Symptom Spotlight: Stimming
This week's feature looks at stimming; a common autistic experience, and one that is often misunderstood. Stimming is short for the diagnostic term 'self-stimulatory behaviour', also called 'stereotypic behaviour'. These behaviours - known as 'stims' - are employed to help the person self-regulate, often in response to sensory or emotional overload.
Contrary to popular belief, stimming is not unique to autism. In fact, everybody stims. If you've ever tapped your foot when waiting for something, or whistled to yourself as you worked, you've engaged in stimming. We all present and utilise stimming behaviours to some degree. However, autistic people are hypersensitive to sensory and emotional input, and so their need to self-regulate is much greater. As a result of this, we tend to stim more often and more noticeably than our non-autistic peers.
Stims can include any of a number of behaviours. The most commonly recognised stims include hand-flapping and rocking, but can also include leg-bouncing, foot tapping, finger flicking and more. For most autistic people, stimming is constant to some degree, although this may be mild. However, as it is a form of self-regulation, stimming will almost always increase when the person become overwhelmed by emotional or sensory input. An increase in stimming is often a clear indicator that an autistic person is on track to experience a meltdown or shutdown if the stressor is not removed,
So why do autistic people stim? Well, the most articulate explanation of this I've ever seen is from autistic journalist and writer, Carly Fleischmann. You can watch this below (please also note and be annoyed by the patronising tones they use when talking to and about her):
As Carly explains, stimming is a way to modify what we're receiving from the outside world, and to block out what we can't cope with. In my experience, stims are also often repetitive, which creates predictable, regular, controllable stimulation which can help us regulate the effects of the uncontrollable and unpredictable input we're getting from external sources.
As stimming helps to relieve sensory or emotional overwhelmedness, most autistics find it to be a neutral or positive experience. However, stimming can sometimes be dangerous. Some stims can be harmful, such as hitting one's head, or biting and scratching oneself, whereas more compulsive stims may impede the person's daily activities, such as counting or lining up items. However, the major source of danger for autistic people is other people. Despite stimming being an almost universal autistic experience, many people do not understand it, and it can draw a very strong negative response from some people. At the milder end this can lead to verbal abuse or invasive questions, but at its worst it has been known for autistic people to be physically harassed or assaulted as a response to stimming.
In terms of self-management, stimming is a perfectly natural and healthy mechanism that for the most part does not need attention. Unless an autistic person's stims are harmful, there is no reason for intervention. Occasionally, an autistic person may wish for additional support with their stimming. In these cases, the following approaches are widely considered to be the most helpful:
Occupational Therapy (OT) which helps the person to build a 'sensory diet' which can help to maintain a more consistent level of sensory processing and reduce the incidence of becoming overwhelmed with sensory input.
Support with anxiety to reduce day-to-day stress levels and reduce the incidence of becoming emotionally overwhelmed.
Building an awareness of triggers and modifying your day-to-day environment to reduce these where possible.
Re-directing harmful stims into similar but less harmful behaviours, e.g. using chewable jewellery to replace biting oneself or others.
If you see an autistic person stimming, the best thing to do in the first instance is simply accept it and move on without drawing attention to it. Unless the person is hurting themselves or others, it's not necessary to intervene or comment. If harm is being caused, you can approach the person slowly and calmly, using a quiet voice and avoiding physical contact. Ask if they need your help, or if you can call someone to support them. It's best to ask each question separately and give them plenty of time to answer, as they may struggle to process the information you're asking for. If they refuse don't pressure them, maintain your distance and look to see if they are accompanied. If they are not, and you think that professional intervention is needed, call a medical professional. Unless absolutely unavoidable, DO NOT call the police. Many autistics will be frightened by a police presence, especially considering that there is a history of autistic people experiencing police brutality. A medical professional is much better placed to help them. If the police are called, make clear during your call that the person in question is a vulnerable adult and needs protection rather than being a threat. This will help to ensure that they are approached with care and that no unnecessary force is used.
In summary, stimming is any behaviour which helps a person to self-regulate. It is not unique to autism, but is often more obvious and varied when done by autistic people. It helps autistic people to manage the overwhelming level of sensory and emotional input that they receive from their environment, and is likely to increase when they become distressed or overstimulated. It is a normal and healthy behaviour which does not require intervention unless it is harming the autistic person (or others) in some way. Otherwise the best thing you can do is leave them to it.
I hope that this Symptom Spotlight has provided you with a comprehensive overview of what stimming is. Let me know in the comments if you want to see more of these, and what you'd like me to focus on!