Definition of Stimming – “The repetitive performance of certain physical movements or vocalisations as a form of behaviour by persons with Autism or other neurodevelopmental conditions: self-stimulation” (Oxford Languages).
Stimming Behaviours
Examples of typical stimming behaviours would be arm/hand flapping, rocking, jumping, finger licking, spinning or twirling, head banging or other complex body movements. It may involve the repetitive use of an object like flicking a rubber band or a piece of string.
Everybody stims in some way and it doesn’t mean we are autistic, but a non-autistic person’s stimming is likely to be much more subtle and is harmless because we know when it is or isn’t appropriate to carry out those behaviours. Examples of this could be nail biting, hair twirling or finger tapping. Stimming is not necessarily a bad thing for an autistic person either unless it becomes obsessive or self-harming. Stimming is, however, part of the diagnostic criteria for autism.
Why do Autistic people stim?
There are a number of reasons why children or adults with autism stim and it will vary from person to person.
- Enjoyment, they purely find it pleasurable.
- To manage their emotions, deal with stress/anxiety, block out uncertainty and make sense of their environment.
- To gain sensory input. To stimulate balance or for visual stimulation.
- To reduce sensory input. To reduce and distract from other distressing noises and external stimuli.
- To regulate emotions and seek comfort.
- Boredom
As a general rule stimming shouldn’t be stopped if it is not causing anyone harm because it is fulfilling a role for the person doing it. However, some stimming behaviours can be self-injurious or unsafe for others. It may be that in some circumstances it is impacting on learning opportunities or causing distress or discomfort. It may then become necessary to look at ways to modify or reduce a persons reliance on these behaviours.
Strategies to Reduce Stimming
In order to do this, it is important to look at the function of the behaviour, is it to reduce anxiety, block out noise or self-occupy? Does the behaviour always occur at the same time or in the same place, in which case what role is the stimming fulfilling? Can the environment or timetable be modified to reduce the need for this behaviour or is there an alternative way to achieve the same sensation? An example of this could be that to reduce an autistic childs need to ‘smear’ might be to introduce messy play with play slime/dough if this then fulfils a sensory need they have.
Maybe structure needs to be increased. This may help to reduce boredom or uncertainty which may be why the repetitive behaviour is occurring. Redirection to other activities may be all that is required to reduce the stimming behaviour. Visual supports in the form of timetables, schedules and social stories may add structure and reduce uncertainty and anxiety. These are all valid things to consider when looking to make any changes.
High functioning autistic people may be able to identify situations in which they feel stressed or anxious and learn strategies to manage this and possibly reduce the need for repetitive behaviours.
Changes in Stimming Behaviours
Some behaviours may change over a period of time and behaviours that may have been acceptable as a child may not be so as an adult, so it may be necessary to look at ways to modify these if possible. The longer behaviours continue the harder they can be to change. Change can be distressing though so this needs to be done slowly and gradually. Where appropriate this can be discussed with the autistic person and agreed targets could be put in place i.e. a specific place or time in the day that the autistic person is allowed time to carry out the stimming behaviour.
Self-Injurious Behaviours
The National Autistic Society estimate that up to 50% of autistic children and adults engage in self-injurious or self-harming behaviour at some point in their life. These behaviours may include:
- Head Banging.
- Hand or arm biting
- Hair pulling
- Eye gouging.
- Slapping themselves
- Skin picking.
- Scratching or pinching.
There can be many complex reasons why anyone will self-harm and it may also be an indication of other mental health issues. In circumstances where self-injurious behaviour is occurring professional intervention should be sought through your GP or other relevant services.
Echolalia – Another Form of Stimming
Echolalia is the repetition of words and sounds. Repetition in this way is common amongst children on the autism spectrum and can develop in early childhood. It may well serve as the initial step in the development of language but for many who do not go on to develop speech in the typical way, it may continue throughout childhood and beyond. My son, James, does echolalia a lot. Other than a few words, ‘car’, ‘mama’, and ‘bye bye’, James is non-verbal. He is attempting to say words like ‘bananas’ and ‘puzzle’ but these are not recognisable to anyone other than us. He does however make some other sounds, ‘ma’, ‘pa’, and ‘ba’, ‘ya.’ He repeats these in a tune with varied intonation so he would say ‘mama mama ma,’ ‘papa papa pa’. He will do this over and over and we do it back to him, and he is able to replicate it back to me even if I change the pattern. He seems to enjoy doing this but I’m not entirely sure of his purpose. Is he initiating ‘conversation’ with us, is he using this as a calming technique or seeking comfort from it. He does it a lot in the car which is a situation he often finds stressful so maybe it is fulfilling that purpose for him. Equally though he does it at times when he appears happy and relaxed. Either way it’s something totally harmless and we play along with it as in my mind anything he does to communicate and make sounds can only be a good thing.
James’ Stimming
In respect of other stimming behaviours James has done a few over the years that come and go. One that has stuck though is licking his hand, and as he does so he wipes it downwards across his face. It tends to be his right hand most of the time but it can be either, and he may not do it at all for a day or two but I can see when he has been doing it a lot as his face actually does get very red and sore. We have to put cream on it then and whilst when I see him doing it its so tempting to tell him not to, I know this will not help and will only provoke a distressed response from him. Instead, I try and distract him from doing it and I always ensure he also has a drink to hand just in case he is doing this because his mouth is dry. I don’t know to be honest of any other alternative but I feel the more attention I draw to it the more the rebellious streak in him just looks me in the eye and does it all the more. Teeth grinding (Bruxism) is another thing he does do regularly and again I have found no alternative to this as James will not put objects into his mouth so sensory chewing toys are not an option.
The repetitive behaviours we commonly identify as stimming are linked to our senses: visual, tactile, auditory, taste/smell, vestibular (pertaining to balance and spatial orientation) and also proprioception. Proprioception is the body’s ability to feel where it is and what it is doing. This presents in behaviours such as rocking, swinging, jumping, pacing etc. Certainly, from Autism groups I belong to on Facebook there are a very high number of autistic children who get a great deal of pleasure/comfort from these types of activities. Very many have hammocks/sensory swings and sit-on spinning toys and this clearly fulfils a need for them.
James’ music therapist and I have had several conversations about proprioception. During his therapy sessions, amongst the many things we do, we have been exploring lots of different activities which have encouraged James to physically move his body and become more body aware. He is making great progress and it’s encouraging to see him now willingly partake in activities which involve movement with dancing, stamping, touch etc. as he is becoming more aware of his body’s capabilities.
This is a very brief overview from my own understanding and experience of stimming. You can find lots of information about Autism and stimming online on the following websites and as always, we’d love to hear about your experiences too.
