Stimming: Understanding this symptom of autism
By Lori Smith, BSN, MSN, CRNP,Medical News Today
17 October 2017

Autism or autism spectrum disorder is a medical condition in which a person experiences certain social and communication challenges.These challenges may include things such as social, speech, and nonverbal communication difficulties, repetitive behaviors and learning differences.

Repetitive body movements or repetitive movement of objects is referred to as self-stimulatory behavior or stimming.

Although stimming is very commonly seen in those with autism, people without autism may also stim. Some people will stim when nervous, employing behaviors such as pacing, biting their nails, hair twirling, or tapping their feet or fingers.

What is stimming and why does it occur?
Repetitive body movements or repetitive movement of objects is referred to as self-stimulatory behavior or stimming. It may also be called stereotypy.

This type of behavior is common in those with autism and those with developmental disabilities or challenges.

Stimming can include the use of all the senses, including visual, sound, smell, touch, taste, and balance and movement.

The reason that stimming occurs is not fully understood. Some research suggests that stimming arouses the nervous system and provides a pleasure response from the release of certain chemicals found in the brain called beta-endorphins.

Beta-endorphins in the central nervous system are responsible for producing dopamine, which is known to increase pleasure sensations.

Some theories suggest that stimming may counteract a lack of sensitivity by stimulating the sensory system.

Others suggest that stimming may have a calming effect, focusing attention away from an overwhelming experience.

Stimming behaviors can provide comfort to people with autism. They can vary in intensity and type and can occur due to a variety of emotions.

Both children and adults with autism may stim occasionally or constantly in response to emotions such as excitement, happiness, boredom, stress, fear, and anxiety. They may also stim during times when they are feeling overwhelmed.

Examples of stimming may include the following:

Auditory stimming
Auditory stimming uses the person's sense of hearing and sound. It may include behaviors such as:

  • vocal sounds, such as humming, grunting, or high-pitched shrieking
  • tapping on objects or ears, covering and uncovering ears, and finger-snapping
  • repetitive speech, such as repeating song lyrics, book sentences, or movie lines


Tactile stimming
Tactile stimming uses the person's sense of touch. It may include behaviors such as:

  • skin-rubbing or scratching, with the hands or objects
  • hand movements, such as opening and closing one's fists
  • finger-tapping


Visual stimming
Visual stimming uses a person's sense of sight. It may include repetitive behaviors such as:

  • staring or gazing at objects, such as ceiling fans or lights
  • repetitive blinking or turning lights on and off
  • moving fingers in front of the eyes
  • hand-flapping
  • eye tracking or peering from the corners of the eyes
  • object placement, such as lining up objects


Vestibular stimming
Vestibular stimming uses a person's sense of movement and balance. It may include repetitive behaviors such as:

  • rocking front to back or side to side
  • spinning
  • jumping
  • pacing


Olfactory or taste stimming
Olfactory and taste stimming use a person's sense of smell and taste. They may include repetitive behaviors such as:

  • sniffing or smelling people or objects
  • licking
  • tasting objects by placing them in the mouth


Stimming may be shown in other repetitive behaviors, which should be discussed with a doctor. Some stimming behaviors may be hazardous.


Complications of stimming
While stimming is often not a dangerous behavior, it can have adverse physical, emotional, or social effects on some individuals.

For some, stimming can include higher-risk behaviors such as banging their hands, head, legs, and objects, which may be potentially physically harmful.

At times, this behavior is not stimming but a nonverbal method of communication that a person uses to make themselves understood. If a person behaves in this way, it is a good idea to speak to a doctor.

For some children and adults, stimming may interfere with their attention and learning abilities, as well as social interaction with others.

Unfortunately, for those who do not fully understand how people with autism cope with their emotions through stimming, this behavior can be upsetting, distracting, frightening, or dangerous.

Sometimes, this misunderstanding can lead to those with autism becoming socially isolated or restricted from doing what they want to.

Treatment options and tips for caregivers
Stimming is a behavior displayed by people with autism who employ it as a coping mechanism for particular emotions.

Stimming is thought to provide a pleasurable sensation and taking it away abruptly could have adverse effects and is not recommended.

To reduce the intensity and frequency of stimming, or even to stop the behavior, experts recommend slowly replacing the behaviors with others that are safer or more acceptable.

The replacement behaviors should also provide the person with the same pleasurable, stimulating, or calming experience.

Examples include:

  • placing the hands in the pockets or gentle finger tapping instead of hand flapping
  • chewing or biting a safe rubber object instead of fingers or an arm


There are other ways of managing or reducing stimming behaviors. These methods may include:

Medication use
Certain medications used in people with autism may be able to reduce stimming behaviors.

However, some of these medications have side effects. People should discuss the risks and the benefits of medication with their doctor.

How these medications control stimming is not fully understood. But, experts think that they may provide arousal or decrease motor movements.

Occupational and behavioral therapy
Certain behavioral or occupational therapies may help people with autism reduce or stop stimming behaviors. Applied behavioral analysis (ABA) is a method of treating autism through a system of reward-giving.

In some cases, occupational therapy may be helpful. It may be recommended to help develop the appropriate responses to certain senses, such as sound and sight.

Speaking with a qualified healthcare professional will be helpful to work out what recommendations are most appropriate.

Environment modification and practice
If there is a known trigger that begins or worsens stimming, it may be helpful to try to remove or alter the situation to reduce anxiety and stress.

For example, if large crowds tend to make a person anxious and their stimming behaviors increase, they could try keeping to less crowded environments when possible.

If it is impossible to stop stimming entirely, it may be possible to change the activity to something more appropriate.

For example, if a child flaps their hands when stressed or anxious, encouraging them to squeeze a stress ball or a soft toy rather than waving their arms about may be a more appropriate option.

It may even be possible to encourage the person to do the repetitive behavior only when they are in a safe environment, such as in their home or the home of a loved one.

With the current advances in therapies for autism, families do not have to face these challenges alone. Speaking to a doctor or another health professional can help determine the best method to address stimming.