Autism Stimming: Causes, Management, and Types
What is stimming?
Stimming or stim is a shortened term for self-stimulation and is one of the many indicators of autism spectrum disorder (ASD). A person who stims shows repetitive body movements that can involve all five senses or moving objects in a repetitive motion. It is also called “stereotypy.”
Causes of stimming
Although the exact cause of stimming is not yet known, some studies suggest that stimming is a way to seek internal pleasure and comfort.
The theory further states that when a person stims, the nervous system is aroused, releasing a chemical in the brain called beta-endorphins. Beta-endorphins are responsible for producing dopamine, which is known to increase pleasure.
Another theory suggests that stimming is a way to block out over-stimulation. This is especially true for hypersensitive individuals who frequently experience sensory overload and want to feel calm.
Types of stimming
Stimming can appear in several different forms. Here are some common examples:
Verbal and auditory stimming
Auditory stimming is anything that affects a person’s sense of hearing. It may include:
- Repetitive speech (learned words like song lyrics, movie lines, book passages)
- Covering or tapping of ears, snapping fingers, or tapping on objects repeatedly
- Humming, grunting, or high-pitched noises
Visual stimming is anything that uses a person’s sense of sight. It may include:
- Staring blankly at objects
- Lining up objects such as toys
- Blinking repeatedly
- Turning lights on and off
Of all the stimming behaviors, hand-flapping is one that’s quite noticeable in people with autism. There’s also a specific way of flapping their hands.
- The hand bends from the wrist
- Hands are high enough so the child can see
- May hop, spin, kick or bounce while flapping
According to the 2008 study Motor Stereotypies in Children With Autism and Other Developmental Disorders, hand-flapping is seen more in children in the autism spectrum than those with other developmental issues.
Another study, Observational Characterization of Sensory Interests, Repetitions, and Seeking Behaviors from 2015 concluded that repetitive movements such as hand-flapping are a way for children with autism to regulate themselves when there is a sensory overload.
Hand-flapping can be triggered by the following:
- Decreased body movements
Although it doesn’t harm the person, hand-flapping can become a challenge if it gets in the way of important tasks. Parents of a hand-flapping child are encouraged to address this behavior using the following:
- Occupational therapy
- Setting limits on flapping
- Making the person aware of the stim
- Autism and hand-flapping are closely related, and it is important for parents to recognize this behavior as early as possible.
Tactile stimming refers to a person’s sense of touch. It may include:
- Rubbing or scratching of hands or objects
- Repetitive hand motions such as opening and closing fists
- Tapping fingers repeatedly
Vestibular stimming refers to a person’s sense of balance and movement. It may include:
- Rocking back and forth or side to side
- Twirling or spinning
- Jumping repeatedly
Olfactory or taste stimming
Olfactory stimming affects a person’s sense of taste and smell. It includes repetitive motions like the following:
- Smelling objects
- Tasting unusual objects
- Licking hand or objects
Stimming and autism connection
Although stimming is seen in other developmental disabilities, it is more common in people with autism. It is, however, important to note that people who do not have developmental disabilities can also display signs of a stim, albeit in a moderate manner.
Stimming is a part of the DSM-5’s diagnostic criteria for autism spectrum disorder. The document states that autism is likely when there is “stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypy, lining up toys or flipping objects, echolalia, idiosyncratic phrases).”
Because people or children with autism process stimuli differently, they may also have unique ways of responding. This is where you might see an autistic person gazing into space when a room gets noisier, or a child with autism flapping her hands as she is about to receive a present.
Why do people with autism stim?
There are many reasons why people with autism stim and it depends on the circumstances and the severity of the behavior.
In most cases, stimming happens for these reasons:
- to stimulate oneself (for hypersensitive people)
- to block sensory overload (for hypersensitive people)
- to overcome anxiety
- to express frustration
- to avoid undesirable activities
- to get attention
- to express distress
Most autism stims are caused by internal or external conditions. This is why it is important for parents and caregivers of children with autism to pay attention to a child’s stims closely and what triggers them.
Most people with autism are prone to overstimulation. While a neurotypical person can hear a loud siren and ignore it, a person with autism can’t easily do so.
Sensory overload is more common in young children who have not fully developed their sensory systems. It is one of the reasons children with autism often resort to stimming. Unlike other causes for stimming, overstimulation is an external factor and can be easily addressed.
People with autism may become overstimulated by:
- Bright lights (sunlight, fluorescent, beam, etc.)
- Strong smells (paint, specific foods, perfumes, etc.)
- Repetitive or persistent noises (ambulance siren, crying babies, dogs barking, etc.)
It’s important to identify an autistic person’s sensitivities to one or all of these stimuli to understand a reaction. When a child is known to be overwhelmed with certain sounds, smells, or sights, then it is easier to prevent overstimulation in the future.
Some useful tips to avoid overstimulation are:
- Have a sensory toolkit (sunglasses, noise-canceling headphones, etc.) ready in case the child finds himself/herself in an overwhelming sensory situation
- Fidget toys to help keep calm and maintain focus
- A few minutes of “quiet time” between activities
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Autism stimming treatment and tips
Although there is no clear-cut option that works for everyone, there are different ways to deal with symptoms such as stimming. It should be pointed out that stimming behaviors are not bad behaviors. Kids often stim to keep themselves calm and attentive.
Here are some methods people have found helpful:
Stimming can greatly be reduced with occupational therapy sessions. Here, a person with autism might be given a reward on the condition he/she is able to control a stim when needed.
Environment modification and practice
This approach replaces stimming behavior with something that is more acceptable. A classic example would be to give the person a squeeze toy or ball in place of flapping his/her hands (stim).
Although medication is not necessary in most cases of stimming, there are times that it is needed due to safety reasons. As with any prescription drug, consult with your doctor and be aware of side effects that medicines might have. The goal is to lessen a stim, not make it worse.
Stim toys for autism
Fortunately, children with autism today have a wide variety of sensory toys to help relieve stress and anxiety. These stim toys, also called fidget toys, provide tactile stimulation while engaging the child in creative playing mode.
Squeeze balls and soft plush toys are no-brainers when it comes to selecting a toy to play with and can be taken anywhere. These are handy for helping a child calm down, focus, or to reduce anxiety.
Squishy toys can also serve as a warm-up activity before a handwork activity like writing or crafting. It is highly recommended to look for toys that are non-toxic, hypoallergenic, and free of BPA, phthalates, and latex.
Great for “sensory seekers,” tactile toys have the right amount of texture to stimulate a child without resorting to stimming. These toys usually come with bumps, spikes, and other textures that stimulate the sense of touch.
Slime, clay, putty, and play foam are some of the many moldable toys that can bring the stimulation that an autistic child craves. These toys not only help lessen stims but they bring out a child’s ability to focus, and they encourage creativity.
While Lego® blocks are great for building, special blocks like ones that make clicking sounds when bent, are great stim toys for children with autism. For some who crave auditory stimulation, fidget blocks offer the satisfying clicks they like to hear.
How to reduce stimming
In most cases, stimming is not harmful and does not need to be stopped nor suppressed. Karen Wang, author of the book My Baby Rides the Short Bus: The Unabashedly Human Experience of Raising Kids With Disabilities believes if a stim is successfully eliminated, then it is likely that it will be replaced with a new one.
Despite this, parents and caregivers of children with autism may want to lessen the behavior to avoid self-harm or maintain a level of social acceptability.
For whatever reasons, there are several ways to reduce stimming in children with autism.
Rule out medical conditions
Some medical conditions like ear infections, migraines, and physical pain can worsen stimming behaviors, so it’s important to have this checked and addressed as soon as possible.
Studies have shown that exercise and other physical activities can release tension and lessen stimming in people with autism. Engaging children with autism in exercise a few minutes every day might help greatly reduce stimming.
Create a calm, safe environment
To prevent stress and anxiety that can often cause stimming, make it a practice to have a quiet space at home. This ensures that most outside factors that trigger stimming are avoided, giving the best possible environment for the child.
Use stimming as a reward
Stimming can be offered as a reward after a challenging activity. With this strategy, the child has the freedom to be himself/herself and will possibly stim less throughout the rest of the day (Moore, 2008).
Teaching Kids about Managing Emotions and Autism Self-Regulation
While there are many ways parents and caregivers can help manage a child’s stims, it might be more effective to instill self-regulation. When a child learns to manage emotions, then stimming can be lessened as a result.
Management of autism emotion
Children with autism not only have difficulty recognizing the emotions of others, but also their own. While it can be challenging to have an autistic child describe what he/she is feeling, it is possible.
Here are some ways to teach children with autism how to recognize and regulate emotions (Naseef, Ariel, 2006):
- Explain why the child is behaving a certain way. This is the first step towards helping him/her understand emotions. Let the child know that everyone goes through it, but there are ways to overcome it.
- Understand the child’s sensitivities and unique reactions to situations and create an action plan. If the child gets anxious in a noisy room, teach him/her to find a quiet place to calm down.
- When there is something that will cause the child stress, inform him/her beforehand and challenge the child to go through it with the promise of a reward when he/she succeeds.
Self-regulation and autism
Self-regulation is the ability to control an urge to do something and, on the other hand, do something even when one does not want to. Both of these can be challenging for a person with autism.
People with autism have not only difficulty understanding other people’s emotions at times but also their own (Bachevalier, Loveland, 2006). There are many ways to help a child with autism self-regulate, but it is a process and will take some time before it becomes second nature.
The ultimate goal in achieving self-regulation is to be aware of emotions and act before it manifests itself into stress-induced behaviors like stimming, tantrums, or meltdowns.
Scott Bezsylko, school director of Winston Preparatory School, a day program for young people with learning differences in the United States, says that children will learn to self-regulate when they are forced to deal with situations that are stressful for them rather than avoid them. He then suggests to coach the child while in the undesirable state to help him/her get through it. Over time, the child should be able to overcome the negative experience in his/her own.
Being mindful or self-aware can also be the key for children with autism to self-regulate. Meditation activities like yoga can help a child become self-reflective and, eventually, self-regulative. As a result, a child with autism can better handle difficult situations, manage emotions, and avoid resorting to repetitive behaviors such as stimming.
Autism and Stimming. Retrieved from https://childmind.org/article/autism-and-stimming/
Self-Stimulatory Behavior. Retrieved from https://www.autism.com/symptoms_self-stim
The Best Fidget Toys to Relieve Stress and Anxiety. Retrieved from https://www.autismparentingmagazine.com/fidget-toys-to-relieve-stress-anxiety/
Motor stereotypies in children with autism and other developmental disorders. (15 December 2008). Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/j.1469-8749.2008.03178.x
Observational Characterization of Sensory Interests, Repetitions, and Seeking Behaviors. (April 2015). Retrieved from https://ajot.aota.org/article.aspx?articleid=2247268&resultClick=3
Playing, Laughing and Learning with Children on the Autism Spectrum: A Practical Resource of Play Ideas for Parents and Carers. (15 July 2008). Retrieved from https://www.amazon.com/gp/product/1843106086/
Voices from the Spectrum: Parents, Grandparents, Siblings, People With Autism, and Professionals Share Their Wisdom. (1 November 2005). Retrieved from https://www.verywellhealth.com/helping-children-with-autism-handle-emotions-260146
The orbitofrontal–amygdala circuit and self-regulation of social-emotional behavior in autism” Bachevalier Loveland (2006). Retrieved from https://www.semanticscholar.org/paper/The-orbitofrontal%E2%80%93amygdala-circuit-and-of-behavior-Bachevalier-Loveland/ecbdac90dbc4df8f6986079887983e4f5f7aa19d
Kim Barloso is a freelance writer and editor based in the Philippines. She works from home while taking care of two kids, one of whom has autism.
Autism Parenting Magazine tries to deliver honest, unbiased reviews, resources, and advice, but please note that due to the variety of capabilities of people on the spectrum, information cannot be guaranteed by the magazine or its writers. Medical content, including but not limited to, text, graphics, images and other material contained within is never intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician with any questions you may have regarding a medical condition and never disregard professional medical advice or delay in seeking it because of something you have read within.