To Stim or Not to Stim?

Please note that I originally posted this back in July of 2008 over at 5 Minutes for Special Needs. I figured it would be a good idea to share it here (along with a couple of edits). You can find the original post here.

Stimming has been a much-discussed topic in my home, at school, and at doctors’ and therapists’ offices. In the early days of Zoe’s diagnosis, we were instructed by doctors and therapists that stimming was a behavior that needed to be eliminated if our child was to function in a “normal” world. Over time we came to realize that Zoe’s stimming, as long as it wasn’t physically harmful to her, was very comforting to her. And as controversial a decision as that may be, we don’t have a problem with allowing Zoe to stim.

For those who are not familiar with it, stimming is a term that means “self-stimulatory behaviors.” It’s the type of repetitive behaviors often seen in autistic children (though I read somewhere that as many as 10% of non-autistics also stim)*. Autistics may stim in a variety of different ways, including (but not limited) to:

• Tactile: squeezing, clapping, hair pulling
• Vestibular: rocking, spinning
• Proprioception: teeth grinding, pacing*
• Auditory: humming, grunting, tapping
• Olfactory: smelling objects, smelling people
• Gustatory: licking, putting things in mouth
• Visual: lining up objects, hand flapping

My daughter likes tactile stimulation the most. Since she was a toddler, Zoe has enjoyed squeezing her hands together. She takes her right hand and squeezes her left thumb at the base of the finger—where the fleshy muscle lies at the palm of the hand. Occasionally she will also do some more vestibular-type stimming like rocking.

Our initial concerns were that Zoe was causing damage to her hands by this repetitive (and may I say forceful) hand-wringing. She was beginning to cause damage to her hands; we could see her wrist and fingers were starting to show signs of wear and tear. Not wanting to take her beloved stim away from her, we got her some therapeutic stim toys to help her. Now when she wants to stim, Zoe squeezes the toys instead of her hand; she gets the stimulation she craves without hurting her hands. Examples of therapeutic “stim-friendly” toys can be found at a few different sites. We personally like the ones we purchased at Abilitations, but do experiment with different types of fidget toys until you find the one that’s best for your child.

I sat down with Zoe to ask her why she enjoys stimming so much. Her response was, “Well, it feels good to my hands.” When I probed a bit deeper, she explained that many times she feels that her hands need to be touching something, not just hanging there on her arms. Zoe said that stimming helps her remain calm in stressful times, or in really loud places (which make her nervous). She also thanked us for buying her the squeeze toys she now uses, because “my hands used to hurt when I stimmed, but now they feel better.” Even though she was experiencing some pain, she was willing to live with the discomfort as long as she could continue getting the sensory stimulation she needed. Now she’s happy (and pain-free) and able to enjoy her stim, and we can feel more at ease about letting her enjoy it.  

We have also found that setting reasonable limits on her stim time helps. Zoe has become more adept at limiting her stimming time to certain portions of the day; for example, she has learned to avoid stimming while she is in class because it tends to keep her off-task and disengaged from her teachers and peers. Before and right after school she takes some time to get herself grounded, and that sometimes includes using stimming or other techniques to get her relaxed. It’s not always easy for her to stick to this, but she’s getting better at it all the time.

* You’ll noticed that I placed an asterisk next to the sections that talk about the non-autistics who stim and proprioception. I marked them because I must include myself in this category. My short, sharp teeth are proof of that.

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