Some children on the autism spectrum engage in repetitive behaviors such as hand-flapping, spinning or repetitive vocal sound effects. Colloquially termed “stimming,” these behaviors are so common that they are among the diagnostic criteria for autism, according to Lauren Bauer, Board Certified Behavior Analyst with Gateway Pediatric Therapy in Bingham Farms. Gateway Pediatric Therapy services seven locations in southeast Michigan.
“In addition to social and communication deficits, restrictive and repetitive behaviors are common among children on the autism spectrum,” Bauer says. “Repetitive motor behaviors might include spinning or rocking, and they occur for different reasons. Kids are not doing this for other people’s attention or approval, but typically because something about the behavior is reinforcing in that it can be self-soothing, anxiety-reducing, or just feels good.”
Is stimming harmful?
Some parents feel unsure about how to respond to stimming and worry that these behaviors will lead to mocking or bullying. Rather than discouraging stimming, Bauer seeks to reframe repetitive behaviors as something we all engage in, to some extent.
“For example, I bite my nails and crack my knuckles. Others might fidget with their jewelry, pace or twirl their hair,” Bauer says. “It can be easy to hyperfocus on the things we want to change, but it’s helpful to recognize that we all engage in some sort of repetitive behavior.”
When we can recognize how it feels to have our own repetitive behaviors pointed out and discouraged, we can better empathize with our children and begin to shift our perspectives on stimming. “Developing a treatment plan then becomes easier. If it’s not negatively impacting the person and is not harming anyone else, we can shift to focusing on other goals rather than working on reducing stimming,” Bauer says.
If, however, the behavior is disruptive — such as loud vocalizations at the library — Bauer says she works with parents and their children to address inappropriate behavior. “I won’t say that loud vocalizations are a bad thing, but will help them self-monitor in order to become more aware. We might give it a name like ‘silly sounds,’ for example, and then work on noticing when it happens.”
Perhaps a child shrieks in response to excitement over a favorite book, or maybe just because it feels good to break the silence of such a quiet place. Either way, the goal is to help a child self-monitor the behavior and save it for a more appropriate environment, such as outside.
Self-monitoring and skill-building
Awareness can aid the discovery of replacement behaviors, especially when stimming is self-stimulatory. With older individuals, Bauer focuses on skill-building activities. “Instead of working on decreasing stimming, we increase adaptive skills and stimming often naturally decreases,” she explains.
One form of stimming is the seemingly random vocal repetition of a phrase, such as a line from a movie or a video game. Similar to physical stimming, this behavior — referred to as “scripting” — happens for many reasons.
Perhaps an adolescent client enjoys playing bingo or Pictionary with others, but has undeveloped conversational skills and turns to scripting. “With this individual, we don’t talk specifically about not scripting, but offer examples of what you can say when starting a conversation or playing a game with others,” Bauer explains. “We talk about saying ‘my turn’ or ‘your turn’ or ‘good job.’ Since we have taught them so many different things, they are now able to generate additional comments that we have not taught.”
By creating a goal of learning appropriate comments to make during a game, Bauer says her clients are able to build a lifelong skill. “It’s exciting for them and for their families, too,” she says.
Parents can even guide grandparents and other family members to focus on positive experiences, rather than dwell on harmless stimming. “A lot of parents are worried about negative stigma, so it’s helpful for them to have conversations with family members and friends to focus on positive interactions with their child,” Bauer says.