What Is Stimming?

Have you ever been so bored in a meeting that you’ve started fidgeting with your pen? Or maybe you’ve been so distracted in class that you’ve doodled designs all over the margins of your notes? Maybe you’re a habitual throat-clearer, or you’re prone to literally jumping up and down with joy when you’re excited about something.

Whether you realize it or not, all of these habits could be considered self-stimulatory behaviors, also known as stims.

“Stimming, which is clinically referred to as ‘self-stimulatory behaviors,’ is identified by its repetitive movements and/or vocalizations,” explains behavior analyst Laura Howk, MS, BCBA. It’s often (though not always) associated with autism spectrum disorder (ASD) and other neurodevelopmental conditions.

Here’s what you need to know about stimming, including what it is, why people do it and when, if ever, it should be managed.

What is stimming and why do people do it?

Stimming is when a person repeatedly makes the same movements or sounds.

“Stims are things you do without meaning to, and they usually serve some purpose, like helping you regulate your emotions,” Howk explains. “A lot of people stim, even if we don’t always hear it referred to that way.”

Maybe you tap your foot when you’re impatient or twiddle your thumbs when you’re bored. These kinds of repetitive behaviors are considered self-stimulatory behaviors, too, even if you don’t call them that or recognize them as such.

There are lots of reasons people may engage in these behaviors, including but not limited to:

• To regulate emotions: “Autistic people commonly report emotional regulation as a reason for stimming,” Howk notes. In one study of adults who stim, participants said it’s a helpful coping mechanism for dealing with anxiety (72%), overstimulation (57%) or to calm down (69%).
• To show excitement: Emotional self-regulation can apply to joyful emotions, too. Ever been so excited about something that you jump up and down or clap your hands without even meaning to? Some people stim when they’re very happy or enthusiastic, described in the study as “positive emotional states.”
• Because it’s enjoyable: No reason required! In the same study, 80% of people said they just like the way it makes them feel.

Some people don’t know why they do it or may not even know the term “stimming” at all. Others, like young children and people who are nonverbal, may not have the words to talk about it.

“If you’re supporting someone who isn’t able to verbalize why they’re stimming, it can be helpful to take in data about the environment when their stimming behaviors are most likely to occur,” Howk says. “Ask yourself: Is it loud? Are there a lot of people around? Are they doing a task that is new or difficult?”

There are also times when it could be a sign of a medical issue. “In rarer instances, stimming can be a means of signaling or trying to relieve pain,” Howk states. In these situations, consult with a healthcare professional ASAP.

One thing is true across the board, Howk says: “Whether or not a person can verbalize the reason, this behavior serves a purpose for that person.”

Types of stimming behaviors

There are countless examples of self-stimulatory behavior, but here are some of the more common forms, broken down by the senses and parts of the body they relate to:

• Auditory (hearing and sound): Humming, whistling, repeating words/phrases or continuous throat-clearing.
• Olfactory (smell or taste): Repeated sniffing or licking.
• Tactile (touching or feeling): Hand-flapping, finger-tapping, skin-rubbing or other types of repetitive hand movements (for example, stretching fingers or clenching and unclenching the fists).
• Visual (sight-related): Blinking, eye-rolling, lining up objects or staring at lights.
• Vestibular (movement): Rocking, spinning, twirling or pacing.

Can you control stimming?

It’s time to change the narrative around this question and move away from the idea of “controlling” or “treating” stimming behaviors.

In the past, healthcare providers focused on helping people minimize or hide stimming behavior, especially if it could be considered socially stigmatizing. For example, a child who flaps his arms when he’s excited might be encouraged to learn to stop for fear of bullying or teasing from his peers.

The intent might’ve been good, but the effect was often harmful. It fostered negative stigmas about stimming, making people feel frustrated. And for people who use stimming as a strategy for emotional regulation, decreasing or stopping can even impact their overall functioning.

“In recent years, the field has shifted to a greater focus of acceptance and understanding of stimming for what it is — a form of adaptive behavior that is sometimes used as a tool,” Howk explains.

When stimming becomes dangerous or disruptive

“Stimming is often harmless, just a different way of processing sensory information,” Howk says. “More often than not, management and intervention aren’t necessary.”

That said, there are situations where stimming can become harmful or dangerous. But how can you tell if it rises to the level of requiring intervention? It depends.

“Sometimes, people who engage in extremely high rates of stimming struggle to attend to or focus on anything else,” she notes. It could also cause you to be unaware of dangerous situations around you (say, a busy street or heavy machinery) or to hurt yourself (like through head-hitting, skin-picking, biting, etc.).

If you’re the person doing the stimming, and you feel that it’s become a problem, then that’s answer enough. But what if you’re a parent of a child who’s stimming?

“We recommend using a general set of questions to determine if an intervention is needed,” Howk advises. Ask yourself:

• Is this behavior harmful to them?
• Does this behavior put others around them at risk of harm?
• Will this behavior impact their ability to learn?
• Will this behavior disrupt or otherwise impact other people’s ability to learn?

Help for dangerous or disruptive stimming

If you’re supporting someone whose self-stimulatory behavior hurts them, causes them to be unaware of dangerous situations or puts them at risk, it’s best to speak with a professional who can help you figure out the best approach. This may include:

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

Here are some strategies you may encounter:

• Coaching: “Coaching teaches people to use cues or prompts to signal when a behavior is occurring,” Howk says. If a stimming behavior has become dangerous or intrusive, but you struggle to realize when you’re doing it, this can help hone your awareness.
• Replacement teaching: This is a common intervention for behaviors that have become unsafe or intrusive. It’s exactly what it sounds like: teaching a person to do one thing instead of another. “It can include providing an alternative and less dangerous way to engage in the behavior,” Howk explains. “For example, someone who engages in finger-biting may begin using an oral motor toy instead, or a child who picks their skin may learn to ‘pick’ at a fidget toy.”
• Breaks: It can help to create specific opportunities to engage in stimming — a time when the stim can occur without any interruption or need for redirection. “Breaks are encouraged and supported as long as the behavior itself isn’t harmful,” she says.
• Shaping: “This can include minimizing the stim into something less harmful or disruptive in an effort to lessen intensity or frequency,” she explains. It can also mean reinforcing less intense or less dangerous behaviors instead.
• Reinforcement: This strategy focuses on providing access to positive reinforcement. It’s typically done with another person, like a parent, who gives praise and encouragement for not engaging in a harmful behavior or for doing it less often.

In rarer or more extreme cases, protective equipment is an option. “It’s used as a means of sensory extinction,” Howk says, “which means that it dulls the sensation while a person is learning a safer option.”

Better understanding stimming

Remember: Learning from healthcare professionals isn’t a substitute for learning from people with autism.

“Many people within the autism community are passionate about stimming, and they emphasize that awareness and acceptance are key,” Howk says. “It’s crucial that we listen to people with autism on this topic and all others relating to them.”

To hear more about this topic, listen to the Health Essentials Podcast episode, “Autism Spectrum Disorder in Kids.” New episodes of the Health Essentials Podcast publish every Wednesday.