Stimming is a common behavior for children with autism and a frequent cause of concern for parents. Called “stereotypy” in clinical terms, stimming refers to the flapping, rocking, humming, or otherwise repetitive behavior we often associate with children diagnosed with autism.
In terms of function of behavior, stimming is included in the automatic reinforcement category. That is, children engage in stimming because it either feels good (positive reinforcement) or because it alleviates some discomfort or pain (negative reinforcement).
We field many inquiries from parents of children with autism asking how to handle stimming. It’s a perplexing behavior that many parents struggle to understand and deal with. On that front, there is both good news and not-so-good news.
The Not-So-Good News…
Stimming can be exceptionally difficult to stop. This is due to the internal nature of the behavior. Children with autism often don’t gain adequate reinforcement from their external environment. Stimming gives them this reinforcement. In other words, stimming provides the child with a level of comfort he can’t get naturally from his environment.
Because the root of the behavior is internal, it is very difficult to modify the behavior. And although there is extensive research on the best treatment for stimming, no clear single approach has been emerged, and none of the research has been shown to provide a long-term impact.
Now for the Good News!
As a child gains new skills, skimming will often resolve itself on its own. Stimming tends to be most pronounced in children who lack the language and other tools to interact with their environment, so as the child develops these skills, stimming will often run its course.
Because of this, and because treatment options are only moderately effective at best, we typically intervene with stimming only if one or more of the following are true:
1.) The stimming behavior poses a safety risk to the child – for example, if a child engages in self-injury.
2.) The stimming behavior is socially stigmatizing the child – for example, if stimming prevents a child from making friends at school.
3.) The stimming behavior interferes with the child’s learning – for example, if a child hums during class and is therefore unable to listen to the teacher.
Tips on Therapy for Stimming
At Positive Behavioral Connections, we use the RIRD approach: Response, Interruption, Redirection. In other words, when the child displays the stimming behavior (the response), we interrupt the behavior and then present a redirection.
Our approach varies depending on whether the stimming behavior is motor (movements) or vocal.
RIRD for Motor Stimming
For any motor stimming behavior, we employ a two-step process: block the behavior and give the child a neutral task appropriate for the skill level, such as a puzzle, stacking blocks or a pen and worksheet.
-If the child’s skill level is on the lower end, we make it harder for the child to display the behavior. For example, we may use weights on the child’s wrists to make it harder for her to flap her arms.
-If the stimming leads to self-injury, we give the child protective equipment. For instance, a child who exhibits head banging might be fitted with a helmet to reduce the risk of injury.
-When possible, we modify the trigger that causes the stimming. For example, if a child likes to flap his arms while watching another child play a video game, we may tell the child that he can only watch the video game if he keeps his hands folded.
RIRD for Vocal Stimming
Vocal stimming presents a tougher challenge, since we can’t directly block the behavior. But we do have a couple of approaches to vocal stimming that may help:
-We give the child a non-preferred vocal demand. For example, if a child hates to answer “what” questions, as soon as the child starts to stim, we give her a bunch of “what” questions to answer. The act of answering these questions will distract and redirect her away from the negative behavior.
-If there’s something environmental the child might want as a reinforcer, such as a particular toy, we might withhold the object until he stops the vocal stimming. We want to find something that trumps the pleasure the child receives from the vocal stereotypy.
Please remember, the best approach to stimming is to focus on skill development. A child who is well equipped to interact with her environment will be less likely to need to rely on stimming behavior to soothe herself. But if your child is engaging in self-injury, is being noticeably stigmatized or is unable to learn due to the stimming, the approaches we’ve outlined above may be the best place to start.
For more help on other challenging behaviors in children with autism, please look at these other blog posts!