Understanding Stimming

Do you click your pen in boring meetings? Play with your hair when you’re concentrating? Maybe you’re a habitual hummer or literally jump with joy when you’re excited.

These habits could be considered self-stimulatory behaviors, also known as stims. Developmental pediatrician Carrie Cuffman, MD, explains what stimming is, why people do it and when (if ever) it’s a problem.

What is stimming?

“Stimming is a behavior where you repeatedly take an action or make a sound that helps you self-regulate,” Dr. Cuffman explains. “You do it, often without meaning to, because it helps you manage feelings like anxiety, excitement or overstimulation.”

While it’s often associated with autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD) and other neurodevelopmental conditions, most people stim from time to time. While they’re sometimes misunderstood, these activities are a form of self-soothing that anyone can benefit from and enjoy.

“Stimming is typically harmless,” she continues. “Think of it as another way to process what’s happening around you, good or bad. It doesn’t usually require any kind of medical management or intervention.”

In fact, recent research suggests that stimming has important social benefits for people with autism.

Types of stimming behaviors

There are countless examples of self-stimulatory behavior, but here are some of the more common forms.

Auditory

Auditory stimming involves making, listening to or seeking out sounds. That might look like humming, whistling or repeating certain words, phrases or noises.

Olfactory

Olfactory stims have to do with your sense of smell. They include sniffing different items around you, repeatedly smelling the same item or seeking out a specific scent.

Oral or gustatory

Oral stimming involves using your mouth to get sensory input — think licking, chewing or mouthing objects, like a pencil or your shirt, or seeking out items with specific textures. Gustatory stims are specifically related to taste. You may, for example, seek out a specific food or flavor.

Tactile

Tactile stims are repeated actions that involve touch, such as hair twirling, skin rubbing, tapping or stroking objects. You may also go out of your way to find — or take comfort in — specific textures.

Visual

Visual stimming is sight-related — meaning it deals with both how you use your eyes and the things you look at. Blinking and rolling your eyes both count as visual stims. So does lining things up or fixating on moving objects like a fan or a lava lamp.

Vestibular

Some stimming involves moving your body. Vestibular stimulation may take the form of rocking, spinning, hand-flapping, pacing and more.

When stimming is a concern

While most stimming is harmless — or even helpful — it can become disruptive or dangerous in certain situations, for certain people.

“Sometimes, people who engage in extremely high rates of stimming struggle to attend to or focus on anything else,” Dr. Cuffman says. “That can cause problems at work or school.”

Stimming becomes a safety concern when someone is so fixated on the behavior that they wander or unintentionally enter dangerous situations, such as stepping into a busy street.

And some stimming behaviors are literally harmful, like head-hitting, skin-picking and biting.

Getting help

If you’re a caregiver for someone whose self-stimulatory behavior puts themself or others at risk, Dr. Cuffman advises reaching out to a professional for help, like:

• A developmental pediatrician
• A board-certified behavior analyst (BCBA)
• An occupational therapist (OT)
• A speech-language pathologist (SLP)

Common strategies for addressing harmful stimming behavior include:

• Coaching: The first step to addressing a behavior is recognizing when it happens. “Coaching teaches people to use cues or prompts to notice when they’re stimming in a harmful or disruptive way,” Dr. Cuffman explains.
• Replacement teaching: Sometimes, the best option is replacing a harmful stim with a safer, less disruptive one. For example, using an oral motor toy (like a chewable necklace) could be an alternative to finger biting.
• Breaks: If the stimming behavior is disruptive but not harmful, carving out dedicated times for it can reduce interruptions while still respecting the need to self-regulate.
• Shaping: “Shaping is a way of modifying a stim to either make it less harmful, less intense or less frequent,” Dr. Cuffman says.
• Reinforcement: This approach involves a caregiver offering praise and encouragement for not engaging in a harmful behavior or doing it less often.

In rarer or more extreme cases, Dr. Cuffman says protective equipment may be an option.

Final thoughts

Stimming is a natural and important tool for coping with stressful situations, intense emotions and overstimulation. Most of the time, it’s healthy, safe and should be respected, not corrected.

“Many people within the autism community are passionate about stimming, and they emphasize that awareness and acceptance are key,” Dr. Cuffman shares.

If your or your loved one’s stimming behaviors are disruptive or dangerous, reach out to a provider for support. They can help you find healthy alternatives that will meet your needs.