Stimming and ADHD: Examples, Triggers, and Management

ADHD stimming (self-stimulatory behavior) is when a person with attention deficit hyperactivity disorder unconsciously repeats certain movements or sounds. Some ADHD stimming examples include humming, pacing, teeth grinding, and rocking, though there are many others.

The reasons for stimming can vary depending on the person and environment. It's thought that, in ADHD, these behaviors may come from a need to improve focus, self-soothe, or channel energy.

Stimming is normal in ADHD, but can be problematic if it disrupts everyday functioning or results in self-harm or injury. Medication, self-control techniques, and environment changes may help.

This article describes types of stimming, factors that trigger such behaviors, and how to manage it.

Examples of Stimming in ADHD

People who ADHD may engage in several different types of stimming, though some may seem to have select behaviors that they tend to default to.

Examples of stimming in ADHD, grouped here by type, include:

• Visual: "Zoning out," spinning objects like coins or fidget toys, pacing, doodling
• Verbal or auditory: Giggling, singing, making repetitive sounds, excessive throat clearing
• Touch (tactile): Nail biting, scratching, hair pulling or twirling, chewing the inside of the cheeks, teeth grinding, rubbing fingers
• Vestibular (balance-based): Rocking, spinning, shaking the head

Fidgeting vs. Stimming

Many people engage in self-stimulatory behaviors from time to time. These can be similar to or even the same as some stimming behaviors seen with ADHD.

In "neurotypical" people, these behaviors are often simply referred to as fidgeting. If you have twirled your hair while talking, tapped your foot while studying, or rubbed your fingers together while nervous, you have engaged in stimming.

The difference is that when you have ADHD, these behaviors are:

• More severe
• Occur more often
• Interfere with or reduce the quality of how you function socially, at school, or in a job
  

Stimming doesn’t necessarily mean you or your loved one has ADHD, or even that changes are needed if there is a diagnosis. But if you are worried about stimming behaviors, reach out to your healthcare provider or a mental health professional.

ADHD Stimming vs. Autism Stimming

Stimming is part of the diagnostic criteria for autism spectrum disorder (ASD), but there are differences between this and stimming in ADHD.

People with ADHD may stim to help improve focus and impulse control, while people with autism may do it to relieve anxiety.

The stims themselves may be different, too. For example, people with autism may flap their hands or flick their fingers. Lining up objects is also a common stimming behavior in people with autism.

Things That Trigger Stimming Behaviors

There is no single reason why people with ADHD stim, but there are several theories.

For example, people living with ADHD are said to have differences in brain development and brain activity that affect attention, the ability to sit still, and self-control. Stimming may be a product of this.

Boredom and Understimulation

People with ADHD may stim out of boredom or to increase stimulation and attention in an understimulating environment.

For example, a child with ADHD may start kicking their feet at their desk during a lesson that they don't find interesting or after they have been sitting for a long period of time.

Overstimulation and Anxiety

On the flip side, stimming can also be born out of a need to reduce stimulation.

People with ADHD can sometimes feel anxious in environments that have a lot going on, like a loud and crowded store or sports complex.

Some may purposefully try to avoid these places because of that. But when that's not possible, stimming may be calming and self-soothing. It can also serve as a way to redirect negative feelings.

Happy Stimming

People with ADHD may also engage in "happy stimming." This type of stimming done to express happiness rather than as a way to improve focus or impulse control.

Happy stimming can look the same as stimming done for other reasons.

ADHD Stimming Management

If stimming behaviors have become particularly time-consuming or result in self-injury, such as bleeding from skin picking, it is time to talk to a professional.

Not all stimming behaviors require management. It will be up to you and your medical care team to discuss the level at which stimming is interfering with your or your child's life or causing safety risks.

If stimming is a problem in children, avoid using punishment as a method of trying to control their behavior. Experts discussing stimming behaviors associated with autism spectrum disorder have said this punishment technique doesn’t work. 

Medication

Medication is an effective way to manage ADHD symptoms in both children and adults. Medications for ADHD work to help a person control their behaviors by:

• Reducing hyperactivity
• Taming impulsivity
• Improving the ability to focus, work, and learn

Your healthcare provider may suggest stimulant medications, non-stimulant medications, or a combination of both to manage stimming behaviors associated with ADHD.

Therapy

Behavioral therapy may help teach a person to recognize and change unwanted, unhelpful, or undesirable behaviors. Working with a mental health professional who is trained in behavioral therapy can also help a person learn necessary skills to self-monitor and self-regulate without stimming. 

Cognitive behavioral therapy (CBT) goes a step further in helping a person develop self-awareness. The goal is to accept your own thoughts and feelings to improve focus and concentration.

Family-based therapy can also help by offering parents or spouses a better understanding of why their loved one stims. A therapist can work with the family as a unit to ensure existing strategies are not doing more harm than good and that there’s a plan in place that everyone not only understands but agrees to. 

Additional forms of therapy may also be helpful as a part of the larger ADHD symptom management plan. Professional-moderated ADHD support groups can also be beneficial.

Additional or Education Support

If you or a loved one requires extra support in managing stimming triggers and behaviors, it’s crucial to tell someone.

For example, if stimming behaviors at school are disrupting other students or are resulting in poor academic progress, an individualized education program (IEP) or 504 plan may be of use to help modify a child's workload or environment to their benefit.

Adults may find certain workplace strategies helpful in manage stimming behaviors. Ask your employer about accommodations like moving to a quieter workspace, work-from-home options, or using noise-cancelling headphones.

Summary

ADHD stimming is self-stimulating behavior. It may done to self-soothe or to increase focus and attention. Rocking back and forth, chewing the inside of the cheeks, and humming are just some examples of stimming.

Stimming is not necessarily a concern on its own, but it can become a problem if it interferes with everyday functioning.

Stimming can be managed with the help of medication, therapy, and additional support/accommodations if needed.