Stimming: Causes and Management

Medically reviewed by Timothy J. Legg, PhD, CRNP on April 12, 2017Written by Ann Pietrangelo on April 12, 2017

What is stimming?

The word “stimming” refers to self-stimulating behaviors, usually involving repetitive movements or sounds.

Everybody stims in some way, but it’s not always clear to others.

Stimming is part of the diagnostic criteria for autism. That’s not because stimming is always related to autism, but because in people with autism, stimming can get out of control and cause problems.

Stimming isn’t necessarily a bad thing that needs to be stifled. But it should be addressed when it’s disruptive to others and interferes with quality of life.

Continue reading to learn more about stimming, when it requires management, and where to get help.

How does stimming differ in people with autism?

Almost everyone engages in some form of self-stimulating behavior. You might bite your nails or twirl your hair around your fingers when you’re bored, nervous, or need to relieve tension.

Stimming can become such a habit that you’re not even aware you’re doing it. For most people, it’s a harmless behavior. You recognize when and where it’s inappropriate. For example, if you’ve been drumming your fingers on your desk for 20 minutes, you take social cues that you’re irritating others and choose to stop.

In people with autism, stimming might be more obvious. For example, it may present as full-body rocking back and forth, twirling, or flapping the hands. It can also go on for long periods. Often, the individual has less social awareness that the behavior might be disruptive to others.

Stimming associated with autism isn’t always cause for concern.

It only becomes an issue if it interferes with learning, results in social exclusion, or is destructive. In some rare cases, it can be dangerous.

Types of stimming behavior

Common stimming behaviors include:

  • biting your fingernails
  • twirling your hair around your fingers
  • cracking your knuckles or other joints
  • drumming your fingers
  • tapping your pencil
  • jiggling your foot
  • whistling

In a person with autism, stimming might involve:

  • rocking
  • flapping hands or flicking or snapping fingers
  • bouncing, jumping, or twirling
  • pacing or walking on tiptoes
  • pulling hair
  • repeating words or phrases
  • rubbing the skin or scratching
  • repetitive blinking
  • staring at lights or rotating objects such as ceiling fans
  • licking, rubbing, or stroking particular types of objects
  • sniffing at people or objects
  • rearranging objects

A child with autism may spend hours on end arranging toys instead of playing with them. Repetitive behavior may also involve obsessions or preoccupations with certain objects or the reciting of intricate details of a particular subject matter.

Other repetitive behaviors can cause physical harm. These behaviors include:

  • head banging
  • punching or biting
  • excessive rubbing or scratching at skin
  • picking at scabs or sores
  • swallowing dangerous items

Learn more: The relationship between ADHD and autism »

Quantity of behavior

With or without autism, there’s quite a bit of variation in the frequency of stimming from person to person.

You might crack your knuckles only when you’re particularly stressed, or you may engage in this behavior multiple times a day.

For some people with autism, stimming can become an everyday occurrence. It may be difficult to stop and can continue for hours at a time.

Why do people with autism stim?

It’s not always easy to determine the reason for stimming. It’s a coping mechanism that can serve a variety of purposes.

For example, a person with autism may be trying to:

  • stimulate the senses or decrease sensory overload
  • adapt to an unfamiliar environment
  • reduce anxiety and calm themselves
  • vent frustration, especially if they have trouble communicating effectively
  • avoid certain activities or expectations

If previous episodes of stimming resulted in wanted attention, stimming may become a way to continue getting attention.

A behavior analyst or therapist with autism experience can help you understand the reasons for the stimming behavior.

In some cases, stimming is an attempt to ease pain or other physical discomfort. It’s also important to determine if what appears to be stimming is actually involuntary due to a medical condition, such as seizures.

If you suspect a medical problem, see your doctor right away.

Can stimming be controlled?

Stimming doesn’t necessarily need to be controlled unless it’s causing a problem.

Management may be needed if you answer “yes” to any of these questions:

  • Has stimming caused social isolation?
  • Is stimming disruptive at school?
  • Does stimming impair the ability to learn?
  • Does stimming cause problems for other family members?
  • Is the stimming destructive or dangerous?

If you or your child is in danger of self-harm, contact your doctor right away. A physical examination and evaluation may reveal existing injuries.

Otherwise, it may be better to manage stimming rather than attempt to completely control it. When working with children, the goal shouldn’t be to control them, but to encourage self-control.

Tips for management

It is easier to manage stimming if you can figure out the reason behind it. Behavior is a form of communication, so understanding what the person with stimming is trying to say is important.

Evaluate the situation just before stimming starts. What appears to be triggering the behavior? What comes of it?

Keep the following in mind:

  • Do what you can to eliminate or reduce the trigger, lower stress, and provide a calming environment.
  • Try to stick to a routine for daily tasks.
  • Encourage acceptable behaviors and self-control.
  • Avoid punishing the behavior, as this isn't recommended. If you stop one stimming behavior without addressing the reasons behind it, it’s likely to be replaced with another, which may not be better.
  • Teach an alternate behavior that helps to meet the same needs. For example, hand flapping can be replaced with squeezing a stress ball or other fine motor activity.

Consider working with a behavior analyst or other autism specialist. They can evaluate you or your child to determine the reasons behind the stimming.

Once the cause is known, they can make recommendations on the best ways to manage the behavior.

Recommendations may include:

  • intervening during unsafe behavior
  • knowing when not to respond
  • advising other family members on how they can help
  • reinforcing acceptable behavior
  • creating a safe environment
  • suggesting alternate activities that provide the desired effect
  • teaching self-management tools
  • working with occupational therapists, educators, and the educational system
  • seeking medical help when needed

Check out: 3 Natural ways to calm your child’s anxiety »

Outlook

Stimming behaviors can come and go according to circumstances. Sometimes they get better as a child matures, but they can also become worse during stressful times.

It takes patience and understanding, but many people with autism can learn to manage stimming.

Over time, achieving self-control can improve life at school, at work, and in social situations.

Keep reading: 22 Things only parents of children with autism understand »

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