“My son has a lot of verbal stimming. At home, it’s okay – he can shout and sing as much as he wants! But when we’re outside, everyone’s looking at him and I try to shush him, but I don’t feel good about it. He can’t help it, but people don’t understand.” Susan (not her real name) – a mother of a 10-year-old boy with autism spectrum disorder – shared her concerns regarding her son's stimming with his educators and therapists. Susan is not the only caretaker who suffers through this dilemma every day. It is a question often asked by caretakers and educators in the industry: Should we stop our children from stimming?
To answer the question, we need to understand what stimming is and what causes it.
Stimming and Autism
Individuals with ASD are characterized to display motor movements that are stereotyped or repetitive (American Psychiatric Association, 2013). Examples of these movements include hand flapping, flipping or spinning toys, clapping, head banging, producing spontaneous sounds, and echolalia/repeating words or phrases. Early literatures of autism have classified such behaviours as self-stimulatory acts that shut away external stimuli and distract their focus or attention (Asperger, 1994/1991; Kanner, 1943). Although the theory can be applied especially in settings where even neurotypical individuals would react in certain ways to specific stimuli, it does not fully explain why individuals with ASD react to some stimuli that neurotypical individuals do not. For example, a child with ASD may cover their ears while listening to other children singing, while his neurotypical peers do not. Moreover, it also does not take into account an individual's internal stimuli in the absence of an external stimulus. For example, a child with ASD may have a song playing in her mind and she may react by singing it aloud in the middle of class, while her neurotypical peers typically do not so.
Later theories have revealed that stimming could be a response towards excessive or insufficient sensory input due to deficits in sensory processing (Ornitz, 1974). There is consistency in the theories as behaviours are observed to have been repeated when the same stimuli are presented (e.g. a child plays with a toy that lights up and then flaps his hands excessively. Later, he produces the same response to another toy that also lights up). Furthermore, the changes in brain waves in different parts of the brain linked to sensory processing revealed the prevalence of sensory processing dysfunctions in individuals with ASD (Gabard-Durnam et al., 2015; Simon et al., 2017; Stroganova et al., 2007).
Continuing from the hypothesis of how stimming could be the result of overstimulation or a lack thereof, recent research has gone on to further theorise that stimming could also be a self-coping mechanism that actually helps individuals with ASD deal with troubling stimuli. Several studies suggested that adults with ASD reported that stimming aided in managing overstimulation, reducing anxiety, and in its process, calmed themselves down (Steward, 2015; Kapp et al., 2019). It is a response to cope with sensory stimulations that can be positive or negative, depending on the individual. Some may even say that it is a way to express themselves when words cannot be said, especially for individuals who are non-verbal.
With the knowledge that stimming may be a helpful behaviour that seems to be a necessity for individuals with ASD, I ask the question again: Should we stop our children from stimming?
Personally, if their stimming does not involve harm or injury towards themselves or to others, my answer is no.
Since it assists in coping with stimulations that are unbearable, we should not take away a system that is essential for their living. By forcing them to stop stimming, it is comparable to telling a person not to cry in a rather sad situation. When people are not allowed to feel or to express their emotions in any way, they may feel resentful either to others or to themselves, regardless of whether they have ASD or not (Kapp et al., 2019). At times, they may even replace the behaviour with another one that may not be better.
Although stimming is described to be stereotyped, repetitive behaviours for individuals with ASD, stimming is something we all do. Behaviours such as nail biting or peeling, rocking back and forth, fiddling with a pencil, or paper tearing are something many neurotypical individuals do especially when they are nervous or anxious. Yet, we consider these behaviours as “normal” due to the standards set by society. If we can recognise and understand that these behaviours are just how individuals with ASD express themselves, we will not see them as strange, weird, or different.
Reducing stimming – not by telling them to stop, but by understanding what causes them to do so
Each individual is different, regardless of if they are diagnosed with ASD. While sensory stimulations like loud noises and bright lights that may cause stimming across many individuals with ASD are commonly known, each of them has their own sensory thresholds and ways of dealing with overstimulation or a lack thereof. There will be instances where they may stim for an extended period, causing distraction to others around (especially in an environment such as a classroom), where it would be helpful or even necessary to reduce the number of times and duration of stimming. How we can help is by observing individuals with ASD, learning about autism by reading up on articles, and understanding their behaviours and the need for them. As our society moves towards becoming more inclusive, we should be adapting the environment to cater to everyone’s needs instead of expecting everyone to be the same by fitting in. In controlled places such as at home or at school, we can still do what we can to reduce or prevent the stimming from happening by providing a more suitable environment (e.g. Changing of seat placement if light is distracting to the individual with ASD, reducing the volume of sounds around them, etc.). However, in places where we cannot control the potential causes, it is up to society to react accordingly.
With that, I hope that the world can be more understanding and accepting towards individuals with ASD and see the potential reasons behind why they stim.
Written by Alisha.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). Arlington, VA: American Psychiatric Pub.
Asperger, H. (1991). ‘Autistic psychopathy’ in childhood. In U. Frith (Ed. & Trans.), Autism and Asperger syndrome (pp. 37–92). New York: Cambridge University Press. (Original work published 1944)
Gabard-Durnam, L., Tierney, A. L., Vogel-Farley, V., Tager-Flusberg, H., & Nelson, C. A. (2015). Alpha asymmetry in infants at risk for autism spectrum disorders. Journal of Autism and Developmental Disorders, 45(2), 473-480. doi: 10.1007/s10803-013-1926-4
Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217–250. Retrieved from http://mail.neurodiversity.com/library_kanner_1943.pdf
Kapp, S. K., Steward, R., Crane, L., Elliott, D., Elphick, C., Pellicano, E., & Russell, G. (2019). ‘People should be allowed to do what they like’: Autistic adults’ views and experiences of stimming. Autism, 23(7), 1782-1792. doi: 10.1177/1362361319829628
Ornitz, E. M. (1974). The modulation of sensory input and motor output in autistic children. Journal of Autism and Childhood Schizophrenia, 4, 197–215. doi: 10.1007/BF02115226
Simon, D. M., Damiano, C. R., Woynaroski, T. G., Ibañez, L. V., Murias, M., Stone, W. L., ... & Cascio, C. J. (2017). Neural correlates of sensory hyporesponsiveness in toddlers at high risk for autism spectrum disorder. Journal of Autism and Developmental Disorders, 47(9), 2710-2722. doi: 10.1007/s10803-017-3191-4
Steward, R. L. (2015). Repetitive stereotyped behaviour or ‘stimming’: An online survey of 100 people on the autism spectrum. Paper Presented at the 2015 International Meeting for Autism Research. Retrieved from https://insar.confex.com/insar/2015/webprogram/Paper20115.html
Stroganova, T. A., Nygren, G., Tsetlin, M. M., Posikera, I. N., Gillberg, C., Elam, M., & Orekhova, E. V. (2007). Abnormal EEG lateralization in boys with autism. Clinical Neurophysiology, 118(8), 1842-1854. doi: 10.1016/j.clinph.2007.05.005