To Stim, or Not To Stim; THAT is the Question......

To be or not to be? No, actually a very popular question I get asked is: "To stim, or not to stim??"

Sterotypy, aka "Stimming" (see my Glossary for an explanation why the term "self-stimulatory behavior" is misleading, and ABA professionals use "stereotypy" instead), can take many forms and can be frustrating or confusing to parents and caregivers.  These repetitive behaviors can be highly enjoyable and automatically reinforcing to the individual doing them, and many Autistics see any attempt to reduce their stims as harmful, ableist, and unnecessary.

 Some examples of stims can include:

• Rocking, spinning, hand flapping, mouthing items/objects, lining items up, spinning items, dropping items to watch them fall, vocal stims such as squeals, shrieks, or scripting scenes from favorite TV shows, visual stims such as staring closely at objects or flicking eyelashes, saliva play, tearing or ripping paper into tiny pieces

From a teaching perspective (either at school or during a therapy session), when children engage in repetitive sterotypy they may seem to completely shut out the outside world and may not respond to instructions or someone speaking to them. Some of my clients will engage in loud vocal sterotypy in group or classroom settings, that makes it near impossible for other children present to focus or learn.

So what's the answer here? What is the balance between personal rights to choose to engage in an enjoyable activity, and the rights of other people present to not tolerate this activity?

Not all individuals on the ASD spectrum have repetitive behavior to the degree that it interferes with learning or social interactions. That must be said. However for those that do, it can sometimes be a pretty significant issue, particularly in a school or work setting.

Many parents feel they don't want their child to "stim" at all. Other parents feel they want their child to know when to engage in sterotypy and when not to, and for some of the families I consult with this isn't even an issue (they do not want sterotypy reduced in any way).

Just imagine that your way of de-stressing after a long day is to have a warm bath and listen to music and everyday a therapist stops you right as you go to turn on the bathtub faucet and says "No. Hands Down". How would you react to that??

I don't recommend simply removing a behavior. You must remember, there is a function (need) involved. It would be better to teach a replacement behavior that is less disruptive and does not prevent learning/social interaction. To put it simply, teach the child what TO do instead of just focusing on what you DON'T want them to do. Consider redirection, Differential Reinforcement, environment enrichment, social interaction, or teaching toy play/hobbies.

I understand sterotypy can be very trying on a parent or teacher, can be intrusive upon learning tasks, and also difficult to handle in public.
A large step towards viewing "stims" as commonplace and not an annoying habit to extinguish is to realize that everybody engages in repetitive behaviors! Really, they do.

The next time you are standing in line at the bank, or waiting at a stoplight, look at the people around you. Do you see someone twirling their hair? (I do that one). Do you see someone tapping their foot? What about humming to themselves? So if you and I engage in repetitive behaviors at times, then what is the difference between that and your child engaging in repetitive behavior? Well, one big difference is the frequency/intensity (especially if the behavior causes harm), and the barrier to interacting or engaging with others while the sterotypy is occurring. So in other words, maybe think about ways to help your child choose better times and places to stim rather than trying to keep the child from stimming at all.

*UPDATE: After reading this post, a young lady contacted me to share her perspective. Her name is Tracy, and she is Autistic.  I think her words are valuable:

"I enjoyed your post on stimming. I like so much how you tell how everyone does it, and the analogy of a neurotypical person not being allowed a hot bath at the end of the day. 

Not being allowed to stim would sometimes be very much like this. Other times, it would be more like not being allowed to smile when I am happy. 

It's interesting to hear a neurotypical perspective: when we stim you feel we're in our own world. This is sometimes true....sometimes stimming helps me concentrate. Actually, stimming almost always helps me concentrate, just not always on the thing I am supposed to be concentrating on! :) When I spin around and flap, though, I don't feel like I'm in my own world. I feel like the I am surrounded by the world, held by the world, and my hands are moved up and down by what is the rhythm, the essence of the world. I stim to get the magical feeling of connection you might feel in the redwoods. True, this does sometimes require less being-with-people, but the world is just so magical and so wonderful and whole that- I don't know. 

As a spur of the moment choice, and as a conscious choice, I think my limited time is better spent spinning than small-talking. Stimming is also catharsis. You're right, it can be used when bored...... and it is a wonderful way to order the world in the midst of sensory overload."