What Is Stimming? Types, Causes, and Possible Treatment
If you've heard of the term stimming, it was likely in conjunction with Attention Deficit Hyperactivity Disorder (ADHD) or Autism Spectrum Disorder (ASD), which formerly included conditions like Asperger's syndrome and some of the disorder's earliest and most easily definable symptoms. Although ADHD stimming has garnered attention primarily as a symptom of ASD, it is a very common human behavior and can be observed in people of all ages, backgrounds, and abilities, including those without disabilities.
What Is Stimming?
The term "stimming" is an abbreviation for "self-stimulatory behavior". While it may sound complicated, it is an umbrella term used to describe any movements, patterns of behavior, or actions used to stimulate the senses. The most common forms of stimming, both in neurotypical and neurodivergent people include humming, swaying side to side, biting nails, biting the inside of the cheek, tapping fingers or toes, and rubbing the skin. These types of stimming can help people self-control and self-soothe and can help them regain a sense of self-control. It’s likely you've seen someone in your life stimming or have even found yourself stimming in a moment of boredom or discomfort.
Stimming And Developmental Delays
While stimming is a natural response that is in no way unique to individuals with intellectual or developmental disabilities, brain differences, or even a brain injury, it can function as a source of comfort and control for children with developmental delays or developmental disorders. Because most children with developmental disabilities also experience some amount of sensory overload, stimming can be used to regain control over a certain sensation or experience. This is especially common with sensory processing disorders.
Children who are overwhelmed by auditory input, for instance, might be found shrieking or shouting in response to a lot of noise. Children overwhelmed by visual input may press against their eyelids to create stars in their eyes or move their eyes back and forth rapidly. This is known as trigger stimming, when the stimming behavior reflects the channel and intensity of the sensory input that disturbs the person.
In the developmentally disabled, stimming is highlighted as an adaptive mechanism used to communicate intense emotions. As a result, the default settings of such stimming could be more likely to be loud, distracting, or different from the common sources of self-stimulation. This may be the reason why people typically associate stimming with delays and disabilities. Understanding the function of stimming can provide insight into the experiences of individuals with sensory overload and their behavior and habits.
Stimming In ADHD
While developmental disabilities or intellectual impairments do not necessarily accompany ADHD, it is common to see children who have ADHD present with sensory difficulties. For that reason, the ADHD stim may be more akin to the stimming you see in a child with Autism Spectrum Disorder (ASD) or other developmental delays. Children with ADHD may stim more in the form of fidgeting. This can entail a child squirming in their seat but can also include more noticeable and disruptive behaviors, including speaking over other people, humming loudly, picking at skin or hair, or pacing back and forth. These behaviors are used to solicit some form of sensory input, though they can distract other students or people in the room. At the same time, these stimming behaviors may help people with ADHD quiet down some of the sensory systems prohibiting focus or creating unpleasant sensations in the body.
The Functions Of Stimming
Medical reviewers confirm that stimming has multiple functions, depending on the person engaging in the behavior and the environment the person is in. Self-stimulatory behavior, by nature, is designed to create a sensation in the body. However, the factors that trigger stimming are unique to each individual and can change from day to day.
For some, stimming is used to exert control over a situation and redirect fear or unpleasant energy, though it may be accompanied by a perceived lack of self-awareness. When this is the reason for stimulatory behavior, sensory overload is usually involved, according to the latest evidence-based research. Stimming is a form of control that will often appear in a more dramatic movement, sound, or behavior such as rocking, jumping, or crying. These can help quiet an overloaded sensory system.
According to peer-reviewed studies, many people with ADHD stim because it is self-soothing. Chaos and feeling overwhelmed are the most common causes that trigger stimming, and the resulting self-stimulatory behaviors help people with ADHD control their sensory overload.
However, some people stim to relieve boredom or excess energy. Pacing, biting nails, tapping feet, and fidgeting can all be used as a means of eating up energy that has no other place to go. Hyperactivity is a core symptom of ADHD, so eliminating excess energy is not an anomaly within the diagnosis but is almost a matter of course. By relieving excess energy, a person with ADHD can calm down to normal energy levels and improve focus.
For others, stimming is engaged as a way to alleviate boredom. This is perhaps the most common reason for stimming in people who do not have a disorder or delay. Stimming for these individuals usually manifests in smaller, more socially acceptable ways, such as twirling one's hair while reading a textbook or tapping one's foot while waiting in line. These small energy expenditures engage the body in several ways and do not require effort or thought to create.
Types Of Stimming
Self-stimulatory behavior can come in many forms. Depending on the person and reasons why they stim, they may focus on one type or engage in many types of stimming behavior. According to high-quality sources featuring input from board-certified physicians, stimming comes in multiple categories: visual, verbal/auditory, tactile/touch, vestibular, and other.
Visual stimming refers to stimming behaviors that utilize the sense of sight. Some visual ADHD stimming examples include staring at objects or excessively drawing or painting.
Verbal stimming involves using one’s voice or utilizing the hearing sense. Examples of verbal stimming behaviors include excessive giggling, humming, making odd noises, or compulsively clearing the throat.
Tactile stimming behaviors focus on the sense of touch. Examples of this type of stimming include picking the skin, rubbing fingers, teeth grinding, or biting fingernails.
Vestibular stimming behaviors focus on body movement and balance. Examples of this type of stimming include spinning, rocking, and swinging.
There are other stimming behaviors that don’t fit into the above categories. These can include excessive gameplay, excessively sharpening pencils, acting out a movie scene repeatedly, or writing the same words or numbers repeatedly.
When Stimming Needs Intervention
Technically, stimming does not require intervention at all. If stimming does not interfere in daily life, it need not be tamped out, eliminated, or lessened. Based on a report from the American Psychiatric Association, research has found that autism and ADHD stimming often have a purpose and can be beneficial to the person. Therefore, there may be no need to manage stimming behaviors.
Therapists, parents, and educators may need to intervene when stimming begins to interfere with living a healthy, well-adjusted life, though. This is very often the case in children with Autism Spectrum Disorder and is sometimes the case with children who have ADHD. In these cases, behavioral therapy is the main treatment protocol.
Staring off into space at the expense of listening to a lecture or lesson in class is an instance in which stimming significantly interferes with a child's ability to function. This behavior has the potential to impede a child's academic achievement.
Stimming In The Classroom
The APA suggests that stimming within the classroom may look different for each child. ADHD has three core symptoms, but these common symptoms are expressed differently from child to child. Some children with ADHD do not have significant sensory issues and might not stim much, apart from the occasional bout of stirring and wriggling in their seats.
Children with ADHD and sensory issues are far more likely to have more significant stimming behaviors, including talking over the teacher, humming, rocking, tapping hands or feet, getting out of seats to run or jump, and twirling in circles. For these children, an individualized education program (IEP) or 504 plan may be necessary to improve learning and encourage academic success.
Stimming At Home
Stimming at home is unlikely to need the same level of assistance as stimming in school, but it may still require parent support and some form of intervention such as therapy. Some children with ADHD may have trouble sitting at the table for meals, and as a result, may develop unhealthy relationships with food and eating. Others may experience sensory issues and difficulty concentrating, which can make completing chores and abiding by parents' requests problematic. This could lead to relationship rifts between parents and children. Still others may experience stimming in the form of self-injury, which is problematic and necessitates intervention.
Stimming With ADHD
Although ADHD might seem primarily like an intellectual issue, its effects are far-reaching and impact far more than just classroom settings. While stimming may initially seem problematic for children with ADHD, it can actually be useful for parents, educators, and therapists. That is, the severity and prevalence of stimulatory behavior can help caregivers determine the extent of a child's sensory issues and help identify the regions of the body and brain where the sensory issues are most prominent.
For some, the thought of discouraging a child to stim is akin to forcing a child to give up a beloved toy or activity; it can seem almost cruel. For others, visible stimming functions as a source of alienation and indicates an area of need, so it may need to be addressed and resolved.
Whether your child with ADHD is experiencing sensory overload or generally struggling with the symptoms of ADHD, stimming is likely to come into play at some point in their treatment journey. Determining whether stimming is a harmful or damaging aspect of ADHD will largely depend on you and your child's goals and the extent to which you are willing to seek treatment.
Is Stimming Interfering With Your Life?
If stimming is an issue for you and it's starting to interfere with your life, it may be beneficial to speak to a therapist. When mental health and/or developmental concerns are already disrupting your life, though, it can be difficult to make time for an in-person therapy session. In this case, you may find online therapy to be a more convenient alternative. This type of remote counseling can be accessed anywhere you have an internet connection. Plus, you can make appointments when it fits your schedule, day or night.
This type of therapeutic treatment is research-backed, too. A comprehensive meta-analysis of studies showed that there is no significant difference between online and in-person therapy in terms of outcomes. The study included results from individuals experiencing a wide range of mental health challenges and illnesses.
A therapist can help you better manage your stimming and arm you with the tools you need to focus on matters of importance. If you are the parent of a child with stimming behaviors and this is negatively impacting your life, a therapist can help you process this as well.
Symptoms of ADHD and other mental health illnesses don’t have to control your life. A trained therapist like those from BetterHelp can help you learn to manage any undesirable symptoms such as stimming, for example. Together, you can plan for a healthier, happier future. Get started today.
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