Let’s discuss stimming as a target behavior, how it is something we ALL do, and when it is acceptable to intervene!!
When speaking with a behaviorist, you may wonder how target behaviors are chosen. There is a lengthy process during an assessment, but basically, we choose socially significant behaviors. These are behaviors that impact the child's life and functioning day-to-day. This also means that we choose behaviors that hinder the child's access to a better quality of life, such as family time, friends, school, social outings, etc. Socially significant behaviors can be something as serious as physical aggression, less dangerous such as pinching one's arm, or even less hazardous flapping of the hands. It truly depends on how invasive that behavior is and how much it hinders the person from accessing a better quality of life. For example, someone who is physically aggressive may get kicked out of school. We want to work on that behavior because it is dangerous to the person displaying the behavior of those around the person and blocking access to educational and social interactions. In this case, we would not work on hand-flapping (a form of stimming), and we would work on reducing physical aggression. It is always individualized, but I wanted to touch on stimming/stereotypy behaviors today and the stigma I have seen in the past.
Let's start with how to define stimming to understand better what it is by definition. Kapp et al. (2019) define stimming as "Stereotyped or repetitive motor movements' are characterized as core features in the diagnosis of Autism…". This definition does not include verbal stereotypy, but I also believe that scripting can be a form of stimming. Scripting is when a person repeats movie lines, songs, quotes, or specific phrases.
Let me give some background to my experience with this type of behavior…
I once worked in an Autism center. It is where I learned how to implement ABA. While working there, I came across a few different children who had stims that interrupted our therapy. Some were physical, but some were also scripting. Currently, I work with a client who uses scripting to cope, kind of like a way to process his emotions. Then, I have worked with children who use scripting to communicate what they are feeling or want to say. They will use movie phrases and lines from videos or songs to express their feelings. I believe that vocal stimming actually solidifies that stimming is used to help individuals process and/or express themself better.
Research suggests that stimming is a way for certain people to process their emotions. Even those who are typically developing have certain stims. Typical stims for those diagnosed with Autism are hand flapping, pacing, picking skin, and vocal stimming. Unfortunately, some children have Self-Injurious Behaviors that are stims and this can be dangerous for the individual. I, personally, play with the front of my hair when I get nervous. Others may start to pick their nails or fidget with jewelry.
I am a true believer that, as long as stims do not interfere with therapy, learning, or cause harm, it is essential to allow people to use them. Kapp et al. (2019) state, "Autistic adults, highlighted the importance of stimming as an adaptive mechanism that helps them soothe or communicate intense emotions or thoughts and thus objected to treatment that aims to eliminate the behavior." Let's listen to those who have lived/are living with the diagnosis and try to understand their experiences in navigating life with Autism. That being said, I believe that if the person wants to work on reducing a stim and can tell you that they want to work on it, then great! Create a goal and work towards it! We always want to remain person-centered. BUT… let us not forget socially significant behavior targets, as we discussed at the beginning of this blog. We want to take the time to make sure that we are focusing on behaviors that will have a significant impact on increasing the quality of life of a person receiving treatment. We must consider the person and their goals, but we must consider their safety above all else. If there are no behaviors that will hinder the safety of an individual, then I believe that working on stimming behaviors can occur safely.
A topic to expand on in the future, or for you to tell me your thoughts: I think stimming is the description of behaviors that we all use to process emotions, but some are just more socially acceptable than others. What are your thoughts about changing to a more accepted stim??? Instead of getting rid of stimming completely??? Let me know your thoughts!!
Reference:
Kapp, S. K., Steward, R., Crane, L., Elliott, D., Elphick, C., Pellicano, E., & Russell, G. (2019). 'People should be allowed to do what they like': Autistic adults' views and experiences of stimming. Autism, 23(7), 1782-1792.
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