I Love ABA!

Welcome to my Blog!

This blog is about my experiences, thoughts, and opinions on ABA. My career as an ABA provider is definitely a passion and a joy, and I love what I do.

This is a personal blog: The views and opinions expressed here represent my own and not those of the people, institutions, or organizations that I may be affiliated with.

Monday, October 10, 2011

To Stim, or Not To Stim; THAT is the Question......

To be or not to be? No, actually a very popular question I get asked is: "To stim, or not to stim??"



Self stimulatory behavior, aka "stimming", can take many forms and can be quite frustrating to parents and caregivers.  Self stimulatory behaviors refer to repetitive behaviors which are enjoyable to the child and serve to calm or awaken their body and central nervous system. Unfortunately when most children with an ASD stim they are also completely shutting out the outside world and tend to not respond to demands, requests for eye contact, and sometimes even touch. I often will say "Ohhhh, you just went on vacation didn't you?" when one of my clients starts stimming and trying to tune me out.


Not all children on the ASD spectrum have stimming behavior to the degree that it interferes with learning. However, many children do.  If your child is stimming during social or instructional times these behaviors can be very persistent, hard to ignore, and stigmatizing. Examples of the more common stims include:

  • Rocking, spinning, hand flapping, mouthing items/objects, lining items up, spinning items, dropping items to watch them fall, verbal stims such as squeals, shrieks, or scripting scenes from favorite TV shows, visual stims such as staring at objects, or flicking eyelashes, saliva play, tearing or ripping paper into tiny pieces
Many parents feel they don't want their child to stim at all. Other parents feel they want their child to know when to engage in stims and when not to. A long time ago I attended a training about stimming and I remember the presenter stating that you should never completely get rid of any stim. I agree completely. This is because the stim serves a purpose to the child, and if you extinguish their ability to stim they may find a replacement behavior which is worse ( you wont let the child flap her hands, so she begins chewing on her fingers). Just imagine that your way of de-stressing after a long day is to have a warm bath and listen to music and everyday a therapist stops you right as you go to turn on the bathtub faucet and says "No. Hands Down". How would you react to that??

I don't recommend completely removing a stim. Yes, I understand stimming can be very trying on a parent and also difficult to handle in public. However if you determine the function of the stimming  then you can simply teach a more appropriate way for the child to calm or alert their body. There are two different ways I do this when working with a child:

  1. At the table- If I am in the middle of or about to start a session and the child begins to get stimmy, I see that as a red flag. It is almost as if the child is holding up a sign that says "You're losing me!". I know that I need to switch up what I am doing, let the child stand, kneel, move around, hold a fidget, I should talk louder, faster, etc. I see that as a sign that something I am doing is not effective in that moment. If my teaching, instructional control, and reinforcers are all strong, then that child would have no reason to engage in stimming. The one I see the most often is verbal stimming. I will be going through a program and the child will start singing, making noises, or scripting a TV show. This is a clear attempt to literally "tune me out". When this happens I change what I am doing to grab the child's attention back. Quick note: I do not like to gain a child's attention by grabbing their face, or making statements like "Look at me", or "Pay attention". I see many therapists do this, and I would rather gain attention in a more natural way. For example if the child starts to get lost in a world of stims I will begin to move through programs very fast, or I will lower their VR so they begin to contact reinforcement much more quickly.
  2. Away from the table- If I am not in session and a child begins to stim or go into their own little world, I use redirection to pull them out of that. Obviously every minute of every day you will not be able to redirect your child. But as much as you can make sure they are moving from one activity to another throughout their day. This is when leisure skills such as knowing how to appropriately interact with a book or toy come in handy. If you are busy cooking dinner you can set up a very basic activity center for your child with 2-3 books, and 1-2 puzzles, and continue to redirect them to this area as needed. Reinforce them for staying on task and being appropriate. This example assumes that your child stims due to under-stimulation or boredom. Your child may differ. It is important to determine the function of stimming for your child. Some children stim when they are bored, some when there is too much activity/noise/chaos around them, some stim if it is too loud, some stim if they are tired, and on and on. Every child is different.

Lastly, a large step towards viewing stimming as commonplace and not an annoying habit to extinguish in your child is to realize that Everybody Stims! Really, they do. The next time you are standing in line at the bank, or waiting at a stoplight, look at the people around you. Do you see someone twirling their hair? Thats a stim (I do that one). Do you see someone tapping their foot? Thats a stim. What about humming to themself? Thats a stim.
If you are able to view stimming as common and typical, then its very likely your patience and tolerance towards this behavior will increase.

 I must add that many parents are okay with their children stimming and do not wish to remove or reduce this behavior at all. That is fine. Decide as a parent what you feel is best, and express that to the ABA therapists.

*UPDATE: After reading this post, a very sweet young lady contacted me to share her opinions about stimming. Her name is Tracy, and she has ASD.  I think her words really put some perspective to this stimming issue:

"I enjoyed your post on stimming. I like so much how you tell how everyone does it, and the analogy of a neurotypical person not being allowed a hot bath at the end of the day. Not being allowed to stim would sometimes be very much like this. Other times, it would be more like not being allowed to smile when I am happy. It's interesting to hear a neurotypical perspective: when we stim you feel we're in our own world. This is sometimes true....sometimes stimming helps me concentrate. Actually, stimming almost always helps me concentrate, just not always on the thing I am supposed to be concentrating on! :) When I spin around and flap, though, I don't feel like I'm in my own world. I feel like the I am surrounded by the world, held by the world, and my hands are moved up and down by what is the rhythm, the essence of the world. I stim to get the magical feeling of connection you might feel in the redwoods. True, this does sometimes require less being-with-people, but the world is just so magical and so wonderful and whole that- I don't know. As a spur of the moment choice, and as a conscious choice, I think my limited time is better spent spinning than small-talking. Stimming is also catharsis. You're right, it can be used when bored...... and it is a wonderful way to order the world in the midst of sensory overload."

4 comments:

  1. I am waiting to be interviewed for an ABA therapist position and your posts are so helpful and informative. I feel I will go into my interview more confident!

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    Replies
    1. Well thank you, and good luck on your interview!

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  2. Eloquently stated!
    go aba!

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