One of the most common questions I get is about stimming and whether it’s a part of autism spectrum disorders. Some people question what is stimming? So today I am answering a few questions about stimming.
There’s a lot of misconceptions about stimming. I just want to make it clear. All people stim. All of our leisure activities are self-stimulatory behaviors. Basically, it’s the function of automatic reinforcement, which means that we do things for pleasure.
For typically developing adults, our leisure activities, like throwing a ball into a net, bring us joy. The goal is to shoot the ball into the net and we could do that by ourselves. So we can do that for 15 minutes. We can do that for an hour. Another self-stimulatory behavior/leisure activity is playing the violin. We can hear when a note is off or a note is on and it builds joy and excitement.
I learned to play the piano online during COVID. So I know my goal is to get the right notes and when I hit the wrong note I know it but I keep going, I don’t need anybody sitting around saying good job, or that was right or that was wrong. I can just play. And I can know whether I did a good job or not. But kids with autism or signs of autism are often very delayed with play skills and independent leisure activities. They can often stay in a very primitive kind of stimming.
So stimming, basically, is what you do when nobody’s engaging you or reinforcing you, or there’s not much going on. If we were sitting in a lecture and it was in another language and we didn’t understand what they were saying, we might start doodling or get our phones out and start flipping through Facebook. These are activities to keep our brains active when the surroundings aren’t that fun. When waiting in line at the grocery store, we don’t just stand there waiting. We think about our next plan or we scroll through Facebook and those sorts of things.
But little kids who don’t have great play skills tend to do very repetitive things when they’re not engaged at the right level. They can rock. I had one client who banged his head on hard and soft surfaces until he had an open lesion on his head. He was only two and just diagnosed with autism.
He had a wound on his head that I took a picture of when we first started because I knew that first and foremost, we needed to get rid of this wound. And when I asked the babysitter and the child’s mother how often did the banging happen and where and when the babysitter said that it happened about 3 hours out of the 9 she was there. It happened on a high back high chair, it happened in a Pack ‘n’ Play when he was supposed to take a nap. He was going down for two naps and banging before he fell asleep and when he woke up. He was banging again while he was sitting on the sofa watching TV.
So we got rid of the high back high chair and told the parents to go down to one nap a day and to get him as soon as he started banging.
Stim behaviors like banging can even be even more severe and cause more than an open wound. So stimming can be dangerous. But it also can just be repetitive, like rocking, vocal stimming, hand flapping, and making noises.
Some people think stimming is just a part of autism, but I don’t agree. I think stimming happens when the child is not engaged in meaningful activities with high levels of reinforcement.
If the child is not pushing that button, they could be pushing the escape button, which means they’re trying to get away from you. They’re whining, crying, swiping materials, or throwing things. Or they could be pushing the automatic reinforcement button. This is stimming, scripting, rocking, moaning, vocal stimming. Basically, it’s their verbal doodling. They’re telling you that the demands are not right and the reinforcement is not right.
We are not trying to get a child to stop stimming. We are trying to get a child to go from rocking or banging his head to a better leisure activity. This might be stacking blocks over and over again. Or maybe watching the same TV over and over again. That’s stimming but it’s not dangerous, like banging your head, and it looks more appropriate. The child could go to church and sit with headphones on, potentially, and they could be happy stimming.
Now we don’t want the child to be stimming for hours a day. Especially if it’s not age-appropriate and really building on their skills. My client, Jack, stimmed with straws and bottles over and over again. But he also needed to learn to eat new foods, to talk, to get dressed, and those sorts of things. And so we’re not trying to stamp out stimming. What we are trying to do is make it into more appropriate leisure activities and prevent physical harm.
