When and Why Do People With Autism Stim & How Can It Be Managed?

The term ‘stimming’ has become quite popular these days. It is used to refer to self-stimulating behaviors that usually involves repetitive movements, sounds, or even objects. Stimming is also known as stereotypic behavior, and it is considered as one of the most apparent symptoms of developmental disabilities and is also a standard diagnostic criterion for autism. While stimming is not necessarily a bad habit that needs to be controlled, but if it starts to be disruptive to others and begins to interfere with the quality of life, then it should be addressed. Here’s everything you need to know about the causes and management of stimming.

What is Stimming?

The term ‘stimming’ is used to refer to self-stimulating behaviors and is sometimes also known as ‘stereotypic’ behavior.(1,2) Stimming usually refers to the repetition of body movements, sounds, words, or even the movement of objects. Stimming is one of the main diagnostic criteria for autism.(3,4) However, this does not mean that stimming is always associated with autism. It just means that stimming in people who have autism can get out of control quite quickly and lead to other problems. At the same time, while stimming is not always a bad thing that needs to be controlled, it should be addressed if it starts to interfere with the quality of life and is causing disruption to others.(5)

Are There Different Forms Of Stimming?

It can be said that nearly everyone engages in some type of self-stimulating behavior – either knowingly or subconsciously. It may range from biting your nails, twirling your hair around your fingers, or even tapping your foot when you are nervous, bored, or stressed and need to relieve tension.(6)

Over time, stimming may become such a habit that you are usually not even aware that you are doing it. For most people, stimming tends to be harmless behavior, and you are able to recognize situations when and where the habit may be inappropriate.

For example, if you are drumming your finger on the table for the last 15 minutes, you will start to understand the social cues that you are irritating the others at the table and decide to stop the behavior. However, in people with autism, stimming can be more obvious. For example, stimming behavior in people with autism may present as twirling, flapping of hands, and full-body rocking back and forth. It also tends to go on for long periods of time. In such cases, the individual is also less socially aware that their behavior may be disruptive to others.(7)

Even though stimming associated with autism is not always concerning, it can become an issue if it starts to interfere with your daily life, with learning, is destructive, or is resulting in social exclusion. In some rare cases, stimming can also be dangerous.(8,9)

Types of Behavior Considered To Be Stims

Generally, behaviors are termed as ‘stims’ when they start to extend beyond what is culturally or socially tolerated. In other words, any behavior that is culturally and socially unacceptable can be described as a stim. Some of the common stimming behaviors include:

  • Biting your fingernails
  • Twirling your hair around your fingers
  • Jiggling your foot
  • Tapping a pencil or pen
  • Drumming your fingers
  • Cracking your knuckles or other joints
  • Whistling

Even though behaviors like nail-biting and hair twirling are considered to be moderately acceptable behaviors, flapping your hands around would be regarded as unacceptable. Again, while mild and occasional rocking is also usually acceptable, but rocking yourself back and forth in a public setting is considered inappropriate and a stim.

In a person with autism, stimming behaviors may differ slightly and may include:

  • Flapping hands
  • Snapping or flicking of fingers
  • Rocking back and forth
  • Jumping
  • Twirling
  • Bouncing
  • Pulling hair
  • Repetitive blinking
  • Repeating certain words or phrases
  • Walking on tiptoes
  • Repeatedly pacing
  • Rubbing the skin
  • Scratching one place repeatedly
  • Sniffing at people or objects
  • Rearranging objects
  • Rubbing, licking, or stroking certain types of objects
  • Staring at lights
  • Staring at rotating objects like ceiling fans

It is common to find a child with autism spend hours at a stretch in arranging and rearranging their toys instead of playing with them. Repetitive behaviors may also include obsessions or preoccupations with particular objects.

While most stims tend to be harmless, some stims can be extreme and even upsetting or frightening to most other people. For example, some autistic people may stim by making very loud noises that can come across as being threatening or scary. Some may even bang their heads against the wall or hit themselves with their hands. These types of stims can be a cause of concern for everyone involved.(10)

Repetitive behaviors that can cause physical harm include:(11)

  • Head banging
  • Picking at sores or scabs
  • Biting or punching
  • Excessive scratching or rubbing at the skin
  • Swallowing dangerous items

When and Why Do People With Autism Stim?

Regardless of whether a person has autism or not, there is a lot of difference in how frequently stimming happens from person to person. You may crack your knuckles only when you are feeling stressed, or you have been engaging in this type of behavior several times during the day.

For some people with autism, stimming can be a daily occurrence, and it may be difficult for them to stop the behavior. It may even continue for hours at a time.

For most people, though, stimming only occurs every now and then. But people with autism may find it difficult to control the stimming and maybe doing it during most of their waking hours. People with autism may engage in stimming when they are happy, excited, anxious, overwhelmed, or simply because it comforts them. When they are under stress, they are likely to stim for more extended periods of time.

Most people are aware of and can control their stims, and even if we need to stim when stressed, we tend to be careful and subtle about it. For example, we choose to jiggle or tap your toes under the table instead of rocking back and forth in public.(12)

It is not always easy to determine the cause of stimming. It is also not understood why stimming almost always can be observed in people with autism. Experts believe it is a tool for self-soothing and self-regulation.(13) Many also believe that it could be an outgrowth of the body’s sensory processing dysfunction that is commonly observed in people with autism.(14)

People can use stimming as a coping mechanism that can be practiced for a variety of reasons:

  • Adapt to an unfamiliar or uncomfortable environment.
  • Stimulate the senses
  • Decrease sensory overload
  • Avoid certain activities, people, or expectations
  • Express frustration, especially they have trouble communicating
  • For people who got a lot of attention during previous episodes of stimming are likely to do it as a way of getting more attention.

A therapist who has experience in dealing with autism or a behavior specialist will be the right person to help you understand the exact underlying reasons behind stimming behavior.

In many cases, stimming can also be an attempt to ease some physical discomfort or pain. At the same time, it is also essential to find out if what seems to be stimming behavior is actually happening involuntarily because of an underlying medical condition. For example, seizures can also cause stimming.(15)

Is It Possible To Control Stimming?

Stimming does not always have to be controlled. If it is not causing any problem, you don’t necessarily need to do anything to control the stimming.

If, however, you experience any of the following, then you may need to manage the stimming:

  • Stimming is leading to social isolation
  • Stimming is affecting your ability to learn
  • Stimming is causing disruptions at school/work
  • Stilling is causing problems with or for other family members
  • Stimming is dangerous or destructive

If you or your child is in any kind of danger due to stimming, you should contact your doctor immediately. Unless there is an underlying medical condition, it might be better to manage stimming instead of trying to control it. When it comes to managing stimming in children, it is crucial to ensure that there is no danger, and you should encourage self-control.

Tips for Managing Stimming

It is easier to manage stimming once you know the reason behind the behavior. Remember that behavior is a form of communication, and understanding what is going on behind the behavior is important.

It is essential to evaluate the situation you or your child was in just before the stimming begins. This will help you identify the trigger behind that behavior. Here are some things to keep in mind:

  • Try to follow a routine for your daily tasks/chores.
  • Try to do whatever possible to reduce or eliminate the trigger, reduce your stress, and have a calming environment around yourself.
  • Encourage self-control and acceptable behaviors.
  • When it comes to children, avoid punishing the behavior. Punishing is not recommended because if you stop the behavior without understanding and addressing the reasons behind it, it is more likely that it will only be replaced with another behavior, which might not necessarily be better.
  • Teach your child an alternate behavior that can help them meet the same needs. For example, using a stress ball to reduce stress or listening to music.

Consulting a behavior or autism specialist can help you find out the reasons behind the stimming. Once the underlying cause is determined, your therapist can make recommendations about the best way to manage the stimming.

Some recommendations may include:

  • Knowing when to step in and when not to respond.
  • Creating a safe environment.
  • Intervening during any dangerous or unsafe behavior.
  • Letting other family members known how and when they can help.
  • Reinforcing acceptable behavior.
  • Teaching your child self-management techniques.
  • Coming up with alternate activities that can also provide the desired effect.
  • Working with educators, occupational therapists, and the school to help manage the stimming.
  • Seeking medical help when needed.

Conclusion

Stimming behaviors can be observed in both children and adults. It is more commonly observed in people with autism. While in some people, these behaviors can come and go, but in others, it may be a permanent habit. Sometimes, as a child grows up, the stimming may get better, but at other times, it may also become worse, especially in stressful times.

Understanding and dealing with stimming can take understanding and patience. Most people with autism are able to learn how to manage stimming over time. Developing self-control can help improve life at work, school, and in social situations.

References:

  1. Rajagopalan, S., Dhall, A. and Goecke, R., 2013. Self-stimulatory behaviours in the wild for autism diagnosis. In Proceedings of the IEEE International Conference on Computer Vision Workshops (pp. 755-761).
  2. Kapp, S.K., Steward, R., Crane, L., Elliott, D., Elphick, C., Pellicano, E. and Russell, G., 2019. ‘People should be allowed to do what they like’: Autistic adults’ views and experiences of stimming. Autism, 23(7), pp.1782-1792.
  3. Bakan, M.B., 2014. The Musicality of Stimming: Promoting Neurodiversity in the Ethnomusicology of Autism. MUSICultures, 41(2).
  4. Nolan, J. and McBride, M., 2015. Embodied semiosis: Autistic ‘stimming’as sensory praxis. In International handbook of semiotics (pp. 1069-1078). Springer, Dordrecht.
  5. Masiran, R., 2018. Stimming behaviour in a 4-year-old girl with autism spectrum disorder. Case Reports, 2018, pp.bcr-2017.
  6. Nolan, J. and McBride, M., 2015. Embodied semiosis: Autistic ‘stimming’as sensory praxis. In International handbook of semiotics (pp. 1069-1078). Springer, Dordrecht.
  7. Kapp, S.K., Steward, R., Crane, L., Elliott, D., Elphick, C., Pellicano, E. and Russell, G., 2019. ‘People should be allowed to do what they like’: Autistic adults’ views and experiences of stimming. Autism, 23(7), pp.1782-1792.
  8. Conn, C., 2015. ‘Sensory highs’,‘vivid rememberings’ and ‘interactive stimming’: children’s play cultures and experiences of friendship in autistic autobiographies. Disability & Society, 30(8), pp.1192-1206.
  9. Mielecki, M., 2017. The Reducing Effects of Stability Balls and Music on Physical Stimming Behaviors in Children with Autism Spectrum Disorder (Doctoral dissertation, Florida Southern College).
  10. Minshawi, N.F., Hurwitz, S., Fodstad, J.C., Biebl, S., Morriss, D.H. and McDougle, C.J., 2014. The association between self-injurious behaviors and autism spectrum disorders. Psychology research and behavior management, 7, p.125.
  11. Tordjman, S., Anderson, G.M., Charrier, A., Oriol, C., Kermarrec, S., Canitano, R., Botbol, M., Coulon, N., Antoine, C. and Brailly-Tabard, S., 2018. Relationships Between Self-Injurious Behaviors, Pain Reactivity, and β-Endorphin in Children and Adolescents With Autism. The Journal of clinical psychiatry, 79(2), pp.0-0.
  12. Marsh, K.L., Isenhower, R.W., Richardson, M.J., Helt, M., Verbalis, A.D., Schmidt, R.C. and Fein, D., 2013. Autism and social disconnection in interpersonal rocking. Frontiers in integrative neuroscience, 7, p.4.
  13. Mazefsky, C.A., Herrington, J., Siegel, M., Scarpa, A., Maddox, B.B., Scahill, L. and White, S.W., 2013. The role of emotion regulation in autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 52(7), pp.679-688.
  14. Tseng, M.H., Fu, C.P., Cermak, S.A., Lu, L. and Shieh, J.Y., 2011. Emotional and behavioral problems in preschool children with autism: Relationship with sensory processing dysfunction. Research in Autism Spectrum Disorders, 5(4), pp.1441-1450.
  15. Coleman, D.M., Adams, J.B., Anderson, A.L. and Frye, R.E., 2019. Rating of the effectiveness of 26 psychiatric and seizure medications for autism spectrum disorder: results of a National Survey. Journal of child and adolescent psychopharmacology, 29(2), pp.107-123.

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