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What Is The Role of Stims Like Finger Flicking in Autism?

November 17, 2021


Stimming refers to (repeated) self-stimulating behaviors; some feel the definition should also include a reference to “self-soothing” to be more appropriate. Whatever the definition, stims like finger flicking are not odd habits—rather, they may be one of the most powerful coping mechanisms for individuals on the spectrum.

What Is The Role of Stims Like Finger Flicking in Autism? https://www.autismparentingmagazine.com/stims-like-finger-flicking/

Have you ever felt a rising sense of panic in an unfamiliar, overwhelming place? A foreign airport perhaps? In such circumstances most of us would do almost anything for red, magic shoes to get us home. When the environment, or even specific sensory stimuli, becomes too much we often rely on our social or emotional skills to obtain relief.

This may not be an option for autistic people whose social-communication skills and emotional regulation may be impaired. For many autistic individuals, stimming (specifically repetitive behaviors with a reliable and soothing rhythm) may be needed to cope with uncertainty and feelings of overwhelm (Joyce et al., 2017).

As you’re reading, are you twirling your hair, or jiggling your foot? Perhaps you’re drumming your fingers, tapping a pen, or cracking your joints. Everyone stims; even though most people refer to such behavior as fidgeting. Autism stimming may differ in quantity, intensity, and type.

In this article, we will take a look at the common stim of finger flicking as well as offering an overview of stimming in autism

Finger flicking in autism

Finger flicking is a type of stimming of autistic kids and adults which involves the hands. Finger flicking and hand-flapping are frequently mentioned by parents as their kids’ preferred stims.

What is finger flicking?

Finger flicking is not a medical term and it has no precise definition. Some parents speak of a motion of opening and closing fingers; they emphasize the involvement of the thumb and index finger in particular. Other parents see finger flicking as a repeated movement involving fingers using an almost “snapping” motion. Another type of stim that may be referred to as finger flicking is described as a quick, repetitive movement of fingers flicking close to the child’s face. This link provides an illustrative photograph (Figure 2, page 172) of such behavior for parents who may need more clarity (Coulter, 2009).

The author of the study, Rachel A Coulter, explains that the reason for the behavior may be compensation for poor spatio-visual skills. Finger flicking may be soothing, or stimulatory to autistic children, but looking at Coulter’s research, it could also address a vital need. According to the author, children on the spectrum may need additional sensory input to compensate for poor visuo-spatial skills.

The repetitive motion of finger flicking close to the face lets the child know where their body is in relation to space and other objects. This and other stimming behaviors may, in some cases, be a sign of a neurodevelopmental condition like autism spectrum disorder (ASD)—it is often one of the early indicators leading parents to seek a diagnosis.

Stereotypies and restricted repetitive behavior—a sign of autism spectrum disorders?

While there may be disagreement about the exact definition of stimming, most experts agree that it may be a manifestation of restricted or repetitive behaviors—a core autism characteristic. The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013) introduced atypical responses to sensory stimuli as a new criterion for an autism diagnosis. Stimming is often a sensory seeking behavior.

An autistic child, covering their ears and rocking, may be displaying an atypical response to auditory stimuli—it may be the only way for them to cope with stimuli that their sensory system is not processing appropriately. Finger flicking may give the child something to concentrate on when they find the environment overwhelming, the rhythm of the repeated behavior may feel soothing, or they may use the behavior to address (or rebalance) an impaired sensory processing system.

It is important to note that, while restricted and repetitive behaviors (including stimming) may be an early sign of autism, stimming is also found in neurotypical children. Furthermore, it is also associated with other conditions like sensory processing disorder and attention deficit hyperactivity disorder (ADHD). Discerning between “autism stimming” and other types of stimming usually comes down to the intensity of the behavior. Children with autism spectrum disorders may stim for hours at a time, while other types of stimming (not associated with autism) usually occur for shorter periods.

In the scientific and research community, behaviors like finger flicking, hand-flapping, body rocking, echolalia, and spinning of objects are referred to as stereotypies. Furthermore, it is believed that stereotypies (scientists are increasingly using the term stimming, as it is preferred by those on the spectrum) are mostly triggered by stress, feelings of overwhelm, boredom, or even excitement.

stimming

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A little more accomodation, a lot more understanding

While there is still a long way to go, society has become more accommodating and accepting of compensations needed, and utilized, by individuals with visible disabilities. For autism, often defined as an invisible disability, coping mechanisms and “compensations” are still regarded as strange. Stimming as a behavior to compensate for overwhelm, underwhelm or to deal with sensory processing issues should be respected and supported. The rights of any individual needing accommodations to deal with a health condition should be championed by society.

While the reason behind stimming, like an under- or overwhelming environment could be managed or eliminated, telling a child to stop stimming is not advised. The child may find another way to stim that may be more challenging to manage. That being said, it is important to intervene if stimming is dangerous, or when it interferes with the child’s happiness or well-being.

Can finger flicking be managed?

However supportive parents may be, they do report instances where stimming becomes problematic. This situation usually occurs when the behavior increases in intensity or frequency, to the extent of interfering with learning and other important activities.

When stimming is harmful in any way, when it makes the child feel like a social outcast, or when it includes self-injurious behavior (like head banging, or picking skin) parents should consider professional help. Finger flicking is not usually harmful but, in these instances, the events or environment triggering such stimming needs to be managed and adapted.

The child should be encouraged to communicate (this includes nonvocal communication) the reason for finger flicking or other stims. For example, a child with auditory processing differences may do it more in noisy environments. Changing the environment or using noise cancelling headphones may help reduce stimming behaviors.

If the child displays dangerous behaviors like head banging when they have to transition to an unfavored activity, transitions may need modifications. When the reason behind challenging stimming behavior is understood, managing the behavior becomes easier.


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Stimulatory or soothing?

The reason some feel finger flicking and similar behaviors are not adequately described by the term “self-stimulatory” may be because of the varied reasons behind stimming. If soothing is the purpose in an environment of sensory overload, is it appropriate to refer to the behavior as stimulatory? At times autistic individuals may stim to meet a specific goal, like balancing sensory input, for example finger flicking or flapping hands to compensate for poor spatio-visual skill. This may be the reason stimming is sometimes defined as automatically reinforced behavior rather than a self-stimulatory behavior.

Browsing through research about stimming, or stereotypies, one can’t help wondering how autistic individuals feel. Do they see stimming as a soothing coping mechanism? Or does the behavior stimulate, relieve boredom and augment sensory under- or overwhelm? For a recent study (Kapp et al., 2019) the authors decided to obtain the insiders’ perspective on stimming.

Autistic adults speak out about stimming

The study titled: ‘People should be allowed to do what they like’: Autistic adults’ views and experiences of stimming aimed to get a better understanding of stimming from the autistic adult’s perspective (Kapp et al., 2019). According to the authors the study results may not apply to children. It is reasonable to assume, however, that the plea for acceptance of non-harmful forms of stimming is a desire of the majority of individuals, of all ages, on the spectrum.

The study further suggests (Kapp et al., 2019) actions like reducing sensory overload by carers, staff and autistic adults themselves may prevent the need for stimming in certain cases. These conclusions highlight an important and necessary shift in managing stimming: intervention should be aimed at the environment, not the autistic individual.

Therapy

A growing number of autistic adults are speaking out against some therapies aimed at eliminating finger flicking and other stims—where children are made to feel broken, and therapy is the fix. This is in sharp contrast to many other therapists who use strength and interest based interventions to encourage and support autistic children to be the best version of themselves. Such therapists understand stimming, they avoid techniques to suppress stims which may increase anxiety.

Stimming is a sensitive topic, some therapists are hesitant to share their opinion about stimming, they fear backlash should their advice be construed as offensive. The controversy may explain the radio silence of a medical expert I reached out to—in hopes of getting the medical community’s opinion on stimming.

Perhaps the problem lies in expecting scientists and therapists to “solve” stimming. Maybe it does not need solving: maybe contributing to managing the environment and promoting acceptance of harmless stimming (according to the advice of autistic individuals) is the real solution.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596.

Coulter, R. A. (2009). Understanding the visual symptoms of individuals with autism spectrum disorder (ASD). Optometry and Vision Development, 40(3), 164–175.

Joyce, C., Honey, E., Leekam, S. R., Barrett, S. L., & Rodgers, J. (2017). Anxiety, Intolerance of Uncertainty and Restricted and Repetitive Behaviour: Insights Directly from Young People with ASD. Journal of autism and developmental disorders, 47(12), 3789–3802. https://doi.org/10.1007/s10803-017-3027-2.

Kapp, S. K., Steward, R., Crane, L., Elliott, D., Elphick, C., Pellicano, E., & Russell, G. (2019). ‘People should be allowed to do what they like’: Autistic adults’ views and experiences of stimming. Autism : the international journal of research and practice, 23(7), 1782–1792. https://doi.org/10.1177/1362361319829628

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