Stimming

Self-stimulation, or “stimming,” actually stems from a quite normal behavioral response. “Stimming” can be used to describe any apparently non-functional behavior involving repetitive or rhythmic action in an unconscious or purposeful response to anxiety, stress or boredom. Examples of socially acceptable self stimulatory behaviors range from physical motions (drumming fingers, tapping feet, biting nails), to imposed sensory input (chewing gum, burning scented candles or incense, drinking coffee), to purposeless activity ( playing solitaire or any number of video games). Self stimulatory behavior becomes problematic only when the behavior is excessive, as is most often seen in those with addictive personalities (gambling, drinking), or when the behavior is socially unacceptable in nature, as seen with many pervasive developmental disorders (PDDs). At that point the self stimulatory behavior becomes socially stigmatizing and preclusive of normal academic or social functioning. In children with PDDs self-stimulatory behavior most commonly takes the form of rhythmic movement patterns (hand-flapping, body-rocking, spinning or flipping of objects), repetitive vocal sequences (echolalia, humming, mouth or throat noises), and imposed sensory input behaviors (atypical body postures, grinding teeth, smelling, tasting, staring).

Common Sensory Input Self-Stimulatory Behaviors

 

Visual

Staring at lights, repetitive blinking, ‘flicking’ or wiggling fingers in front of the eyes, peripheral vision hand-flapping

Auditory

 

tapping or covering ears, snapping fingers or shaking/rattling objects close to ears, deep throat vocalizations (growling/grunting), humming, grinding teeth, 

Tactile

 

Rubbing, scratching, tapping, or slapping any part of the body (especially hands and fingers) or any other object on the self, clothing/fabric, objects, or other people, 

Balance

 

Rocking front to back or side-to-side, crashing into walls or objects, perching on or falling off of chairs or any other surface, climbing, swinging, spinning, twirling, and any other full body movements

Taste

Tasting or licking anything and everything, pressing or rubbing objects or body parts on tongue, cheeks, lips, teeth or chin

Smell

smelling or sniffing anything and everything, pressing or rubbing objects or body parts on or into the nose

 



Effectively intervention for these behaviors is only possible with a clear understanding of the function of the behaviors, or whether the behavior is being used to reduce or increase the level of environmental sensory stimulation to achieve a more comfortable state of nervous system arousal. Suppression of “stimming” behaviors alone is only effective when the suppression technique is in use, and usually results in increased “stimming” behavior when it is not in use. However, there are a number of replacement strategies used to satisfy the sensory need with more socially appropriate or acceptable behaviors that are often paired with offering the “stimming” behavior as positive reinforcement that can be extremely effective in increasing the level of attention and focus necessary for learning:

Redirection/Replacement: This strategy involves refocusing attention from the inappropriate self-stimulatory behavior to a more socially acceptable, less intrusive activity. Theraputty, koosh balls, and hand held video game consoles can help for flapping (Nintendo Gameboy & DS even offer console ‘extenders’ for joint comfort); an IPOD full of favorite tunes with ear-phones can help with humming (which is completely normal when listening to music!); move & sit seat wedges & cushions, balance discs, and ball chairs can help with ‘perching’ (sitting on the edge of a seat for balance input); vibrating, flavored, scented, or textured chew tips for pencils or pens, strong flavored/scented gum, chewy candy, and lollipops (jolly ranchers, gummy bears, skittles, dum-dums) can help with tasting and chewing behaviors; flavored & scented lip gloss can help with smelling; and personal trampolines and bean bag chairs can help with hopping and crashing behaviors. The key to effective replacement intervention is to find a socially acceptable alternative "stim" that provides the same type and level sensory input provided by the unusual or unacceptable “stim.”

Reinforcement/Routine: This strategy involves using self-stimulatory behavior as a positive reinforcement for specific criteria or conditions met. This can be used as both immediate (a certain amount of ‘stim’ time directly proceeding task completion) or delayed reinforcement (a certain amount of ‘stim’ time each day or week), and usually involves designating a specific environment or space for the self-stimulatory behavior to occur, thereby reducing the social implications of unusual behaviors. Scheduling ‘stim’ time into a predictable daily routine can reduce overall anxiety levels as long as that routine remains predictable. Reinforcement ‘stim’ time can be very effective as long as the criteria or conditions are achievable. However, unpredictable or unachievable conditions can result in an increase in both the intensity and severity of self stimulatory behaviors, with the potential for the occurrence of self-injurious behaviors, especially in children with lower levels of meaningful expressive language skills.