of muscles of the pelvis, extremities, and back mimicked the ‘orgasms’ of a masturbating adult. [ 56 ] Associated stereotyped behaviors: Typically, five distinct hand activities (fisting, grasping, chorea-like piano-playing finger movements, genital manipulation, and bimanual handling of items) have been described in CGS.…”

“…[ 6 , 15 ] Autonomic features: The events were associated with ‘quiet grunting’, facial flushing, labored breathing, and profuse sweating. [ 5 , 8 , 10 , 19 , 20 , 25 , 30 , 33 , 50 ] Nonspecific changes (tachycardia and high-amplitude waves) were recorded on EEG. [ 1 ] After an episode, the child usually felt tired and tended to fall asleep akin to the experience of orgasm in adults, a trance state followed by general relaxation and lethargy.…”

“…[ 25 , 26 , 27 , 28 , 49 ] Direct stimulation of the genitalia using hands or rubbing against hard surfaces was observed in others. [ 5 , 49 , 50 ] The playful genital manipulation along with contractions of muscles of the pelvis, extremities, and back mimicked the ‘orgasms’ of a masturbating adult. [ 56 ]…”

“…[ 48 , 49 ] Direct genital manipulation was not uncommon, sometimes accompanied by penile erection and sweating. [ 48 , 50 , 51 ] Misdiagnosis was common, with one study reporting an initial diagnosis of epilepsy in 31% of children and infantile colic in 26%. [ 49 ] Diagnosis of CGS was reached from history, normal neurological examinations, home video tapes, and hospital observations.…”

“…[ 49 ] Diagnosis of CGS was reached from history, normal neurological examinations, home video tapes, and hospital observations. [ 48 , 50 , 51 ] In most cases, parental reassurance and behavioral therapy were effective. [ 48 , 49 , 50 , 51 ]…”