What Is Stimming?

"Stimming," which describes self-stimulatory behaviors, involves repetitive or ritualistic movements or sounds.

While stimming most commonly refers to the repetitive behaviors in autistic people, those who are not autistic can stim, too. For example, tapping your foot when you're nervous could be an example of stimming.

The main difference is that when stimming is linked to autism, the type or quantity of behaviors matters. At times, stims like hand-flapping or rocking back and forth can become excessive and/or obtrusive.

This article lists examples of stimming. You will also learn why autistic people stim and how to help them manage stimming if it creates problems for them.

Examples of Stimming

If you're wondering if your loved one or child is stimming, pay attention to their behavior. Stimming suggests repetitive behavior that goes beyond what is considered culturally or socially acceptable.

For example, nail-biting and hair-twirling can distracting but are usually acceptable in most social situations, like at work or school. Hand-flapping or spinning in circles—stimming examples that are common in autistic people—would be less socially accepted.

Other examples of autistic stimming include:

• Hand-flapping
• Finger-flicking
• Rocking back and forth
• Pacing back and forth
• Spinning or twirling
• Repeating words or phrases (echolalia)
• Humming
• Hard blinking
• Opening and closing doors
• Flicking switches
• Finger-snapping
• Spinning or tapping objects
• Covering and uncovering the ears
  

Is Stimming Harmful?

Most stims do not cause harm, though they can come across as odd or distracting to neurotypical people.

An autistic person certainly can stim to "defuse" feelings of being overstimulated or distressed, but it's not always a sign that they're uncomfortable. Many autistic people stim when they're excited and happy.

However, some stimming behaviors can cause self-injury and be alarming to others. If stims have the potential to be harmful, that person may need help managing them.

Stims that may need to be managed to prevent harm include:

• Excessive self-rubbing or self-scratching
• Excessive nail-biting
• Head-banging
• Hand-biting
• Ear-clapping
• Slapping or hitting oneself

These stimming examples often reinforce the stigmatization of autistic people. When they become more ostracized and alone, potentially harmful stimming behaviors may continue and get worse.

Benefits of Stimming

Although there is some debate about the actual cause of stimming, most experts consider it a tool for emotional self-regulation.

We're still learning about how the brain responds to stimming. For example, for autistic people, stimming can be a way to tone down or block out sensory input that is too much.

Autistic people often have sensory processing dysfunction—they either over-respond or under-respond to stimuli such as sounds, textures, and smells.

For example, they might be overcome by a strong odor and experience sensory overload. Their response is hypersensitive.

When they are less responsive to stimuli, like not reacting to or even noticing a loud noise, their response is hyposensitive.

In these sensory situations, stimming can help people with autism in a few ways:

• Overstimulation: Stimming can block out excessive sensory input when someone is hypersensitive.
• Understimulation: Stimming can provide the necessary stimulation to someone who is hyposensitive.
  
• Regulation of emotions: Stimming can help manage emotions (positive and negative) that may feel too "big" for an autistic person to handle.
• Pain reduction: Stimming can help distract from physical discomfort and pain.

ADHD Stimming

Some of the reasons why autistic people stim are shared by people with attention deficit disorder (ADHD) who stim. A person with ADHD who is "fidgety" is often trying to self-regulate their need for stimulation in a situation where they are feeling under- or unstimulated.

There are also some differences: for example, an autistic student may stim in class because the light and sound in the room are overwhelming while a student with ADHD finds that stimming helps them focus. For other people with ADHD, stimming simply becomes a habit.

How to Manage Stimming

There is no reason to stop someone with autism from stimming if it's not causing problems. It's only when stims are very disruptive (such as in a school classroom) or dangerous (such as causing injury) that they need to be managed.

It can be hard to change stimming behaviors. Caregivers may think punishing an autistic child when they stim will make them stop, but it can actually make the situation worse. Punishment ignores the core reason that a child is stimming.

Remember that stimming is a tool for coping. It is not "bad" behavior—it's not even necessarily an intentional behavior.

There are a few techniques for helping an autistic person manage stimming:

• Applied behavior analysis: This is a form of behavioral therapy that aims to get autistic children to adapt to social situations that they may not understand. It involves positive reinforcement for positive behaviors and consequences for negative ones. ABA therapy is controversial and some experts do not think it is appropriate or an effective way to help autistic people.
• Sensory diet: A "sensory diet" is a form of occupational therapy that tries to reduce stimming by scheduling activities into a child's day to meet their individual sensory needs.
• Environmental changes: Reducing environmental and social stresses can reduce the risk of sensory overload. This may involve placing a child in smaller classrooms, soundproofing windows and rooms, and removing textures or lights that might be upsetting for them.
• Stress management tools: Introducing objects in place of rocking or hand-flapping, like a stress ball or fidget, can help some people transition to different stims. A swing set or a dedicated quiet space with sound-blocking headphones can also be useful.
• Medications: If needed, medications like Risperdal (risperidone) and Abilify (aripiprazole) can be prescribed to reduce the irritability and aggressiveness that can fuel excessive stimming.

Can Tests Diagnose the Cause of Stimming?

Stimming is not a disorder on its own. While it's a central feature of autism, stimming is not diagnostic of the condition.

Diagnosing autism spectrum disorder (ASD) can be difficult. There is no single medical test that can specifically pick up the condition. Autism is also a spectrum, so not every person who is autistic has the exact same experience.

The diagnosis of autism is made based on criteria that are outlined in the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual, Fifth Edition (DSM-5).

To be diagnosed with autism, a person needs to meet all three of the following DSM-5 criteria:

• A deficit in social-emotional reciprocity: This means that a person is unable to have normal back-and-forth conversations, share interests or emotions with others, or start or respond to social interactions.
• A deficit in non-verbal communications: This means that a person is unable to comprehend social cues or express themselves nonverbally (such as with facial expressions or body language).
• A deficit in developing, maintaining, and understanding relationships: This includes difficulty adjusting behaviors to social situations, engaging in imaginative play, or exhibiting interest in friendships or making friends.

When to See a Healthcare Provider About Stimming

Stimming does not need to be medically treated unless it is harmful to the person or the people around them. For example, aggressive behaviors like head-banging or hand-biting, or actions like nail-biting, self-scratching, or ear-clapping can cause physical injury.

Antipsychotic drugs like Risperdal or Abilify can be prescribed along with behavioral therapies to help manage excessive stimming while a person learns to self-regulate their emotions.

Summary

Stimming is common in autistic people but it's not diagnostic of the condition; stimming can also occur in neurotypical people.

Stims are behaviors like rocking, hand-flapping, and repeating words or phrases. Autistic people engage in stimming to help manage their emotions or block out overwhelming sensations.

Stimming does not need to be treated unless it is constant, disruptive, or causes harm. In these cases, behavioral therapies, environment changes, stress reduction tools, and even medications can be used to help manage stimming while a person learns skills to regulate their emotions.

A Word From Verywell

Acceptance is key to coping with stimming. If your autistic child, partner, or loved one stims, you may not understand it. You may find it embarrassing or distracting. It's important to keep in mind that stimming serves many functions for autistic people, and it's generally not harmful.

If stimming does become a problem, there are ways to help an autistic child or adult learn to self-regulate their emotions or use stims that won't be harmful to themselves or others.