Gratification disorder is a rare and often misdiagnosed form of masturbatory behavior, or the behavior of stimulating of one's own genitals, seen predominantly in infants and toddlers.^[1] Most pediatricians agree that masturbation is both normal and common behavior in children at some point in their childhood.^[1][3] The behavior is labeled a disorder when the child forms a habit, and misdiagnoses of the behavior can lead to unnecessary and invasive testing for other severe health conditions, including multiple neurological or motor disorders.^[1][4][5]

This article needs more reliable medical references for verification or relies too heavily on primary sources, specifically: This section relies mostly on primary sources. (August 2023)

The behavior of gratification disorder closely mimics that of a seizure, though the exact appearance varies.^[4] It often involves symptoms of flushing, or when the skin of the face becomes red, sweating, grunting, and erratic movements of the body.^[6] The child remains conscious during episodes of infantile masturbation and can be distracted from the behavior, which could help rule out the suspicion of a serious condition.^[5] Additional symptoms can include: rhythmic or rhythmical rubbing of genitals against objects or hands;^[7] a fixated or dazed gaze;^[8] straightening of the legs or crossed legs;^[8] and a pleasant feeling post-episode.^[7]

Duration and frequency of the episodes vary from as little as 5–10 minutes,^[8] to episodes reported to last 30–40 minutes.^[7] Some episodes occur weekly, while other reports document episodes occurring multiple times throughout a single day.^[7] In general, parents of children affected by gratification disorder noted an increase in both duration and frequency as time went on before an intervention, or remedy, such as behavioral therapy was introduced.^[7]

Because this behavior can be worrisome, the possibility of sexual abuse to the child should be thoroughly examined by parents and/or health care professionals to help determine that this is not the likely reason for this behavior.^[4] This masturbatory behavior tends to diminish with age, and as of 2023, there were no clinical trials that explore medical approaches or defined treatment options for gratification disorder.^[3][5]

Gratification disorder may be unrecognized by both families and clinicians,^[9] possibly due to the absence of genital manipulation or physical touching of the genitals.^[9] Because of the inability to correctly recognize and diagnose gratification disorder, children are put at higher risk for more invasive testing because the disorder and its characteristics are largely misunderstood.^[4] Failure to correctly diagnose can lead to an increased risk of unnecessary testing or the use of potentially harmful medications, such as medications used for seizures or other neurological disorders.^[3][4]

Most instances of gratification disorder occur from the ages of 3 months to 3 years but it can sometimes resurface in older adolescence.^[1]