What Is Stimming? ADHD And Possible Behavioral Issues
By: Nadia Khan
Updated August 17, 2020
Medically Reviewed By: Lauren Guilbeault
If you've heard of the term "stimming," it was likely in conjunction with 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 it has garnered attention primarily as a symptom of ASD, stimming is very common human behavior, and can be observed in people of all ages, backgrounds, and abilities, including those without any discernible disabilities or delays.
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 that are used to stimulate the senses. The most commonly seen forms of stimming, both in neurotypical people and in people with delays, include humming, swaying side to side, biting nails, biting the inside of the cheek, tapping fingers or toes, and rubbing the skin. Using these as a guide, you've undoubtedly seen someone in your life stimming, or have found yourself stimming in a moment of boredom or discomfort.
Stimming In Developmental Delays
While stimming is a natural response that is in no way unique to individuals with intellectual or developmental disabilities 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 as a way to regain control over a certain sensation or experience. This is especially common in sensory processing disorder.
Children who are overwhelmed by auditory input, for instance, might be found shrieking or shouting in response to a lot of auditory stimuli. Children who are overwhelmed by visual input may press against their eyelids to create stars in their eyes or move their eyes back and forth rapidly.
In the developmentally disabled, stimming is often more pronounced and exaggerated than the general population and is more likely to be loud, distracting, or different from the standard sources of self-stimulation. This is likely the reason why people typically associate stimming with delays and disabilities. Understanding the function of stimming in these individuals can provide insight into the experiences of individuals with sensory overload as well as into your own behavior and habits.
Stimming in ADHD
While ADHD is not necessarily accompanied by developmental disabilities or intellectual impairments, it is common to see children who have ADHD present with sensory difficulties. For that reason, ADHD stimming may be more akin to the type of stimming you see in a child with Autism Spectrum Disorder (ASD) or other developmental delays than it is to the behavior of typical peers. 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. All these behaviors are used to solicit some form of sensory input and may help people with ADHD quiet down some of the sensory systems that are prohibiting focus or creating unpleasant sensations in the body.
The Functions of Stimming
Stimming has multiple functions, depending on the person indulging in the behavior, and the environment the person is in. Self-stimulatory behavior, by nature, is designed to create a sensation in the body. The reasons for seeking sensation are unique to each individual, however, and can change from day-to-day. For some, stimming is used as a means of exerting control over a situation and redirecting fear or unpleasant energy. When this is the reason for stimulatory behavior, sensory overload is usually involved. Stimming is a form of control that will often appear in a more dramatic movement, sound, or behavior, such as rocking, jumping, or crying. All of these can help quiet an overloaded sensory system by taking the reigns and acting as the source of the feeling.
Some people stim to relieve 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 and is commonly seen in children with ADHD. 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.
Still, 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 a lot of effort or thought to create.
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. But when stimming begins to interfere with living a healthy, well-adjusted life, therapists, parents, and educators must intervene. This is very often the case in children with Autism Spectrum Disorder and is sometimes the case with children who have ADHD, which is also a developmental disorder.
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. Staring into space and failing to acknowledge or listen to an educator will impede a child's academic achievement. Similarly, stimming by humming or speaking over others will likely require intervention, such as applied behavioral analysis, as both of these behaviors can negatively impact a child's social behaviors and social skills.
Stimming in the Classroom
Stimming within the classroom will look different for each child, even if multiple children are affected by the same disorder. 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 both ADHD and sensory issues are far more likely to have larger 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 IEP or 504 plan is likely necessary to improve learning and encourage success in academics.
Stimming at Home
Stimming at home is unlikely to need the same level of assistance as stimming in school, but 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. Some may experience sensory issues and difficulty concentrating, which can make completing chores and abiding by parents' requests extremely problematic, leading 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. Children with ADHD very often experience sensory issues as well, which can exacerbate existing behavioral struggles and can alienate family members and peers. While stimming may initially seem to be problematic for children with ADHD, it can actually be useful for parents, educators, and therapists. The severity and prevalence of stimulatory behavior can help caregivers determine the extent of a child's sensory issues and can help identify the regions of the body and brain 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 seems almost cruel. For others, visible stimming functions as a source of alienation and indicates an area of need, so it has to be addressed and resolved. Whether your child with ADHD is experiencing sensory overload, or they are struggling entirely with the symptoms of ADHD, stimming is likely to come into play at some point in their treatment journey. Determining whether or not 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 go to seek treatment for undesirable behaviors.
If stimming is an issue for you and it's starting to interfere with your life, consider speaking to a therapist. BetterHelp is a great resource for any questions you may have about ADHD and stimming. Professional mental health therapists are also available to you from the comfort and privacy of your own home (or wherever you have an internet connection). A therapist will be able to help you better manage your stimming and arm you with the tools you need to focus on matters of importance.
For people with ASD or ADHD, different types of therapy can include social skills training and behavioral management through applied behavioral analysis, a method that can help meet the needs of each individual and promote positive and productive behavior changes and replace negative, maladaptive ones.
Clinical care in the form of medication can also be useful for keeping some symptoms under control and can reduce stimming too. Consult with a psychiatrist or your doctor at your local clinic or general hospital to see what options are available.
Below are some reviews of BetterHelp counselors, from people experiencing similar issues.
Vivian has been so warm and understanding through this process. I am new to therapy, but she made me feel so comfortable and never made me feel silly for anything I brought up. Having her to go to when I needed a listening ear has been more helpful than I could have ever predicted. She has taught me some new techniques that have brought me a lot of relief in my everyday life, and I am so thankful for her!"
"Jeni has such simple and direct ways of getting to the heart of the matter and such great suggestions for changing behaviors through acknowledging and understanding feelings. I found it especially helpful to write to her, and her written responses have been timely and to the point. I so appreciate being able to work with her."
Frequently Asked Questions
Is ADHD On The Autism Spectrum?
Attention-deficit hyperactivity disorder and autism spectrum disorder are two separate and unrelated mental health issues in the Diagnostic and Statistical Manual by the American Psychiatric Association, and therefore, ADHD is not on the autism spectrum.
However, they are both developmental conditions that can appear at a very young age and cause many challenges throughout adulthood without treatment.
Can You Stim And Not Be Autistic?
While stimming is very common with children on the autism spectrum, anyone can potentially stim, and many people do so out of boredom.
Is Clumsiness A Sign of ADHD?
People who stim might drift off and stop paying attention, and while being clumsy and unable to focus can certainly be common symptoms of ADHD, they aren’t necessarily indicators of the disorder.
There are different criteria that must be met in order to receive a diagnosis for ADHD, and while clumsiness and unrefined motor skills could be part of it, a doctor or psychiatrist must look at the complete picture.
What Are The 3 Types of ADHD?
Depending on which and how many symptoms an individual displays, a person who is diagnosed with attention-deficit disorder may be classified into one of three groups. These types of ADHD include:
- Inattentive type
- Hyperactive-impulsive type
- Combined type
If someone receives predominantly more symptoms that belong to the inattentive symptom cluster, they will receive that type, whereas if they mainly have hyperactive-impulsive symptoms, that is the type that they will get.
The combined type is the most common type that people get diagnosed with, and it requires that the patient meets 6 or more symptoms in each of the main clusters.
Keep in mind, though, these typings are not permanent, and ADHD symptoms can change over time, and child and adolescent care may also shift as well, which can then create more challenges when it comes to treating the disorder.
At What Age Does ADHD Peak?
While there is no definitive age where ADHD becomes most severe, the disorder is most commonly diagnosed between the ages of 6 to 12 years old, while they are in elementary school and past the developmental milestones. However, many will receive a diagnosis by the time they reach 8 years old.
Is ADHD A Form of Mental Illness?
When people think of the term mental illness, they imagine the most severe cases; however, mental illness is a very broad and general term to describe problems that affect a person’s way of thinking, their behaviors, and their emotions, much like the terms mental disorder or mental condition do.
ADHD is a chronic condition that can cause significant challenges in all of these areas, and while it might be upsetting to hear, especially for some parents, ADHD is a mental illness, and it requires treatment in order for improvements to be made.
Can You Stop Stimming?
You can’t, nor you should, stop stimming because it’s a completely normal behavior trait that everyone does; however, if it becomes problematic, assistance is available to help manage it.
In addition to working with a therapist, there are other strategies that can be used to help keep stimming under control such as adhering to basic routines, reduce triggers, and importantly, try to provide a calming environment that reduces stress.
It’s important to note that you should never punish someone who struggles with stimming because they may replace it with other maladaptive behaviors. However, replacement isn’t always a bad idea, though, and there are alternative methods for stimming behaviors.
Does Anxiety Cause Stimming?
In addition to various conditions like autism spectrum disorder, or attention-deficit hyperactivity disorder, anxiety can cause people to stim, and some of the most common ones that are done in response to it are tapping feet or fingers, nail-biting, and pacing, to name a few.
These types of repetitive movements and behaviors can help people cope with the anxious situations that they are in, but over time, they can develop into habits. Therefore, people who struggle with chronic anxiety disorders, as well as obsessive-compulsive disorder, may stem more often than others.
Is Playing With Hair Stimming?
Twirling and playing with hair is a form of stimming and many people do it while they are focused on something, such as listening and concentrating on someone speaking, or while they are bored and anxious.
Ultimately, stimming itself is not a bad thing and should never be regarded as such. Instead, stimming should be recognized for what it is: an outward display of an inward process that can provide clues as to what someone is feeling, thinking, and experiencing, even if they are not capable of putting those experiences into words. Interventions for stimming can vary from actual therapeutic interventions, like applied behavioral analysis, to simple at-home or in-school changes to a child's routine, usually depending on the amount of distraction and problematic behaviors the stim creates. Remember that everyone does this. If it's a concern or interfering with your daily life, there are tools to help you. Take the first step today.
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