Motivational conflicts in Rett syndrome.

Some of the peculiar symptoms of Rett syndrome including stereotypic wringing and washing hand movements, staring, social withdrawal, bouts of hyperpnea, are interpreted as the expression of motivational conflicts occurring in severely brain damaged patients unable to perform useful hand movements. These behaviours can be considerably reduced, if external 'requests' are substantially diminished and sources of keen interest (stories, music, face to face interactions) are activated. These preliminary observations were derived from 34 patients seen by the author.