Stim Up!!!

Stim Up!!!

I have a friend who rocks while standing during any intense discussion (She is an SLP by the way)

Another friend has a habit of shaking his legs while sitting in the classroom.

I fidget with a pen if I have one in hand while thinking about something.

And many more people around me have repetitive behaviors.

That’s the thing — “ Everyone stims”.

Though this is not an SLP topic, I will tell you what I learned through these many years working with Autistics and reading about it.

The word stim is short for self-stimulation. It is most commonly associated with Autism. Medical professionals call it “autistic stereopathy.” It is also sometimes called “stereotypy.”

The DSM-5 includes stimming as part of the diagnostic criteria for Autism Spectrum Disorder:

“Stereotyped or repetitive motor movements, use of objects, or speech.” It also says, “Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.”

That is the difference between autistic stimming and typical stimming: When the stimming interferes with everyday activities and prevents learning, it is often a symptom of Autism.

The most common question my OT colleagues use to hear is:

“How do I stop the stim?” That’s usually the first question parents ask when a young child discovers stimming.

But it’s the wrong question.

First of all, no one can stop self-stimulatory behavior completely, because everyone does it anyway! Secondly, even if one stim can be removed, it will be replaced by another — and the next stim may be less preferable that the current one.

The most important reason not to eradicate stimming is that you may cause your loved one to withdraw more and more, and lose your opportunity to encourage healthy interactions.

What you should ask is :

“Why does my child engage in this behavior?” Seeking to understand the motivation for a behavior is always a great place to start. There are several hypotheses and known causes for stimming:

Overstimulation- Stimming can help block out excess sensory input.

Under stimulation- Stimming helps provide extra sensory input when needed.

Self-regulation-Some stims serve the purpose of soothing or comforting.

Pain reduction-The repeated banging of the head or body actually reduces the overall sensation of pain.

Management of emotions- Both positive and negative emotions may trigger a burst of stimming. We have all seen physical reactions to joy or excitement, such as hand-flapping. Frustration or anger may intensify a stim to the point that it becomes destructive.

Reasons to reduce stimming

Self-stimulation can interfere with learning and social situations. Some types of self-stimulation are self-harming and may lead to infections or require surgical repair.

Self-stimulation may also be a symptom of an ongoing medical problem that a person with a disability may be unable to verbalize.

How to reduce stimming

Here are some ideas for increasing relationship skills while reducing time spent stimming:

Manage the sensory environment and emotional environment to maximize personal comfort.

Get a medical exam to eliminate the possibility of physical causes for stims, such as ear infections, and chronic pain.

Exercise reduces the need to stim (An Occupational therapist could help more on this point)

Continue interacting while stimming occurs. MacDonald recommends turn-taking activities to engage a child without trying to stop stimming during the activity; the activity will gradually become increasingly comfortable and attractive, naturally reducing the stim.

One way to use stimming as a productive part of the learning process is to allow stimming as a reinforcer or reward after a period of playful interaction or work.

Julia Moor writes in her book Playing, Laughing and Learning With Children On The Autism Spectrum that making time for stimming will allow the child the comfort of being himself, encourage more interactions and actually reduce the total number of hours per day spent stimming.

Some treatment programs, including Son-Rise and Floortime, propose joining in the self-stimulatory behaviors as a way to initiate interaction. If a person is humming, hum along. If a person is rocking back and forth, then rock back and forth right next to the person. “The overall principle is to offer the child experiences that produce the same sort of sensations as the self-stimulatory activity but lead up the developmental ladder of regulation, engagement, and interaction.”

In other words, to reduce the stimming, offer a replacement that is more alluring than the stim!

N P Shilpa
Assistant Director

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