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Do you find ever find yourself scratching your head or rubbing your temples when you are trying to process something challenging? Or maybe unable to control your excitement, so you clasp your hands and do a little bounce? What you are doing is called stimming. Stimming is one of the key characteristics of autism, but many neurotypical people do it too, albeit subtly. The word stim comes from ‘stimulation’, and stimming in autism is a method of self-stimulation and self-soothing.
What is stimming, and what does it have to do with autism?
Stimming in autism refers to repetitive, self-stimulatory behavior that increases environmental feedback. While many of us have ‘nervous ticks’ that manifest as repetitive movements – tapping our feet or chewing our nails – stimming in autism stands out as the behaviors are frequent and rather pronounced. Common examples of stimming include hand flapping, rocking, and oral fixations like sucking and chewing.
Temple Grandin, a prominent scientist with autism, used her understanding of sensory regulation to revolutionize how farmers handle their cattle. She is a world-famous autism advocate and was named one of TIME Magazine’s “100 Most Influential People in the World” in 2010.
She described how stimming affected her:
“When I did stims such as dribbling sand through my fingers, it calmed me down. When I stimmed, sounds that hurt my ears stopped. Most kids with autism do these repetitive behaviors because it feels good in some way. It may counteract an overwhelming sensory environment or alleviate the high levels of internal anxiety these kids typically feel every day.”
What are examples of stimming movements in autistic children?
There are many different types of stimming, but all serve the same purpose. For example, Stimming is a self-soothing mechanism that can ease anxiety. Stimming can be physical, verbal, auditory, oral, or olfactory.
Physical
Physical stimming usually involves rocking, headbanging, hand flapping, rocking back and forth, and tapping. While it may seem strange to see a child with autism rocking back and forth, consider the following: It’s a mother’s instinct to rock her baby when it needs soothing. Cradles often have rocking mechanisms, children play on rocking horses or swings, and we often picture the elderly sitting peacefully in a rocking chair as they relax. Autism rocking movements are soothing, and autistic children stim to self-soothe.
Nail biting is also a common form of stimming, but let’s be honest – many people do that when they are anxious or bored. The difference is that a child with autism is more likely to do it compulsively and excessively.
Verbal
Verbal stimming involves repeating words or sounds. The child can either repeat words or phrases or make sounds like humming, clicking, or whistling. This is called echolalia and can be a self-soothing tool or an attempt to communicate (or deal with the pressure of communicating). For example, the child may not be able to answer a question but will echo it instead.
Oral and olfactory
Children with autism often have an oral fixation. For example, parents of autistic children are frequently frustrated by the number of T-shirts their child goes through, as they lift them to their mouth and suck on them so regularly that it forms a hole. The child may also seek out certain smells, tastes, and textures that provide sensory oral stimulation.
Visual
Visual stimming can involve actual eye movement or seeking visual stimuli. For example, they may find staring at moving objects (like a screen saver or fish in a tank) mesmerizing. A child may place objects in neat rows as they find the uniformity of it visually satisfying. Other forms of visual stimming include repetitive blinking, looking sideways, or squinting.
Auditory
Repetitive sounds can also be soothing for a child with autism. For example, they may listen to the same song repeatedly, need the TV on a high volume, or make sounds by clicking or tapping their fingers.
How stimming affects children with autism
Neurotypical children also stim. The difference is that they usually stop if it gets unwanted or negative attention. They are also less likely to be so extreme. Autistic children don’t pick up on social cues or read facial expressions and body language, so they will often stim in a distracting or inappropriate way. There are several reasons why children with autism stim to such an extent.
Self-regulation
Stimming is comforting and, to some extent, intuitive. Babies and young children often suck their thumbs to relax. However, when someone with autism is overwhelmed and flooded with adrenaline and energy, they need to channel their energy elsewhere. Stimming is an outlet that soothes them so that they can cope and continue functioning.
Reduce pain
Certain types of stimming, such as head banging, are for seeking pain reduction. It may sound like a paradox, but when we hurt ourselves, our body is flooded with endorphins (feel-good hormones) and serotonin to help us cope. This is the same reason people struggling with depression and mental health issues sometimes resort to self-harm, like cutting. It offers some relief from emotional pain.
Ability to control sudden bursts of emotions
Many of us are urged to jump up and down when we are ecstatic or chew our nails when we are anxious. Children with autism have difficulty managing their emotions, and stimming is a physical outlet for them to process and express their emotions so they avoid becoming overwhelmed.
Overstimulation
If a child with autism is overstimulated by their environment, stimming can be a distraction that helps them settle. For example, if they are in a particularly loud place, they may compensate by making repetitive sounds that they can focus on instead.
Understimulation
Sometimes, lack of sensory input results in stimming. If a place is too quiet, the child may begin humming or whistling to break the silence. Likewise, many of us drum our fingers or tap our feet when bored or impatient. Children with autism do the same, only more often and more intensely.
Is stimming normal? Should I be worried?
For the most part, stimming is harmless. We all do it, and it can be beneficial if it brings comfort and facilitates self-soothing. The only disadvantage is that the stimming may be seen as distracting or strange to others, but most autism moms and dads have dealt with that enough in their lives to let it slide.
However, stimming can be a problem if it causes self-harm. If this is the case, then it needs to be managed. Excessive scratching, extreme nail-biting, headbanging, or/and hitting themselves can cause injury and be alarming to witness. It also perpetuates the stigma attached to autism and can make it even more challenging for the child to be accepted socially. It’s best to seek professional advice if your child’s stimming is potentially harmful.
How to manage stimming
If your child’s stimming is causing injury or impacting their quality of life, it is in their best interest for you to seek professional medical advice and to consider treatment programs.
A doctor can also rule out any other cause of the behavior that may be mistaken for stimming. For example, perhaps the child has a chronic ear infection or allergy that causes discomfort, and they cannot articulate how it makes them feel physically.
The most widely practiced behavior therapy for children with autism is Applied Behavior Analysis (ABA). Using positive reinforcement, ABA increases positive and appropriate behaviors while reducing or eliminating the behaviors that can create challenges that hinder the child’s quality of life. This includes severe and undesirable stimming.
Create a positive environment
If your child feels overstimulated or overwhelmed in an environment, ensure they have a quiet place to retreat. On the other hand, if your child is seeking stimulation, offer them a tactile activity – like playdough, for example – play some music, or take them outside to play.
Encourage the child to engage in physical and mental activities as a diversion
Children can become restless and anxious if they don’t exert their physical or mental energy. So offer them plenty of opportunities to stimulate their mind and exercise their bodies in a way that suits them but ensures their energy is spent.
Use stress-management tools like a stress ball or fidget
Whether a child is hypersensitive to stimuli or experiences hyposensitivity, toys and tools are available to help them cope with their sensory issues.
Children with autism often have an oral fixation that helps them regulate their stress levels. Chewable necklaces can satisfy their urge and spare their clothing simultaneously. A well-designed chewable necklace is made of food-grade silicone, so it is safe and tough to chew through.
Playdough is a simple, inexpensive tool that is an excellent method for children on the spectrum who experience sensory issues. In addition, kneading, flattening, manipulating, and rolling the dough is an ideal outlet for stress and can reduce anxiety – which is often the root cause of meltdowns.
There are toys and tools available to help your child, regardless of the type of sensory integration disorders they are dealing with. Plus, many of these make an excellent gift for a child with autism!
Medications
There are medications available that are prescribed to reduce irritability, anxiety, and compulsiveness that often lead to excessive stimming. Risperdal (risperidone) and Abilify (aripiprazole) are most commonly prescribed.
To stim, or not to stim?
At its core, stimming is a natural coping mechanism and is common in all children. However, the frequency, intensity, and timing can make it a challenge for children with autism. If stimming does a lot to quell your child’s anxieties and soothes them, there is no urgent need to step in. However, if there is any chance of your child harming themselves (or others or if it is negatively affecting their daily life, it’s essential to seek support.
At Circle Care Services in New Jersey and Massachusetts, we provide comprehensive ABA to help your child overcome excessive stimming and will tailor a treatment program to your child’s needs. In addition, we offer in-home services and preschool readiness programs, and we work in school settings with our clients. If you are seeking ABA services and have questions about ABA, we are here to help.
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