Stimming, short for self-stimulatory behavior, involves repetitive movements or sounds. Examples of stimming include actions like arm flapping or rocking back and forth, often observed in individuals diagnosed with autism spectrum disorder (ASD). However, stimming isn’t exclusive to autism. Everyone stims to some extent. For instance, tapping your foot when feeling nervous is a common form of stimming. While stimming is a universal human behavior, it can present differently and become more pronounced in autistic individuals, sometimes becoming excessive or socially obtrusive, such as repetitive finger flicking or twirling.
What Does Stimming Look Like?
Stimming is characterized by repetitive behaviors that may go beyond what is typically considered culturally or socially acceptable.
Common behaviors like nail-biting or hair-twirling, while sometimes distracting, are generally accepted in many social contexts, such as workplaces or schools. In contrast, stimming examples more frequently seen in autistic individuals, like hand-flapping or spinning in circles, tend to be less socially accepted.
Here are further examples of autistic stimming:
- Finger-flicking
- Rocking back and forth
- Pacing
- Repeating words or phrases (echolalia)
- Humming
- Blinking rapidly
- Opening and closing doors repetitively
- Flicking light switches
- Finger-snapping
- Spinning or tapping objects
- Covering and uncovering ears
Neurodivergent Stimming vs. Neurotypical Stimming
Neurotypical individuals usually cease stimming behaviors when they notice social disapproval or become aware that their actions are attracting unwanted attention. Autistic individuals, however, often process social cues and body language differently. They may not readily perceive others’ reactions to their stimming, leading them to stim in situations deemed socially inappropriate. This difference in social perception is a key factor distinguishing neurodivergent stimming from neurotypical stimming.
What are the Reasons for Stimming?
While the precise causes of stimming are still debated, most experts agree that it serves as a crucial tool for emotional self-regulation.
Autistic individuals frequently experience sensory processing differences. These differences can lead to either over-responsiveness (hypersensitivity) or under-responsiveness (hyposensitivity) to sensory inputs like sounds, lights, textures, and smells.
In cases of hypersensitive reactions, an individual might be overwhelmed by a strong smell, resulting in sensory overload. Conversely, with a hyposensitive reaction, someone might barely react to or even notice a very loud noise.
In these varied sensory contexts, stimming can function to:
- Block out overwhelming sensory input in hypersensitive individuals.
- Provide needed sensory stimulation for hyposensitive individuals.
- Help manage intense emotions, both positive and negative, that might feel overwhelming.
- Serve as a distraction from physical discomfort or pain.
Common Stimming Triggers
Autistic individuals might stim more frequently in specific situations or when exposed to particular sensory inputs. Common stimming triggers include:
- Anxiety or stress
- Joy, excitement, or happiness
- Frustration, anger, or sadness
- Loud and crowded environments
- Unfamiliar settings or people
- Boredom
- Changes in routine or plans
- Physical injury
- Uncomfortable clothing or footwear
Is Stimming Harmful? Understanding Potential Risks
Many autistic individuals stim when happy and excited, not just as a response to overstimulation or distress. While most stimming behaviors are harmless, some can pose risks.
Stims that may require management to prevent physical harm include:
- Excessive self-rubbing or scratching that can damage skin
- Severe nail-biting leading to injury
- Chewing on inedible objects like toys or erasers, posing choking hazards or dental damage
- Head-banging
- Hand-biting
- Ear-clapping with excessive force
- Self-slapping or hitting
Stimming can also become problematic if it becomes excessively frequent or prolonged, potentially causing distress and hindering emotional self-regulation.
Furthermore, certain stimming examples can contribute to the stigmatization of autistic people. Harmful stimming behaviors might worsen if an individual feels isolated or ostracized.
Stimming in ADHD
Some reasons behind stimming in autistic individuals are also shared by people with attention deficit hyperactivity disorder (ADHD) who stim. “Fidgety” behavior in someone with ADHD often represents an attempt to self-regulate and address a need for stimulation in under-stimulating situations.
However, there are differences. For example, an autistic student may stim in class due to overwhelming sensory stimuli like bright lights and classroom noise, while a student with ADHD might stim to enhance focus and attention. For others with ADHD, stimming can simply become a habit.
How to Manage Stimming Behaviors
It’s important to recognize that there’s generally no need to stop an autistic person from stimming if the behavior isn’t problematic. Management is only necessary when stims become significantly disruptive, such as in a school classroom, or dangerous, leading to self-injury.
:max_bytes(150000):strip_icc()/what-is-stimming-in-autism-260034-5c1af80f46e0fb0001541f75.png)
Attempting to suppress stimming through punishment can be counterproductive and detrimental. Punishment overlooks the underlying reasons for the behavior – stimming is a coping mechanism, not inherently “bad” or intentionally disruptive.
Effective strategies for managing stimming include:
- Sensory Diet: This occupational therapy approach involves creating a customized schedule of activities designed to meet an individual’s specific sensory needs throughout the day, reducing the urge to stim.
- Environmental Modifications: Adjusting the environment to minimize sensory and social stressors can decrease the likelihood of sensory overload. This might involve strategies like smaller classroom settings, soundproofing rooms, and removing potentially upsetting textures or lighting.
- Stress Management Tools: Providing tools like stress balls or fidget toys, such as fidget spinners, can redirect repetitive motions to less obtrusive hand movements instead of larger body stims like hand-flapping. Swings or quiet spaces equipped with noise-canceling headphones can also be beneficial.
- Medications: In some cases, medications like risperidone (Risperdal) and aripiprazole (Abilify) may be prescribed to manage irritability and aggression that can exacerbate excessive stimming. These medications may be used temporarily or long-term, depending on individual needs and the effectiveness of other management strategies.
- Applied Behavior Analysis (ABA): Applied behavior analysis is a behavioral therapy approach focused on helping autistic children adapt to social situations. It uses positive reinforcement for desired behaviors and consequences for unwanted ones. However, ABA therapy remains controversial, with some experts questioning its effectiveness and appropriateness for supporting autistic individuals in developing life skills and reducing challenges.
Diagnosing the Cause of Stimming
While stimming is a core characteristic of autism, it is not a disorder in itself.
Diagnosing autism is complex and relies on behavioral observation rather than specific medical tests. Autism is a spectrum disorder, manifesting differently with varying support needs across individuals.
Autism diagnosis is based on criteria outlined in the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual, Fifth Edition (DSM-5).
According to DSM-5 criteria, an autism diagnosis requires demonstrating persistent challenges in all three areas of social communication and interaction:
- Social-emotional reciprocity: Difficulties with back-and-forth conversation, sharing interests or emotions, and initiating or responding to social interactions.
- Non-verbal communication: Challenges understanding social cues and using nonverbal communication like facial expressions.
- Developing and maintaining relationships: Difficulties adjusting behavior in social contexts, engaging in imaginative play, and showing interest in or forming friendships.
Additionally, diagnosis requires exhibiting at least two of the following four patterns of restricted, repetitive behaviors or interests:
- Repetitive movements, speech, or use of objects (including stimming).
- Insistence on sameness, inflexible adherence to routines, and distress at changes.
- Highly restricted, fixated interests that are abnormal in intensity or focus.
- Sensory differences, including atypical responses to sensory input like light, sound, texture, or temperature.
When to Seek Professional Help for Stimming
Medical intervention for stimming is generally unnecessary unless the behaviors are causing harm to the individual or others. Aggressive stims like head-banging or hand-biting, or self-injurious behaviors like excessive nail-biting, self-scratching, or forceful ear-clapping, warrant attention.
Consult a healthcare provider if stimming behaviors are causing physical harm or significant disruption. They can provide guidance and may recommend interventions, including medication if appropriate.
Key Takeaways: Understanding Stimming
Stims are repetitive behaviors like rocking, hand-flapping, and repeating words or phrases. Autistic individuals use stimming as a way to manage emotions or cope with sensory overload.
Stimming is not inherently negative and generally does not require treatment unless it becomes constant, disruptive, or harmful. In such cases, behavioral therapies, environmental adjustments, stress-reduction techniques, and sometimes medication can be employed to help manage stimming while fostering emotional regulation skills.
