Stimming

Have you ever found yourself mindlessly rubbing your hands together, bouncing your leg, or twirling your hair? These are all harmless self-soothing or self-regulating behaviours most of us engage in daily. In some cases, we use these behaviours as a way to cope with anxiety and stress, and they often become habitual. However, we are usually aware of and able to control these behaviours if needed. For example, you may bite your nails when working in front of your computer at home, but not in front of your prospective boss in a job interview.

In the cases of individuals with Autism Spectrum Disorder (ASD), these types of behaviours may take forms less common to the general population (e.g. rocking back and forth, walking on toes, hard blinking, looking at things at an angle, or flapping hands), and are referred to as self-stimulatory behaviour or “stimming”. The Diagnostic and Statistical Manual of Mental Disorders (volume 5) speaks of “hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of their environment.” It also speaks of “stereotyped or repetitive motor movements and the use of objects, or speech.” The former often leads to the latter – the repetitive and seemingly non-functional movements serve to protect or stimulate the individual from a sensory perspective. Individuals with ASD often do not have either the ability to control/mask the behaviour, or the desire to control/mask the behaviour for the benefit of others’ comfort within the realm of what is considered to be socially appropriate. It can be a coping mechanism, and thus any attempt to redirect or stop it must be considered carefully from an ethical perspective before implemented.

When we look at whether or not it is ethical and appropriate to put plans in place to alter a behaviour of a fellow human being, we have to consider whether it qualifies as a problem behaviour. To qualify, it must do one of the following:

• Interfere with learning
• Interfere with social interaction
• Risk harm to self
• Risk harm to others
• Risk damage to property

Once a behaviour has been established as a problem behaviour, we must look at what function the behaviour is serving for that individual. That individual has needs, and is as entitled to them as anyone else is. There are many sensory channels, e.g. visual, tactile, physical, auditory, olfactory, vestibular, proprioceptive. It is important to determine which sensory channel is being protected or stimulated, and to delve into a process of figuring out the why, when, how, and where of the behaviour. This is not always an easy process, especially if the individual is not able to communicate effectively, because sensory regulation is an internal process which we do not have direct access to. However, the more time we take to know, empathize with, and understand the person, the more likely we are to know how to help them meet their needs in a way that does not interfere with social interaction or learning, or meet the other criteria for designation as a problem behaviour.

While there are several well-researched interventions for stimming that the team at Applied Behaviour Solutions are trained in, three of the most common are to find an appropriate replacement behaviour for the stimming, teaching the individual to access the sensory regulation they need in an appropriate way or at an appropriate time, and teaching the individual to communicate their sensory needs to others. The objective is to implement an intervention that will help the individual self-advocate and meet their needs in a way that keeps them safe and open to learning and interaction.