Rabu, 04 Juli 2012

Stimming behavior in autism

Stimming behavior in autism
“The stimming behavior increased very much, now he is clearly flapping his hand almost all the time (earlier it was just tapping some object on face, now he just shakes his hand for no reason, screaming at least 10-12 times in a day, he is running in circles on the bed , jumping on sofa …I am at my wits end … stimming is my biggest concern…”
As a fellow parent, I completely empathise with the mother who posted the above comments on an autism forum. Stimming behavior makes our children look really autistic. Besides hand flapping, stimming can also take other forms:

Visual stimming: staring at lights, repetitive blinking, moving fingers in front of the eyes, rolling eyeballs
Auditory stimming: tapping ears, snapping fingers, making vocal sounds
Tactile stimming: rubbing the skin with one’s hands or with another object, scratching
Vestibular stimming: rocking front to back, rocking side-to-side
Taste stimming: placing body parts or objects in one’s mouth, licking objects
Smell stimming: smelling objects, sniffing people
Most of the time, these are coping strategies are due to overloads in sensory perception, such as noisy shopping centres, or due to psychological demands such as learning new tasks. Or, stimming behavior could also be due to biological reasons, such as yeast die-off effects. Sometimes, autistic children may also stim from lack of sensory input. In such cases, stimming behavior serves to stimulate the brain. So stimming actually serves a purpose for the autistic child.

In fact, normal adults also stim but not exactly in the same manner. For example, we might pace up and down while talking on the phone or twirl our hair when bored. Many students twirl their pens when solving complex mathematics problems. These activities do help release tension.

Donna Williams, a high functioning autistic individual, had this to say about stimming behavior:

Stimming is a word created by non-auties with often negative connotations. It was a word created by non-auties who didn’t understand that

some folks had compulsive but involuntary tics,
some had self calming tools they didn’t understand,
some had sensory fascinations they couldn’t relate to,
some needed to tune out to tune in,
some needed a tool for social distance in the face of compulsive social invaders,
some needed to be repetitive in order to download,
some needed to compensate for a non-autie multitrack world they couldn’t process in their mono-tracked reality,
some needed something to get lost in when utterly blowing all fuses….

and, anyway, the non-auties labelled, as is their tendency, this vast array of experiences with one word as if it was one thing at all times to all people labelled ‘Autistic’.

Forgive them. They know not what they see.

Given this, eradicating stimming behavior could lead to a full blown tantrum melt down. In fact, we allow children to stim as much as they need when they are in our clinic for consultation. However, this is obviously not desirable in public places. So what should parents do about the stimming behavior of their autistic children? If the cause is biological — for example, candida treatment or Vitamin mB12 therapy — the stimming is normally self-limiting and should stop in a matter of several weeks.

If there are obvious environmental stressors — like in a noisy place or consulting in a clinic — the child should be taken out of the situation as soon as possible. Stimming behavior due to new tasks should also resolve once the child has mastered the tasks.

Some autism therapists have suggested substituting full blown stimming behavior like hand flapping, for less obvious behavior like tapping the fingers on the thighs. This would be more socially acceptable. However, this implies that stimming cannot be eradicated. Yet, normal people can stop stimming behavior at will, once they become self-conscious. In other words, they have cortical brain control over their behavior.

Is this achievable for the autistic child or adult? Can we help the autistic child regulate the brain? Yes, my autistic teenage daughter has done this. She has recovered from very severe verbal stimming.

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