Repetitive Behavior and Stimming in Autism

Repetitive behaviors are common features of autism, but they can present differently from person to person.  Repetitive behaviors are simply behaviors that a person does repeatedly or insists on doing the same way every time.  These behaviors can include asking about the same thing several times in a row, lining up objects (toys) in a particular way, spinning objects, obsessively closing and opening doors or drawers, or repeating certain movements or gestures.

Are Repetitive Behaviors a Problem?

Repetitive behaviors are not unique to autistic people and most people engage in at least some of these behaviors in some way.  Pacing, toe-tapping, compulsive cleaning, and nail biting are some common repetitive behaviors that most people do.  Usually, these behaviors present under stress and function as a self-calming strategy.  Repetitive behaviors only become a problem if it harms the individual or interferes with their daily activities.

What is Stimming?

Stimming is a type of repetitive behavior that involves a person performing repetitive movements or repeating certain sounds.  People engage in stimming behaviors for a variety of reasons.  Stimming might help autistic people self-sooth, may serve as a source of sensory stimulation, or the autistic person might simply enjoy making those particular movements.  Some common stimming behaviors are:

• Biting fingernails
• Twirling hair around fingers
• Cracking knuckles or other joints
• Tapping pencil
• Whistling
• Rocking
• Flapping hands or flicking or snapping fingers
• Bouncing, jumping, or twirling
• Pacing or walking on tiptoes
• Pulling hair
• Repeating words or phrases
• Rubbing the skin or scratching
• Repetitive blinking
• Staring at lights or rotating objects such as ceiling fans
• Licking, rubbing, or stroking various types of objects
• Sniffing at people or objects
• Rearranging objects

Hand Flapping Behavior

Repetitive hand flapping is a very common sign of autism, in which, the person waves their hands back and forth at the wrists.  As a more clinical description, during hand flapping, the affected person bends their arms at their elbows, moves their forearms, and flicks their wrists back and forth.  Hand flapping can be one of the first obvious signs of autism that a child may display (though not all autistic children hand flap) and isn’t necessarily a “bad” behavior – in fact, it can help autistic people make sense of the world.  Reasons that autistic people hand flap can depend on the individual and context.  Some reasons that autistic people hand flap include:

• Frustration from not being understood or not understanding what they are sensing or feeling.
• A way of communicating with the world around them.
• Expressing their emotions: happy, sad, excited, etc…
• A coping mechanism: hand flapping can help autistic people calm their nervous system when they feel over stimulated, anxious, excited, or scared.
• Help with body awareness.

Reducing Hand Flapping or other Stimming Behaviors

Hand flapping behavior is not harmful for the individual, but there are some methods to reduce this behavior if it interferes with daily activities or if it is detrimental to learning.  Hand flapping is not a problem itself, but it can be a sign that the autistic person is overly excited or distressed.  If reducing stimming behavior becomes necessary, changing those behaviors should only be done under the guidance of a trained clinician.  Reducing the amount of stimming someone does will likely involve:

Identifying the behavior: The first step is identifying what stimming behavior (hand flapping, rocking, making a certain sound, etc…) a person does.  After that, a therapist will try to identify when and why the behavior might be occurring.  They will look at the environments that the stimming happens in and what activities are happening before the stimming starts.

Trying replacement behaviors:  Having identified triggers for stimming behaviors, the therapist will look for alternative behaviors that meet the autistic person’s emotional or sensory needs, but that are safer and/or less distracting.  This technique is more effective the sooner it is implemented.

Teaching how to use replacement behaviors:  Ultimately, the therapist’s goal will be for the autistic person to perform the replacement behavior without the therapist needing to remind them.  To get to that goal, caregivers may need to help the autistic person remember to do the replacement behavior.  Caregiver involvement is important because the autistic person will need to do the replacement behavior consistently in order to make it a habit.  Since therapists are not with their clients 24-7, caregivers will need to help by giving the autistic person reminders.

Changing the environment: If the autistic person finds certain environments to be over-stimulating, they might need a quiet place to go or they many need to have activities to help them focus.  On the other hand, if a child needs extra stimulation, letting them play with toys, listen to background music, or spend more time outside may be good alternatives to stimming.

Working on anxiety: The repetitive or stimming behavior might be caused by anxiety.  A professional can examine the child and can recommend an appropriate treatment.

Encouraging physical activity: Physical activity can be a distractor for stimming behavior, so exercise might help the child focus on their work more easily.  Trying different physical activities throughout the day may reduce repetitive behavior.

Many adults on the spectrum learn to inhibit the immediate need to stim or perform repetitive movements until they are in a private setting.  They learn when and where it is appropriate to flap their hands so that they do not need to give it up totally.

OCD in Autistic Children & Adults

Studies have shown that obsessive-compulsive disorder (OCD) and autism are genetically linked and involve overlapping brain regions.  OCD is an anxiety disorder characterized by ritualistic behaviors (compulsions) and recurring/unwanted thoughts (obsessions).  Individuals with autism are twice as likely to have or develop OCD, which is the most common anxiety disorder to occur with autism.  These two disorders resemble each other, but the key difference is that individuals with autism often engage in a variety of repetitive activities as a way to ease anxiety, whereas individuals with OCD generally engage in one particular repetitive behavior as a response to unwanted thoughts or obsessions.

Article by: Sarika Mahajan and The Autism ToolKit

References:

https://goodautismschool.com/stimming-in-individuals-with-autism-hand-flapping-behavior/#:~:text=Hand%20flapping%20is%20a%20form%20of%20a%20stimming,turning%20but%20it%20is%20not%20always%20the%20case.