Restraining Self-Stimulatory Behavior

What is the current (or what are the current trends in) research about self-stimulatory behavior and intervention? I read somewhere that you should not physically restrain a child during the activity, but that you should work to refocus his/her attention, maybe through another sensory activity, etc. I'm thinking that I must be up against a difference in treatment perspective here.

Background: We don't interrupt stimming unless it is self-injurious or dangerous to others in the area (sometimes he knocks on people's heads out of frustration, though I wouldn't classify this as stimming). The school folks, however, do interrupt the behaviors, and now our son is lashing out at them.

I don't want to steer them wrong, but I don't want to undo the work we've done at home and in our church relations, where the "ignore and reward" system and the sensory systems of treatment seem to be working well alongside the ABA treatments we've got going.

Any help with where to find articles on this?

Hi, Sonja, and welcome to the IAN Discussion Forums.

Unfortunately, much of the medical literature focused on repetitive behaviors and restricted interests in children with ASDs laments the lack of research on what specific approaches work with which specific types of behavior in children with which specific type of ASD, leaving those implementing treatments with little concrete guidance

I am not an expert in ABA or behavioral interventions, but I believe that in practice, behavioral interventions are often based on what the function of the behavior is perceived to be. Is a child stimming to comfort himself because he's stressed? To help regulate himself because he can't otherwise? To escape an unpleasant task? To get attention? How an expert chooses to intervene is often based on his or her belief about the function of the behavior. How well the expert guesses, in turn, may be influenced by how well he or she understands ASD.

There is some evidence, for example, that boys with ASD engage in disruptive behavior to escape demands that interfere with repetitive behavior or to escape negative sensory experiences more often than children with other types of developmental delays. (These other children, as well as girls with autism, more often engage in disruptive behavior to escape demands in general or to get attention.) See "Functional Characteristics of Disruptive Behavior in Developmentally Disabled Children with and without Autism" by Reese and colleagues in the Journal of Autism and Developmental Disorders, Vol. 35, No. 4, August 2005.

One thing that might be helpful for any parent stuck between different institutions with different philosophies or opinions is to ask to have those philosophies spelled out. If an ABA or Occupational Therapy program instituted certain practices, ask to understand their rationale for that, along with supporting articles or write-ups, not to mention your own knowledge of what has worked. Ask for the school's philosophy and practices, too. At the very least, you will discover if one group has support for their position while the other is simply on auto-pilot. You will also understand what other concerns may be driving matters, such as a belief that the behaviors are preventing your child or other children from learning, etc. In any case, understanding the basis of each institution's philosophy may help you to bridge the gap between, become clearer on your own position, and advocate for the approach you believe best with whoever is least in line with that approach. It may also open up a helpful dialogue between different groups working with your child, allowing them to pool their observations, concerns, and insights.

Thanks so much for your quick reply. I'll read the article you brought up and have a long talk with the teachers and specialists in our program.

Thanks again--I really appreciate the collective here. Finding all of the research on my own was quite taxing before IAN came along.

Thanks Sonja.

I hope other parents will use this forum to share their experiences. What "stimming" behaviors does your child engage in? What purpose do you think this stimming serves, and how have you intervened? What has worked for you? What has not worked?

My son stims constantly. Most of his behaviors are thought to be just that, Self-stimulatory. I have been advised by our behavior specialist that we should focus on the most dangerous behaviors first and move down the list. He flaps, makes shapes with his fingers in front of his eyes, drops things in front of his eyes (pencils, pens, coins, basically anything that has more than 3 items), he also hits his head, arm, and thighs with his fist(sometimes this is from frustration, but most of the time he actually calms when he hits himself). The hitting is what we are working on now, the rest we aren't worried about, at least for now. Let's face it, we all stim to calm ourselves, whether you chew on a pencil, tap your foot, twirl your hair...)

Mainly we look at the stims that are strictly for the sensory input and decide if they are a danger to him, others, or property, if not, we let him go.

Connie and fullhouse,

Thank you both so much. I really appreciate you both. My son's stimming seems similar to what you describe, fullhouse, and we occasionally have to intervene with the knocking on his and other's heads with the closed fist.

I have talked with his teachers and therapists at school and have a better picture now of what's going on when they intervene. They are seeing him move to stimming activity to avoid (or delay) the requested activity or behavior, so they are intervening to redirect him to the activity. They then allow him to stim for a few moments once he has completed the task.

They have included in his IEP, however, the dismantling of certain of his stimming activities that I see as minimally worrisome--hand flapping and jumping up and down. I figure that we have plenty of time to work on those issues later--they aren't so terrible right now that they interfere in his ability to be accepted by other children. I'd rather spend our time and energy on getting the open exchange of ideas going with him (get him more verbal, or at least fluently signing).

Thanks again for joining the conversation. I really do appreciate it.

hello my name is nina i am new to the autism world but my son does different stimming and i dont think its natural so when i see him do that i tend to stop him...... any advice with this?

Hi zandersmom, and welcome to IAN.

As you see in the posts above, it can be rather complicated to decide if, when, and how much to interfere with a child's stimming. As you work with professionals to figure out your son's behavior, it's important to try to understand the function of the behavior. It's also important to figure out how benign or destructive it may be. For example, a child who is injuring him or herself --say, by smashing their head against a wall or biting their arms-- has to be stopped, no matter what the function of the behavior is.

When the behavior is not destructive, as I said in a post above, it's up to a treatment team and parents to figure out what the behavior is about. If the behavior is self-soothing, it can even be used as a reward. (If a child loves to pet a toy doggie over and over, maybe they can have the doggie after finishing a certain task.) If it's purely for attention, the approach may be different - generally, most behavioral experts would encourage NOT rewarding a negative attention-seeking behavior in order to eliminate it.

In practice, it's hard for parents to balance it all out. For example, my child, a 13 year old with Asperger's, soothes himself by inventing entire worlds out of legos, talking to himself about those worlds while pacing about the room, etc. How much do I let him do this? How much do I try to interfere? It comes down to trying to figure out what a healthy balance is - pushing involvement and tasks in the Real World yet permitting enough of the soothing "down time" which makes him so happy and content. Again, evaluating the helpfulness/destructiveness of the behavior and trying to eliminate it or permit it to a helpful (but not unhealthy) extent is the tricky part.

It is definitely useful to ask for the input of your treatment team, as well as teachers and others who observe your child often, to try to figure this out and respond accordingly.

I have asperger's syndrome which is a form of autism. From my personal experience stimming is for pleasure and as a way to cope with stress.

I want you to imagine the best back massage you have ever gotten, and if you have never had a good one just pretend you have

So it feels so good, you don't want to stop and that is how it is with stimming it gives pleasure, its relief from stress. Even NTs (neuro typical) like yourself stim, have you ever rubbed your temples when headache or migraine?? If you have that is stimming everyone stims it is normal human behavior. .

If your son is hurting himself or others or breaking the issue needs be addressed promptly and properly. There is no way to get rid of stimming or the root autistic type stimming.

I understand why your son is lashing out. I want you to imagine your at work and you have the worst migraine in the world you feel like your about to die from pain. So you start rubbing your temples to get some relief and your boss comes in and tells you that you cannot that because its not an acceptable behavior. This is what your son is facing when they say no you cannot do that. It is horrible feeling when your not doing anything wrong your trying to calm down, or feel pleasure and someone tells you that what your doing is wrong.

Your the parent your in charge you know what is best for your son. Your son is lashing out that means there is a big problem at the school not with your son but the people working with your son. I am not saying this to scare you or anything of that nature but lashing out delays positive breakthroughs. I know your son's autism and mine are different but I lashed out as well and it slowed my emotional growth down a lot. This is an issue that needs fixing as so as possible.

I wish you all the luck in the world, and I am so sorry I can't be of any more help.