Medicine:Stimming

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Short description: Repetitive self-stimulatory behaviour common in neurodevelopmental disorders
Hand rubbing faux-fur
Feeling soft or otherwise enjoyable textures is a common form of stimming.

Self-stimulatory behavior, also known as "stimming"[1] and self-stimulation,[2] is the repetition of physical movements, sounds, words, moving objects, or other repetitive behaviors. Such behaviors (also scientifically known as "stereotypies") are found to some degree in all people, especially those with developmental disabilities such as ADHD, and are also frequent in people on the autism spectrum.[2] People diagnosed with sensory processing disorder are also known to potentially exhibit stimming behaviors.[3]

Stimming has been interpreted as a protective response to overstimulation, in which people calm themselves by blocking less predictable environmental stimuli, to which they have a heightened sensitivity.[2][3] A further explanation views stimming as a way to relieve anxiety and other negative or heightened emotions.[4]

An autistic adult (center right) stimming with her hands during the 2015 Erasmus Prize ceremony

Although some stimming behaviors have been shown to be healthy and beneficial—as they help regulate intense feelings—[5][6] stimming is often socially stigmatized and looked down upon. People who are neurodivergent often feel that they need to hide or decrease their self-stimulatory behavior, as it appears to not be socially acceptable, and often elicits an undesirable response from those who do not understand the compulsion behind them. There are also potential mental health and well-being risks in suppressing and masking autistic stimming behaviors that are harmless or adaptive.[7][6][5][8][9]

Stimming behaviors can consist of tactile, visual, auditory, vocal, proprioceptive (which pertains to limb sensing), olfactory, and vestibular stimming (which pertains to balance). Some common examples of stimming (sometimes called stims[10]) include hand flapping, clapping, rocking, blinking, pacing, head banging, repeating noises or words, snapping fingers, and spinning objects.[11][12] In some cases, stimming may be dangerous and physically harmful to the person doing it; for example, individuals may risk injuring themselves by forcefully banging their body parts against walls.[13]

Stimming and autism

Young autistic boy stimming with cold water in the kitchen sink.

Stimming behavior is almost always present in autistic people but does not, on its own, necessarily indicate the diagnosis.[14] The biggest difference between autistic and non-autistic stimming is the type of stim and the quantity of stimming.[14] In the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, stimming behavior is described as "stereotyped or repetitive motor mannerisms" and listed as one of the five key diagnostic criteria of autism spectrum disorder.[15]

Different perspectives suggest that stimming involves both sensory and motor functions. Underdevelopment of these sensorimotor functions can result in stimming behaviors produced by the person as a controllable response. One study which interviewed thirty-two autistic adults found that unpredictable and overwhelming environments caused stimming.[16]

A hard blue rubber chewable stim ring with its lanyard tied in a lark's head

Stimming can sometimes be self-injurious, such as when it involves head-banging, hand-biting, excessive self-rubbing, and scratching the skin.[17]

As it serves the purpose of self-regulation and is mostly done subconsciously, it is difficult for others to suppress stimming.[18] Managing the sensory and emotional environment while increasing the amount of daily exercise can increase comfort levels for the person, which may reduce the amount of the need for stimming.[19] Consciously or subconsciously suppressing stimming with the aim to present as neurotypical is one type of autistic masking.[20][21] It typically requires an exceptional effort and can negatively impact mental health and well-being.[20][21][22]

See also

References

  1. ↑ Rosalind Bergemann (2013). An Asperger Leader's Guide to Living and Leading Change. Jessica Kingsley Publishers. ISBN 9780857008725. https://books.google.com/books?id=7X4QAgAAQBAJ. 
  2. ↑ 2.0 2.1 2.2 Valerie Foley (2011). The Autism Experience. ReadHowYouWant.com. ISBN 9781458797285. https://books.google.com/books?id=FGO8S2RmckEC. 
  3. ↑ 3.0 3.1 Gretchen Mertz Cowell (2004). Help for the Child with Asperger's Syndrome: A Parent's Guide to Negotiating the Social Service Maze. Jessica Kingsley Publishers. ISBN 9781846420429. https://books.google.com/books?id=JiBo8JYaBjIC. 
  4. ↑ Eileen Bailey (15 July 2011). "Autism Spectrum Disorders and Anxiety". Health Central. http://www.healthcentral.com/autism/c/1443/141549/spectrum-disorders. 
  5. ↑ 5.0 5.1 Charlton, Rebecca A.; Entecott, Timothy; Belova, Evelina; Nwaordu, Gabrielle (2021). ""It feels like holding back something you need to say": Autistic and Non-Autistic Adults accounts of sensory experiences and stimming". Research in Autism Spectrum Disorders 89: 101864. doi:10.1016/j.rasd.2021.101864. https://doi.org/10.1016/j.rasd.2021.101864. 
  6. ↑ 6.0 6.1 Collis, E.; Gavin, J.; Russell, A.; Brosnan, M. (February 2022). "Autistic adults' experience of restricted repetitive behaviours". Research in Autism Spectrum Disorders 90: 101895. doi:10.1016/j.rasd.2021.101895. https://www.sciencedirect.com/science/article/abs/pii/S1750946721001707. 
  7. ↑ Kapp, Steven K; Steward, Robyn; Crane, Laura; Elliott, Daisy; Elphick, Chris; Pellicano, Elizabeth; Russell, Ginny (2019-02-28). "'People should be allowed to do what they like': Autistic adults' views and experiences of stimming". Autism 23 (7): 1782–1792. doi:10.1177/1362361319829628. ISSN 1362-3613. PMID 30818970. 
  8. ↑ McCormack, Lynne; Wong, Sze Wing; Campbell, Linda E. (2022-07-04). "'If I don't Do It, I'm Out of Rhythm and I Can't Focus As Well': Positive and Negative Adult Interpretations of Therapies Aimed at 'Fixing' Their Restricted and Repetitive Behaviours in Childhood". Journal of Autism and Developmental Disorders (Springer Science and Business Media LLC) 53 (9): 3435–3448. doi:10.1007/s10803-022-05644-6. ISSN 0162-3257. PMID 35781855. PMC 10465631. https://link.springer.com/content/pdf/10.1007/s10803-022-05644-6.pdf. 
  9. ↑ Waizbard-Bartov, Einat; Ferrer, Emilio; Heath, Brianna; Andrews, Derek S.; Rogers, Sally; Kerns, Connor M.; Wu Nordahl, Christine; Solomon, Marjorie et al. (2023). "Changes in the severity of autism symptom domains are related to mental health challenges during middle childhood". Autism. doi:10.1177/13623613231195108. PMID 37691349. https://journals.sagepub.com/doi/10.1177/13623613231195108. 
  10. ↑ Temple Grandin, PhD (November 2011). "Why Do Kids with Autism Stim?". Autism Digest. http://autismdigest.com/why-do-kids-with-autism-stim/. 
  11. ↑ Eileen Bailey (27 August 2012). "Stimming". Health Central. http://www.healthcentral.com/autism/c/1443/155585/stimming/. 
  12. ↑ "Stimming: What autistic people do to feel calmer". BBC. 5 June 2013. https://www.bbc.com/news/blogs-ouch-22771894. 
  13. ↑ Smith, Lori; Legg, Timothy J. (19 February 2018). "What is stimming?". https://www.medicalnewstoday.com/articles/319714. "For some, stimming can include higher-risk behaviors such as banging their hands, head, legs, and objects, which may be potentially physically harmful." 
  14. ↑ 14.0 14.1 Rudy, Lisa Jo (13 October 2009). "Stimming". About.com. http://autism.about.com/od/autismterms/f/stimming.htm. 
  15. ↑ American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders : DSM-5. (5 ed.). Arlington, VA. ISBN 978-0-89042-554-1. OCLC 830807378. https://www.worldcat.org/oclc/830807378. 
  16. ↑ Kapp, Steven K. (2019). "'People should be allowed to do what they like': Autistic adults' views and experiences of stimming". Autism 23 (7): 1782–1792. doi:10.1177/1362361319829628. PMID 30818970. 
  17. ↑ Fadhil, Tamara (2018). "Live Monitoring System for Recognizing Varied Emotions of Autistic Children". 2018 International Conference on Advanced Science and Engineering (ICOASE). pp. 151–155. doi:10.1109/ICOASE.2018.8548931. ISBN 978-1-5386-6696-8. 
  18. ↑ Devita-Raeburn, Elizabeth (2016-08-10). "The controversy over autism's most common therapy" (in en-US). Simons Foundation. https://www.spectrumnews.org/features/deep-dive/controversy-autisms-common-therapy/. 
  19. ↑ Cunningham, Allison (2008). "Stereotypy in Autism: The Importance of Function". Research in Autism Spectrum Disorders 2 (3): 469–479. doi:10.1016/j.rasd.2007.09.006. PMID 19122856. 
  20. ↑ 20.0 20.1 Pearson, Amy; Rose, Kieran (2021-03-01). "A Conceptual Analysis of Autistic Masking: Understanding the Narrative of Stigma and the Illusion of Choice" (in en). Autism in Adulthood 3 (1): 52–60. doi:10.1089/aut.2020.0043. ISSN 2573-9581. PMID 36601266. 
  21. ↑ 21.0 21.1 Hull, Laura; Petrides, K. V.; Allison, Carrie; Smith, Paula; Baron-Cohen, Simon; Lai, Meng-Chuan; Mandy, William (August 2017). ""Putting on My Best Normal": Social Camouflaging in Adults with Autism Spectrum Conditions" (in en). Journal of Autism and Developmental Disorders 47 (8): 2519–2534. doi:10.1007/s10803-017-3166-5. ISSN 0162-3257. PMID 28527095. 
  22. ↑ "6A02 Autism spectrum disorder". 2022. https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/437815624. 



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