A Therapists Guide to Fix the Developmental Delay of Baby Milestones

weird habitStimming is a conundrum, that’s for sure. It’s a behavior that serves a purpose.

So what’s a parent, or therapist for that matter, to do? When parents asked me to provide a solution to this problem, I was never sure which solution to the stimming was the best course of action. One option sort of transferred the behavior, and the other option tried to eliminate it. As a caregiver, you have to decide which one is right for your child.

For those who have never heard of this term, it is a short-hand reference to self stimulatory behaviors. They are most often seen in children who are diagnosed with autism spectrum disorder, but can also be exhibited by lower functioning children and those with sensory processing issues.

It is a stereotypic and repetitive behavior. Examples of stimming can include the following: blinking, staring, licking, flicking, clapping, jumping, rocking, twisting hair, grunting, lining up objects, sniffing people … the list goes on. It is not really understood as to why children perform these behaviors, but it is believed to be a means of organizing and coping with whatever is going on in the environment. Given that these behaviors are assumed to be helpful to the child, why is it viewed as a problem? Despite apparent benefits, they actually interfere with the child’s ability to focus and pay attention. They also stigmatize the child. And by their nature, they reinforce themselves and prevent the child from adopting alternative and more acceptable self-calming techniques. Let’s be honest – sniffing people or repeatedly licking objects isn’t conducive to social acceptance.

All of us display some of these tendencies at some time or another, but especially under stress. Who hasn’t twisted their hair, or tapped their toes, or drummed their fingers repeatedly (and to the annoyance of others?). In the mainstream population, these habits are viewed as irritating outlets for stress. When you think about it in these terms, it is more understandable. Everyone has a nervous habit or two which emerges in stressful or anxious situations. And unexplainably, it is calming.

Social acceptance is generally not an issue in the mainstream population, but it is a key goal for the special needs population. Sadly, the more unusual the behavior exhibited by a child, the less likely they will be well received.socially unacceptable

Stimming behaviors can be so odd as to be repellant to others. That means that it is important to either suppress the stimming, or redirect it to a more acceptable form. I personally prefer to try and suppress these behaviors. If the child can learn to cope by using other resources and finding more appropriate means for self calming, then it is less likely they will revert to these behaviors if they decompensate. No matter how well a child is progressing, there will always be times when they regress. My son has no problem acting like a two year old when he is over tired, or has been pushed past his coping abilities. I believe that if you merely re-direct behaviors, it becomes easier to fall back on the original behavior. If you can teach the child not to engage in repetitive behaviors, it is less likely they will revert. They will have become more distanced from the original behavior.

I believe the most effective method for treating stimming is by using behavioral strategies. Applied behavior analysis (ABA) has proved to be very effective in changing disruptive behaviors and eliciting more appropriate ones.

 Many practitioners who implement ABA therapy incorporate something called “discrete trial training” (DTT). This is very effective with children with autism, PDD and related disorders. DTT helps by rewarding and reinforcing desired behaviors via discrete events. It also works on extinguishing undesired behaviors. Reward reinforcement is great for helping to build positive behaviors. With DTT, the components of an action are broken down, and each component is worked with individually. Reward is given for each good response. The components, when put together, form the new behavior. If the therapist seeks to eliminate a behavior, a child is rewarded when they are told to stop and they do stop. Eventually the behavior is extinguished.

An alternative approach is to replace the undesired stimming with a more acceptable method of self-calming.

Obviously, if a child’s stimming is manifest in licking objects, they need to stop. Aside from the fact that it might cause them to be ridiculed by peers, it poses a health risk. At a minimum, it is unsanitary. A therapist might try to find acceptable food items, like sugarless lollipops, which will replace the licked object. If a child is touching others, the therapist can try to give the child a doll or a stuffed animal to touch instead. But these solutions are often limited to a very young population. Once the child is older, there are not as many substitutes available. That’s why I think that eliminating the behavior is best, despite the child’s overt need for stimming. When you consider both the positive and negative aspects, I think the negative tend to outweigh the positive.

We know that stimming satisfies an internal need in children with certain disorders. But, as I just said, it seems that the benefits don’t exceed the problems. That is, the stimming diverts attention which is necessary in order to learn and take in important information. It also exposes the child to being ridiculed and stigmatized. It is definitely difficult to treat because the child relies on the behavior as a coping mechanism. However, working with the child to gain purposeful skills and possibly giving them alternative ways to cope can help diminish, and possibly eliminate, stimming.

One Response to “How to stop stimming (or at least help)”

  1. Anthony says:

    Good morning. Great article! I am the father of a 3 year old boy diagnosed with PDD at 15 months. He has been receiving ABA, been on the gluten and casein free diet for about a year, and we (my wife and I) have seen great strides! There was a period of time when his stim behaviors improved but now we have noticed a resurgence. His behaviors involve stroking the inside of his palm, dropping his jaw while rubbing his legs and feet together when he is tired. When he is excited, he clenches his fist with arms extended and he hums, while going on the tips of his toes. He also is a chronic thumbsucker! We have tried the imitation, which does stop him momentarily, but the behavior has continued. Do you have any other recommendations?

Leave a Reply