There are many things we do to stimulate or calm our senses. We rock babies to soothe them and we sing or hum to ourselves in the shower, we fan ourselves to cool off when we are hot, and we hug and kiss others to give and receive comfort. When we want to increase or arouse our senses we often run or engage in some form of physical activity or exercise, or we may turn the music on loud to get in a party mood and dance. Most of these behaviors are seen as appropriate if carried out at the proper time and in the proper place.
Then there is the term 'stimming', often associated with Autism, which conjures up a more negative image. The term 'stimming' or 'stim' cannot be found in the Merriam-Webster Dictionary but is defined by Wikipedia as "a repetitive body movement, such as hand flapping, that is hypothesized to stimulate one or more senses".
In the world of Autism 'stimming' is known as any type of repetitive, stereotypical behavior engaged in to alleviate or increase sensory input. It is derived from the verb; to stimulate; to provide stimulation in order to get a response, make someone interested, more alert or engaged in something.
We all engage in sensory regulation - behaviors that seek to arouse or calm our nervous system and there are many that are approved by our culture but we don't refer to all of them as 'stimming'. Is stimming just another word for patterns of self-regulatory behavior that are unacceptable? Depending what form the behavior takes and how often it occurs it could be seen as normal - a way to help a person function, or abnormal - a pattern of obsession.
Every child whether on or off the Autism spectrum, will attempt to modulate his or her sensory experience as they interact with their world. Only ten percent of children with an Autism Spectrum Disorder (ASD) actually engage in what we now call 'stimming' - exaggerated self-stimulation. Many of these activities would be considered outside the norm, such as hand flapping, spinning, toe-walking, licking objects, tracking hand movements or sniffing foods, items or people, to mention a few.
Unfortunately these activities can be embarrassing and even stigmatizing because our culture does not yet understand Autism. Many individuals who are not touched by Autism, and even some of those who are, fear anything that is odd, different or left or right of the so-called norm. The hope is that tolerance and better understanding will come but what is a parent to do in the meantime?. ..
It is very important that you discuss these behaviors with your child's Occupational Therapist and follow his or her recommendations. If your child does not have a qualified OT, find one. Make this a priority regardless of insurance coverage. Whatever money you may need to expend, you will get a wonderful return on your investment. A qualified occupational therapist will be able to create a customized sensory diet for your child that will not only help reduce 'stimming' behaviors but will address emotional meltdowns and much, much more.
While you are shopping around for an occupational therapist there is much you can do yourself. You are the expert on your child! You alone hold the key to unlocking his or her world - the more you understand, the better you will be able to maximize his or her potential.
In addition, any occupational therapist you currently have or are about to acquire will appreciate any and all of the information you can provide from the suggestions below. Here are a dozen ideas to help you understand and manage what some call 'stimming' behaviors in your child.
1. Conduct a detailed review. When solving any problem, I you to begin with a thorough assessment of your child's behaviors. Is there a behavior that interferes with daily living such as his ability to pay attention? Are there any behaviors that negatively impact her social life? Are any of these behaviors obsessive?
2. Seek to understand the function of these behaviors. It is important to remember that most of these are unconscious and they occur involuntarily to some degree, especially in the beginning. However, once a child realizes the rush or relief it brings to her senses it then becomes more intentional and easily gets reinforced into a habit. As long as it is deemed appropriate it can become a functional way to self-regulate one's sensory experience but if it is seen as dysfunctional and not channeled in the right way it can easily spiral out of control.
3. Gather information. If your child is verbal don't be afraid to engage him in conversation about his repetitive behaviors. If your child stares excessively at an object, consider asking him, "Are you trying to do something with your eyes? Tell me what you see." If he is able to verbalize an answer you will have gathered extremely useful information to address the behavior with.
4. Make lists. Most of your child's behaviors are functional - serve a purpose for meeting a sensory need - but they may not necessarily be appropriate. Make a list categorizing the behavior(s) as functional and appropriate vs. functional and inappropriate then you can create a plan to address them.
5. Focus on the positives first. Concentrating on appropriate behaviors and explaining the function they serve and why they are acceptable can reinforce more of the same. "I like the way your hands are being quiet. It makes it easier for you to pay attention to what is going on around you." Then the focus can turn to redirecting the inappropriate behaviors and substituting them with more suitable outlets.
6. Create a calm environment. It is well known that children with ASD often engage in 'stimming' when they are stressed or as a means to manage emotions such as fear, anger and anxiety. Therefore maintaining an atmosphere that is as tranquil, predictable and appeasing to her senses as possible will prevent many of these behaviors from occurring.
7. Be an early bird. Catch any behavior that is less than acceptable when it first begins to repeat itself. Don't comment or draw attention to the behavior. Use your detective powers to surmise what purpose the behavior may be serving and then calmly redirect your child to another more acceptable activity that will still provide similar sensory relief.
8. Schedule 'stim' time to teach appropriate time and place. No one can stop a behavior cold turkey, especially if it has been meeting a physical, psychological or sensory need and there is nothing to replace it with. Schedule times and places throughout your child's day when she knows she will be able to engage in the behavior you are trying to modify. Think of it as a gradual weaning process - as you decrease exposure to the negative stimuli you slowly increase exposure to the more positive substitute.
9. Change your vocabulary. Just because someone else may refer to certain behaviors your child exhibits as 'stimming' it doesn't mean you have to use the term yourself. We all have habits, mannerisms, and idiosyncrasies that we engage in. I challenge you to think outside the box and create your own term, something more positive to describe your child's repetitive behaviors.
10. Use distraction. When you notice your child beginning to engage in a repetitive behavior give your child something to do or start a conversation. When we are bored, we all default into behaviors that we are not even conscious of doing. So just in case the trigger is boredom, get your child physically active - engage her in exercise or some other activity she can chose from. Sometimes just asking, "What are you thinking about?" will be enough to distract her and stop the behavior.
11. Be realistic. There are some behaviors that may be defined as 'stimming' that your child may need to keep as a way to cope with daily life. It is unrealistic to expect to completely eradicate all of her repetitive actions. There is no need to take these activities away from her as this can create even more anxiety. What IS realistic to expect is to be able to modify and or shift them into more appropriate and acceptable forms of behavior as time goes on.
12. Count your blessings and focus on the positive. Take ample time to dwell on all the things your child can do well and the baby steps towards progress he is making. Keeping a journal is a wonderful way to maintain your attention towards the positive. Once the good is documented it takes on a life of it's own and becomes much more difficult to dismiss.
Remember, 'stimming' behaviors are very unique to the individual. As the saying goes, "Once you have met one child with Autism, you have met one child with Autism." Your child may need to reduce their visual input by constantly squinting and moving her head to a certain angle in order not to get overwhelmed in certain situations. Another child may need excessive sensory stimulation by staring at lights but then there are some neuro-typicals that get a sensory rush from bungy jumping, or flying off a cliff... We all have little idiosyncrasies that help us deal with and experience the world, there is no better or worse, it's just different for everyone, especially for individuals on the Autism spectrum.
Connie Hammer, MSW, parent educator, consultant and coach, guides parents of young children recently diagnosed with an autism spectrum disorder to uncover abilities and change possibilities. Visit her website http://www.parentcoachingforautism.com to get your FREE resources - a parenting e-course, Parenting a Child with Autism - 3 Secrets to Thrive and a weekly parenting tip newsletter, The Spectrum.
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