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Stimming
The term “stimming,” short for self-stimulating behaviors, refers to repetitive or ritualistic movements or sounds that help an individual self-soothe when stressed or otherwise cope with their emotions. The word “stimming” is most commonly associated with autism; indeed, “stereotyped or repetitive motor movements” is one of the symptoms of autism in the DSM-5. However, many people engage in stimming behaviors to some degree—for example, someone may twirl their hair when focusing intensely or bite their nails when anxious.
While some stimming behaviors may be alarming to outside observers or considered socially unacceptable, stimming is thought to serve an important purpose, especially for people with autism; it helps individuals regulate their emotions, cope with feelings of over- or understimulation, or better manage physical pain. However, stimming can become harmful when the behavior itself inflicts physical damage (for example, pulling out one’s hair), causes significant disruption to others, or is embarrassing for the individual. In those cases, learning strategies to minimize or redirect the stimming behavior could be beneficial.
Stimming can manifest as a wide variety of repetitive behaviors—including physical movements and/or audible sounds—some of which are more noticeable than others. Certain stimming behaviors are most often associated with autism, while others can occur in neurodivergent and neurotypical individuals alike.
Examples of stimming behaviors that tend to be specific to autism include:
- Hand-flapping
- Head-banging
- Rocking
- Hitting oneself
- Clapping hands over ears
- Mouthing or licking objects
- Repeating words or short phrases
- Hard or excessive blinking
- Spinning or twirling
Stims that may appear in autism, ADHD, or in neurotypical individuals include:
- Hair-twirling
- Nail-biting
- Scratching or rubbing the skin
- Pulling hair
- Pacing
- Humming
- Snapping fingers
- Tapping objects or surfaces
- Jiggling one's foot or leg
- Squeezing objects such as a stress ball
Though stims all serve the same general purpose, some types of stims, particularly those that are more likely to appear among neurotypical people, may be considered more socially or culturally acceptable than others; someone who twirls their hair, for example, will likely be seen as less disruptive than someone who bangs their head. Many stims are harmless, but certain types of stims, such as head-banging or hitting oneself, may cause injury to the individual or others around them.
Vocal stimming refers to repetitive sounds made with the mouth or breath. Someone who engages in vocal stimming may repeat a word or phrase over and over, hum, squeal, grunt, shriek, or similar. It is also possible for someone to stim in a way that is non-vocal yet still audible. This may include tapping an object, clapping, or snapping one’s fingers.
Nail-biting is a common stim for people with autism, as well as a way for many people without autism to manage negative emotions, such as boredom or anxiety. Because nail-biting is relatively common in the general population, it is generally seen as more socially acceptable and may be less noticeable than others stims.
Trichotillomania and other BFRBs can be considered a form of stimming, since they are often triggered by feelings of boredom or anxiety and may temporarily help soothe these negative emotions. However, unlike many other stims, many people with BFRBs are considerably distressed by their behavior and wish to stop.
The term “fidgeting,” which describes repetitive movements such as leg bouncing or foot tapping, is often used in relation to ADHD, but these behaviors can also be considered a form of stimming. Children with ADHD often fidget or stim to help them focus or calm feelings of restlessness.
Stereotypic movement disorder is a motor disorder that involves repetitive, seemingly purposeless movements. It is closely related to stimming and involves many of the same behaviors. However, a diagnosis of stereotypic movement disorder is generally not given when self-stimulating behaviors can be better explained by an autism diagnosis. (To learn more about symptoms, causes, and treatment, see Stereotypic Movement Disorder.)
Autism and Tourette syndrome (or other tic disorders) often co-occur, and tics and stims may at times look similar to an outside observer, but they’re not quite the same thing. Tics are sudden twitches of muscle groups that are generally considered involuntary, or rather “unvoluntary”—the urge to engage in a tic appears suddenly and usually feels overwhelming, and though it can sometimes be suppressed with great effort, this is often uncomfortable for the individual. Stims, on the other hand, are deliberate and repetitive behaviors, even if they’re often engaged in subconsciously, and can often be stopped without physical discomfort.
Many people, both autistic and not, engage in self-stimulating behaviors from time to time. Often, these behaviors occur when someone is bored, anxious, overwhelmed, in pain, or experiencing another strong emotion; in these cases, the behavior is usually short-lived or can be stopped with a small amount of effort.
For autistic people, however, stimming behaviors may be more frequent or more intense. Because autism frequently co-occurs with sensory processing sensitivity, someone with autism may regularly feel overwhelmed by sensory input in a way a neurotypical person may not; when this occurs, they may stim in order to self-regulate. Because autism affects social processing, an autistic individual may not pick up cues that others are noticing the behavior or becoming uncomfortable with it. Stimming can also be a form of communication in itself; when someone with autism feels frustrated or does not want to engage in an activity, they may stim to convey their discomfort, especially if they are nonverbal or otherwise struggle to communicate.
Similarly, people with ADHD often fidget to heighten their focus; because stimming provides a physical outlet for extraneous energy, many find that they are better able to pay attention to the task at hand without feeling physically antsy. Stopping the behavior, while technically possible for many with ADHD, may increase distraction or exacerbate feelings of restlessness.
Absolutely. Stimming, in and of itself, is not necessarily indicative of autism or ADHD, and many people report that they stim from time to time. However, neurotypical stimming is usually short-lived and may be less noticeable than autistic stimming. In its more severe forms, autistic stimming may be physically harmful, which is less likely to occur with neurotypical stimming.
Stimming can be a valuable coping mechanism for autistic and non-autistic people alike. As long as the behavior is not dangerous or excessively disruptive, letting it run its course is usually the recommended course of action. While parents or caregivers may feel embarrassed or frustrated by a child’s repetitive behavior, punishing a child for stimming is usually ineffective and may have lasting negative consequences, such as heightened anxiety or distrust of a caregiver.
In many cases, however, someone with autism may wish to hide or minimize their stims in order to avoid negative attention from others. And when stimming is physically harmful to the individual or those around them, or when it interferes with daily life, taking steps to manage or redirect the behaviors may be appropriate. Common techniques to manage stimming include behavioral therapy, replacing one stim with another, implementing a “sensory diet” to provide appropriate sensory input throughout the day, or adjusting the individual’s environment to eliminate triggers. In some cases, medications may be helpful, especially if someone is struggling with strong anxiety that manifests in stimming behaviors.
Many autistic people, but not all, are able to manage stimming behaviors with practice. However, it’s important to remember that most people engage in self-stimulating behaviors to some degree, and stopping these behaviors entirely is often neither possible nor desirable.
In general, no. Trying to force a child to stop stimming altogether is often counterproductive; even if one stim is eliminated, it doesn’t eliminate the child’s need to self-regulate, and the original stim is usually replaced by another. What’s more, children who are made to stop stimming may lash out, withdraw, or develop symptoms of depression or anxiety. Instead, parents should ask themselves if the stim is actually harmful to their child or simply embarrassing to the parent. If the former, steps should be taken to redirect the child to a safer or less disruptive stim, while still allowing them space to manage their emotional and sensory needs; if the latter, the parent should work on managing those feelings (with the help of a qualified therapist, if necessary) without attempting to change their child’s behavior.
Often, the first step in managing a stim is figuring out why it’s occurring. Many stims are triggered by sensory overload, for example; in those cases, moving to a quiet, calming environment can reduce the urge to engage in the behavior. Conversely, some autistic individuals stim when they are understimulated; for them, working with an occupational therapist to establish a "sensory diet"—or a set of activities that provide the sensory input they're lacking—can help reduce the need to stim. If eliminating a particular trigger isn’t possible, replacing an undesired stim with an alternate behavior can help the individual self-regulate without hurting themselves or attracting unwanted attention; depending on the person and the stim, behavior therapy or another form of professional help may be required to successfully navigate this process. And ultimately, as long as a stim is not dangerous, accepting that stimming can be managed but likely not eliminated can be liberating for parents and children alike.
