Stimming
What is Stimming?
Stimming is short for self-stimulatory behavior. It often includes behaviors such as rocking, hand-flapping, jumping or repetitive speech. Sometimes the term “stereotypy” is used interchangeably with the term “stimming”. [1,2]
Stimming is not something that is exclusive among those with autism. Many people fidget in subtle ways, such as clicking a pen or tapping their foot while thinking or biting nails when nervous. These could all be considered stimming.
When stimming interferes with daily activities and learning, then it is a symptom of autism.
Stimming is also a common symptom of ADHD, though it is often less severe
Stimming is very common among those with autism though the ways in which each person stims often differ. Stimming is often used to relieve excess energy, anxiety, or sensory overwhelm.
Some believe that stimming behaviors are beneficial and should not be discouraged so long as they are non-injurious. [7]
Stims that are injurious (ex: headbanging) could be a way for some to relieve pain. In cases like this it may be worth exploring medical reasons that may be behind behaviors like this (ex: headache, migraine, or other pain).
Signs/Symptoms
Examples of stimming include [6]:
Staring
Looking out of the corner of the eyes
Humming, shrieking or making other noises
Covering and uncovering the ears
Chewing, biting or sucking on objects
Repeating phrases from movies, TV shows or songs
Repetitive movements like jumping, pacing or spinning
Walking on the tiptoes
Head banging or picking at skin
Potential Root Causes
It is generally believed that stimming behaviors are done as a coping mechanism; in an effort to comfort, calm or self-soothe or release/regulate emotions like anxiety, frustration or excitement. [1,6, 7]
Stimming may help to block out sounds or sensations that are overstimulating to the person. [1,7]
Stimming may also provide extra sensory input.[6] A person may do this if they are bored or it may help them to concentrate on other tasks. [1]
Some stimming behaviors like head-banging may help to relieve pain. In cases like this it may be worth exploring medical reasons that may be behind behaviors like this (ex: headache, migraine, or other pain).
There are some that link stimming with an overload of toxins in the body of an autistic person. There is little research to substantiate this claim. However, it is known that people with autism have a reduced ability to detoxify and it is possible that if the toxin load were to increase, all symptoms of autism, including stimming, may also increase.
Next Steps
Nutritional Considerations
One research study, which lasted for a year, included a gluten-free, casein-free, soy-free diet that met calorie needs, with adequate intake of fruits and vegetables, adequate protein, minimal junk food and avoidance of artificial flavors, colors or preservatives. In addition to supplementation, the results included improvement in irritability, lethargy/social withdrawal, stereotypy, and hyperactivity. [8]
Supplement Considerations
Supplementation of omega-3 fatty acids may improve hyperactivity, lethargy, and stereotypy in ASD patients. [3]
Sulforaphane supplements in the form of broccoli sprout extract may improve irritability, lethargy, stereotypy, hyperactivity as well as improvement in awareness, communication, motivation and mannerism. [2]
Supplementation with a multivitamin/mineral, essential fatty acids, carnitine, digestive enzymes, and epsom salt baths may improve irritability, lethargy/social withdrawal, stereotypy, and hyperactivity. [8]
Lifestyle Considerations
There is research which suggests that stimming may be reduced with exercise and physical activity. [4]
Behavior therapy may be helpful in reducing motor stereotypies or those stimming behaviors that involve physical movements of the body. [5]
Some believe that stimming behaviors are beneficial and should not be discouraged so long as they are non-injurious. [7]
There are many toys designed to channel the impulse to fidget or stim. There are sensory swings, safe chewable necklaces and pen-toppers and small gadgets that fit in the palm of the hand.
DISCLAIMER: Before starting any supplement or medication, always consult with your healthcare provider to ensure it is a good fit for your child. Dosage can vary based on age, weight, gender, and current diet.
Stimming & Autism in the Research
There is a limited amount of research about stimming, especially in terms of treatments for these behaviors. In many cases, stereotypy or stimming is just one of many autism symptoms that is monitored and evaluated with a research intervention. Because of this, it is difficult to determine how an intervention may be affecting stimming alone. There seems to be a trend that as many autism symptoms improve, stimming tends to improve/decrease but more research is needed to solidify this.
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[1] McCarty MJ, Brumback AC. Rethinking stereotypies in autism. Semin Pediatr Neurol. 2021;38(100897):100897. doi:10.1016/j.spen.2021.100897
[2] Singh K, Connors SL, Macklin EA, et al. Sulforaphane treatment of autism spectrum disorder (ASD). Proc Natl Acad Sci U S A. 2014;111(43):15550-5.
[3] Cheng YS, Tseng PT, Chen YW, et al. Supplementation of omega 3 fatty acids may improve hyperactivity, lethargy, and stereotypy in children with autism spectrum disorders: a meta-analysis of randomized controlled trials. Neuropsychiatr Dis Treat. 2017;13:2531-43.
[4] Celiberti DA, Bobo HE, Kelly KS, Harris SL, Handleman JS. The differential and temporal effects of antecedent exercise on the self-stimulatory behavior of a child with autism. Res Dev Disabil. 1997;18(2):139-50.
[5] Singer HS, Rajendran S, Waranch HR, Mahone EM. Home-Based, Therapist-Assisted, Therapy for Young Children With Primary Complex Motor Stereotypies. Pediatr Neurol. 2018;85:51-7.
[6] Masiran R. Stimming behaviour in a 4-year-old girl with autism spectrum disorder. BMJ Case Rep. 2018;2018:bcr-2017-223671.
[7] Kapp SK, Steward R, Crane L, et al. 'People should be allowed to do what they like': Autistic adults' views and experiences of stimming. Autism. 2019;23(7):1782-92.
[8] Adams JB, Audhya T, Geis E, et al. Comprehensive Nutritional and Dietary Intervention for Autism Spectrum Disorder-A Randomized, Controlled 12-Month Trial. Nutrients. 2018;10(3):E369.
