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The Child with Unusual Behaviours - Self Stimulation

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Everyone requires and can be rewarded by different amounts and types of stimulation. Our bodies function normally by maintaining a number of systems in a balanced state called homeostasis. This balanced state affects our heart rate, blood pressure, temperature, breathing and internal levels of stimulation. If a child or adolescent experiences too much stimulation, this results in stress to the body. Too little stimulation can result in sensory deprivation, from too little input. Studies suggest that in order to function well we need a balanced level of stimulation that is neither too high nor too low. Children and adolescents experiencing problems in this area have difficulty regulating and managing these levels of stimulation. These individuals at times seem compelled to seek sensory stimulation.

All human beings have self-stimulating behaviours; for example, we click our pens, play with coins in our pockets, rock our feet, or twirl our hair. We do not know why the human body is so dependent on such behaviours but it likely has to do with regulating our bodies to either calm ourselves or to arouse ourselves. However, there is a difference between the behaviours we display and can control and those that appear to be outside an individual's control. There is also a difference in how the stimulation is obtained. In a typical child or adolescent, stimulation is obtained through typical verbal, social, work, leisure and recreation activities. Children and adolescents with developmental disabilities may seek stimulation through repetitive and stereotypic behaviours, which are referred to as self stimulation.

Mild self-stimulation in children and adolescents may not be reason for concern. However, in those with developmental disabilities such as autism spectrum disorders, self-stimulation may occupy large segments of the day.

Some parents ask, why not allow the child to continue the self-stimulating repetitive behaviors? The reason is that such behaviours will not lead to social integration and acceptance. If the behavior will increase the social gap between the child or adolescent and his or her peers or interfere with independent self-sufficient functioning, then it is a behavior that should be targeted for change so that the child or adolescent is more so a part of their social world.

Examples of self-stimulating behaviours:

Visual
  • staring at lights
  • opening and shutting doors
  • spinning the wheels of a toy car
  • flicking objects
  • repetitive blinking
  • moving fingers in front of the eyes
  • hand-flapping
Auditory
  • tapping ears
  • snapping fingers
  • making vocal sounds
  • covering ears in an attempt to block stimulation
  • echoing other people's speech
  • humming

Tactile
  • rubbing the skin with one's hands or with another object
  • scratching
  • skin picking
  • touching parts of the body repetitiously
  • sifting sand
  • hair twirling
  • tearing paper repetitiously
  • nail biting
  • tapping

Vestibular (sense of balance)/Movement
  • rocking front to back
  • rocking side-to-side
  • leg swinging
  • pacing
  • hand flapping
  • jumping repeatedly on the spot

Taste
  • placing body parts or objects in one's mouth
  • licking objects
  • mouthing objects repetitiously

Smell
  • smelling objects
  • sniffing people.

Self injurious behaviours
  • eye poking
  • head hitting with fist
  • self-biting
  • head banging
  • thigh slapping
  • hair pulling
  • self scratching/pinching
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Children who are under-sensitive to some sensations tend to seek out those sensations, while children who are over-sensitive to some sensations have a tendency to avoid those sensations. The following examples show how these children react to different sensations
 
 
Under-sensitive Child
 
Over-Sensitive Child
Movement:
- The under-sensitive child seeks out movement by running backwards and forwards
- Seeks sensory input
Movement:
- The child who screams and refuses to go in an elevator may be over-sensitive to movement. Their behaviour reflects their strong desire to avoid movement
 
Touch:
- The under-sensitive child may become upset when you hug them
 
Touch: 
- The over-sensitive child may lean against another person
 
Vision
- The under-sensitive child may seek sensory input by wiggling his fingers quickly in front of his eyes, flicking the lights on and off, looking at objects from an unusual angle, and watching repeated movements.
 
Vision:
- the over-sensitive child may dislike lights and turn them off
 
Smell:
- The under-sensitive child may do odd things such as smelling others.
 
Smell:
- The over-sensitive child may be sensitive to strong smells such as cleaning products or perfume.
 
Taste:
- The under-sensitive child may like spicy and salty foods. Parents report their over-sensitive children enjoy strong yeast products such as marmite.
- The child may lick objects.
 
Taste:
The over-sensitive child may be very fussy about food and show a preference for foods with uncomplicated taste. The child may only eat foods that can be presented separately on the plate and refuse to eat dishes that combine vegetables and meat.
 
 
 
 
 
 
When any self-stimulatory behaviour interferes with the child’s ability to pay attention to their environment and participate in meaningful activities, there is cause for concern. In early childhood, children learn from play and interactions with others. If your child’s self stimulatory behaviours prevent them from interacting with you and others or playing with toys in an interactive way, look in the Course to Follow section in this chapter to see many ways you can help your child to decrease these behaviours and increase their participation in meaningful activities.


  • Young children may engage in a variety of repetitious behaviours.
  • They may repeat what their parents tell them more than once, at least for a short period of time. They may flap their hands in the air when excited. They may jump up and down or run to and fro when happy or upset.
  • As well, they may nail bite, scratch, tap surfaces, hum, and so on. They may also lie on the floor, kick their legs and engage in mouthing or other repetitious behaviours.
  • To the extent that these behaviours appear infrequently, last for short periods of time and are associated with specific mood states, they should not be considered alarming. Jean Piaget, the father of developmental psychology, described these behaviours in his own infants and toddlers, calling them "primary", "secondary" and "tertiary circular reactions". The children engaged in them in an attempt to make interesting things last longer, and hence to master them.
  • However, the form these behaviours take is important in deciding how worrisome they may be. Hair twirling, nail-biting, leg swinging and jumping on the spot are certainly mild self-stimulatory behaviours that need not alarm us. They tend to be transient and will likely end on their own or may be replaced by other such mild self-stimulatory behaviours in some children.
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  • When self –stimulatory behaviours prevent young children from interacting with adults, playing beside or with peers, focusing on and participating in an activity, and/or are disruptive to others or are a result of your child becoming agitated, these would be Yellow Light behaviours that warrant your concern.
  • An example of such behaviours is the child who is very active, runs backwards and forwards, twirls, and jumps for significant periods of time. At home and in preschool these behaviours would prevent the child from engaging in meaningful activities. A further example is the child who flicks the pages of a book and moves the book quickly in front of his or her face while he or she stares at the pictures.
  • Sometimes self-stimulatory behaviours occur when the child becomes aware of a change in an activity or their routine. Picking at their skin, tearing up paper, and flicking their fingers in front of their eyes are self-stimulating behaviours that may be an indication that your child is anxious about the change in activity.
  • Self-biting, rocking, head banging, and covering ears are behaviours that need to be monitored as to their frequency and intensity as well as the child's ability to control them.
  • Such behaviours are not common in typical children, unless the child is under some stress or feeling of uncertainty. Even then, the behaviours should be reduced or completely eliminated when the stress is no longer present.
  • If the behaviours continue, are frequent or intense, and are displayed along with other problems at home and/or at school, they become of concern. They certainly need to be followed up, particularly in children who have other problems such as developmental delay or difficulty in focusing attention.
  • Such behaviours may themselves be a sign of the possible presence of mental health issues in the child. In addition, children with self-stimulatory behaviours are at risk for having difficulties in relating to peers, accepting change, or using language and communication effectively.
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  • Children who engage in extensive self-stimulation, particularly if it involves self-abuse, ear covering, rocking, spinning, twirling and head-banging are certainly in need of careful monitoring.
  • Such children are likely to present some major mental health and adjustment issues, and require immediate attention.
  • Their behaviours are likely to become more noticeable with time, and to be increasingly likely to be visible to others.
  • Children who display self-stimulatory behaviours may themselves be oblivious to their actions and ignore the reactions of others to them. As a consequence, they do not attempt to control their self-stimulatory behaviours.
  • It is unlikely for them to be embarrassed or upset when others appear aware of their self-stimulation.
  • When self–stimulatory behaviours increase in intensity and prevent young children from interacting with adults, playing beside or with peers, focusing on and participating in an activity, and/or are disruptive to others or are a result of your child becoming agitated, these would be behaviours that warrant your concern.
  • An example of such behaviours is the child who is very active and spends a significant amount of the day running backwards and forwards, twirling, and jumping. At home and in preschool these behaviours would prevent the child from engaging in meaningful activities. A further example is the child who seeks to spend as much time as he or she can flicking the pages of a book and moving the book quickly in front of his or her face while staring at the pictures.
  • Sometimes self-stimulatory behaviours occur when the child becomes aware of a change in an activity or their routine. Picking at their skin, tearing up paper, and flicking their fingers in front of their eyes are self stimulating behaviours that may be an indication that your child is anxious about the change in activity. If this occurs at most transitions then it would be Red Light behaviour.
  • If a child is on medication, such behaviours may intensify when the medication is withdrawn abruptly and without the necessary precautions on the part of the parents or attending professional. It is therefore important to alert others to the appearance of such behaviour in a child who is known to be on medication.
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  • Children in this age range may display mild forms of self-stimulatory behaviours that are of short duration, low intensity and can be easily brought under voluntary control by the child.
  • These behaviours are likely to be mild self-stimulations, such as leg swinging, hair-touching or twirling, nail biting, tapping, and mild body-rocking, or face-touching. They would not involve self-harm such as self-biting, head banging or banging repetitiously on objects.
  • Because mild self-stimulatory behaviours can cause embarrassment, particularly for the older children in this broad age group, these behaviours would not likely be in evidence when others are around. Children who suppress such behaviours in the presence of others are showing that they are able to monitor themselves and control the behaviour in question. This is a good sign.
  • The self-stimulatory activities of children in this group are likely to be transient and to stop on their own without requiring intervention, or to be replaced by other mild self-stimulation. This is more likely the case when the child is happy at home, doing well at school and has no peer-related difficulties.
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  • Some forms of self-stimulation for this age group may become worrisome when they are of relatively long duration, intense and only partially under the child's control.
  • The form of the self-stimulation is also relevant. For example, a rare expression of repeating sounds or words, biting oneself, rocking, head-banging, hand-hitting and covering of ears needs to be watched. It may be just a single occurrence, or it may have occurred a few times but be starting to decline in frequency. But if the behaviour is increasing in frequency, parents should closely monitor the situation. The behaviour could be associated with a major mental health problem, and the child will need attention and assistance.
  • Self-stimulation that goes along with communication problems, difficulties interacting with peers, and rigid behaviour, is particularly worrisome. In this case, parents would also likely observe school difficulties and peer-related problems as well as varying degrees of cognitive impairment.
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  • When self–stimulatory behaviours increase in intensity and prevent children from interacting with adults, interacting with peers, focusing on and participating in an activity, and/or are disruptive to others or are a result of your child becoming agitated, these would behaviours that warrant your concern.
  • An example of such behaviours is the child who is very active and spends a significant amount of the day running backwards and forwards, twirling, and jumping. At home and in school these behaviours would prevent the child from engaging in meaningful activities. A further example is the child who seeks to spend as much time as possible flicking the pages of a book and moving the book quickly in front of his or her face while staring at the pictures.
  • Sometimes self-stimulatory behaviours occur when the child becomes aware about a change in an activity or their routine. Picking at their skin, tearing up paper, and flicking their fingers in front of their eyes are self stimulating behaviours that may be an indication that your child is anxious about the change in activity. If this occurs at most transitions then it would be Red Light behaviour.
  • Self-abusive behaviours such as head-banging, head hitting or hand banging, rocking, ear-covering, biting oneself, producing sounds in a repetitious manner and flapping, particularly a combination of a number of these, would be particularly worrisome.
  • These behaviours are usually combined with problems at school and difficulties in peer relationships, and herald the presence of serious mental health problems in the child.
  • Such behaviours generally have a history going back to early childhood. On rare occasions, however, they may appear for the first time in children of this age group. A child might start behaving this way for a number of reasons such as the presence of seizures or a major psychological stressor.
  • It is also possible that the behaviours might have been present from earlier ages but are becoming worse with time because not enough attention has been paid to them. When these problems are accompanied by cognitive and communication difficulties, it signals the need for immediate action in the form of referral to mental health agencies.
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  • Young adolescents may show some mild forms of self-stimulation, some of them specific to this age group.
  • Concern about acne, body structure and body weight may become more common at this stage. This can contribute to stress, leading to nail biting and face-touching or other mild repetitious behaviours.
  • Intensity, duration and ability to control the self-stimulation should be taken into account in deciding whether it should be of concern.
  • Because of their potential for embarrassment, most such behaviours are not generally overt and obvious to others. Behaviours such as pimple squeezing and repeated face-touching would be most likely practiced in private by the youth. They are likely not to interfere with the youth's academic or social activities.
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  • When self-stimulatory behaviours increase in intensity and prevent youth from interacting with adults, interacting with peers, focusing on and participating in an activity, and/or are disruptive to others or are a result of your youth becoming agitated, these would behaviours that warrant your concern.
  • An example of such behaviours is the youth who is very active and spends a significant amount of the day running backwards and forwards, twirling, and jumping. At home and in school these behaviours would prevent the child from engaging in meaningful activities. A further example is the youth who seeks to spend as much time as possible flicking the pages of a book and moving the book quickly in front of his or her face while staring at the pictures.
  • Sometimes self-stimulatory behaviours occur when the youth becomes aware of a change in an activity or their routine. Picking at their skin, tearing up paper, and flicking their fingers in front of their eyes are self stimulating behaviours that may be an indication that your youth is anxious about the change in activity. If this occurs at most transitions then it would be Red Light behaviour.
  • Self-stimulation that is of relatively long duration, is intense, and particularly when it involves specific self-abusive behaviours, needs observation and monitoring.
  • Rocking, head-banging, hand hitting, covering ears, engaging in the same behaviours repeatedly and non-functionally, without an obvious purpose, over short periods of time should alert parents to the need for ongoing monitoring.
  • These behaviours are likely to co-exist with other difficulties such as poor peer relationships and school problems.
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  • Self-stimulation that is intense, enduring and interferes with the youth's academic, communication and social activities needs immediate attention. This is particularly the case when the stimulation is not under the youth's control, is ongoing and is made worse by stress. Examples are: head banging that is intense, biting oneself, hitting hard with the hands on solid objects, covering of ears, rocking, and spinning uncontrollably.
  • Youth who fit this description are likely to have shown such behaviours in the past; it would be extremely rare for such behaviours to develop in early adolescence. The behaviours may be ongoing and appear to provide some relief to the youth when he or she is engaging in them. Repetitive behaviours can help a youth reduce feelings of stress and relax in the predictability of the routine. For example, the person who rocks while sitting, reading, or in class may find this comforting, not unlike those who enjoy sitting in a rocking chair to watch television. The behaviours are likely to re-appear after adults make attempts to have the youth suppress them.
  • The behaviours may be ongoing and appear to provide some relief to the youth when he or she is engaging in them. They are likely to re-appear after attempts at suppression by others.
  • There is no embarrassment evident, and the youth engages in the behaviours instead of the usual activities and academic interests expected of young people this age.
  • If your youth has been taking medication, parents will want to discuss with their child’s physician whether the young person is undergoing any kind of medication withdrawal.
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All early adolescents will self-stimulate. A portion of these youngsters will have behaviours which cause concern. Parents should be discussing their concerns with their son or daughter and mental health professionals to determine which ones to address, and how to do so.

The self-stimulating behaviours in adolescents are similar to those at all other age groups. For some, the behaviours are mild and do not interfere with the life and learning of the adolescent (e.g., twirling hair, rocking legs, clicking pens.) Those are the types of behaviours seen in typically-developing human beings. It is not uncommon to be speaking with another person and note that either they or yourself is rocking from foot to foot, playing with a pen, or playing with their hands. Many typically developing people have fidget toys such as worry-beads, a bracelet that they twirl around their wrist, or a ring that they twirl around their fingers. Adolescents may make fun of each other for having such behaviours, but they all have them.

However, there is a group of adolescents for whom self-stimulating behaviours are excessive and interfere with daily living. Usually, such excessive behaviours are seen in those with developmental disorders such as autism spectrum disorder or developmental disability. The adolescent may rock their body, pick at their skin to the point of drawing blood and scarring the tissue, spin objects, flick their fingers in front of the window in an apparent intent to watch the light between their fingers, repeatedly flick light switches or open and close doors, and/or a myriad of other similar behaviours.

Many adolescents will masturbate. Typically developing adolescents know where and when to engage in this very satisfying behaviour. Those with developmental disorders are not likely to be aware of how such behaviour is perceived by others and are more likely to engage in masturbation in public. This is extremely disconcerting to teachers, peers and parents and is a behaviour which must be addressed by teaching the adolescent where and when they can masturbate.

It is generally believed that any self-stimulating behaviour can be stopped through the use of behavioural strategies. However, it is also generally believed that when the behaviour stops it is replaced by another one which may be even less socially acceptable. Therefore, when observing self-stimulating behaviours, parents must determine which ones they can live with and which ones must be stopped. They must consider the function of the self-stimulating behaviour and determine if there is another behaviour they could teach the adolescent which might serve the same function in a more socially acceptable way. For example, it is not reasonable to teach the adolescent that they can never masturbate. It may be reasonable to teach them that they can do so in the privacy of their own bedroom. It may not be reasonable to tell them they can never rock. It may be more reasonable to expect that they use a rocking chair.

  • Adolescents may show some mild forms of self-stimulation, some of them specific to this age group including masturbation in private settings.
  • Concern about acne, body structure and body weight may become more common at this stage. This can contribute to stress, leading to nail biting and face-touching or other mild repetitious behaviours.
  • Intensity, duration and ability to control the self-stimulation should be taken into account in deciding whether it should be of concern.
  • Adolescents are generally quite good at hiding their self-stimulating behaviours for fear of being ridiculed by their peers. Behaviours such as pimple squeezing and repeated face-toughing would be most likely practiced in private by the youth. They are likely not to interfere with the youth's academic or social activities.
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  • Self-stimulation that is of relatively long duration, is intense, and particularly when it involves specific self-abusive behaviours, need observation and monitoring.
  • Rocking, head-banging, hand hitting, covering ears to avoid noises, engaging in the same behaviours repeatedly and non-functionally (without an obvious purpose) over short periods of time should alert parents to the need for ongoing monitoring.
  • These behaviours are likely to co-exist with other difficulties of an academic and social nature. The more stressed the adolescent is, the more likely such behaviours will increase in intensity.
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  • Self-stimulation that is intense, enduring and interferes with the youth's academic, communication and social activities needs immediate attention. This is particularly the case when the stimulation is not under the youth's control, is ongoing and is made worse by stress. Examples are:
    • head banging
    • self-biting
    • hitting hard with the hands on solid objects
    • covering of ears
    • rocking
    • spinning uncontrollably
  • Youth who fit this description are likely to have shown such behaviours in the past; it would be extremely rare for such behaviours to develop in adolescence. The behaviours may be ongoing and appear to provide some relief to the youth when he or she is engaging in them. Repetitive behaviours can help an adolescent reduce feelings of stress and relax in the predictability of the routine. For example, the person who rocks while sitting, reading, or in class may find this comforting not unlike those who enjoy sitting in a rocking chair to watch television. The behaviours are likely to re-appear after others have attempted to suppress them.
  • There is no embarrassment evident, and the youth engages in the behaviours instead of the usual activities and academic interests expected of young people this age.
  • If the adolescent is ending or changing a medication, any new behaviours should be discussed with the prescribing physician.
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All adolescents will self-stimulate. A portion of these young people will have behaviours that cause concern. Parents should be discussing their concerns with the adolescent’s teachers to determine which ones to address and how to do so. Back to top

Explanations as to what may lie behind self-stimulation are the same regardless of age. Therefore, this section relates to all age groups.

We are still unclear as to why self-stimulation occurs. There are a number of views about its possible origins and function.

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  • Research suggests several biologically-based reasons a child or adolescent may engage in self stimulatory behaviour.
  • One approach focuses on the relationship of self-stimulation to brain functioning, particularly the connection between the front part of the brain, called the frontal lobe, and the lower brain centers.
  • It is thought that our brain always runs on neutral gear, much like the engine of an automobile. When the brain function is impaired, it cannot respond to stimulation in a flexible and efficient manner. Instead, it responds in loops of actions that are repeated.
  • Repetitious behaviours seem to result from the child's readiness to spring into action in response to a stimulus. But, even though the loops may be an attempt to maintain a stable level of arousal, the self-stimulation in fact indicates a decrease in behaviour flexibility, and may often increase arousal.
  • In addition, there may be inappropriate levels of dopamine (a major brain lubricant) in the brains of people who engage in self-stimulation, possibly due to missing cells in the frontal lobes.
  • Another theory suggests that self stimulatory behaviour is a child or adolescent’s response to events that they find over-stimulating in the environment. Such a child or adolescent may be described as hypo-sensitive. According to this point of view, the child or adolescent engages in self-stimulatory behaviour in an attempt to block out the over-stimulating environment. Their attention moves from the environment to themselves in an activity that is stimulating to them, such as flicking their fingers in front of their eyes.
  • Another point of view sees these behaviours as providing needed sensory stimulation. The child or adolescent is seen as needing more sensory input than is typical for an individual of their age. The theory is that their brain is craving this stimulation, and therefore they engage in these behaviours to arouse their nervous system.
  • There is a belief that some self-stimulatory behaviours, such as head banging and other self injurious behaviours, release endorphins in the body. Endorphins, which are naturally produced by the body to help the body manage pain, result in good feelings such as the “runner’s high” some people get after a long run or good workout. The result of the release of these endorphins is internal pleasure.


Explanations based on Learning
  • Learning theorists believe that some children display self-stimulation at high levels because they have inadvertently been rewarded for doing so. In this explanation, self-stimulation could be the result of negative attention seeking.
    • It might work this way: the child occasionally engages in self-stimulation of a mild form and, for reasons of social desirability, parents and teachers may ask the child to stop it. The child finds this attention rewarding, and therefore maintains or even increases the level of self-stimulation in question.
  • Another form this learning view takes is that self-stimulation is the result of a limited repertoire of skills in the child. This view argues that the greater the number of choices a child has, the lower the likelihood that he or she will repeat the same behaviour over and over again. This view may be more relevant to children who also experience some form of developmental disability.
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  • Another position attributes self-stimulation to the child's need to control anxiety and stress. The self-stimulation, according to this view, is the child's reaction to adverse circumstances within the family. The birth of a sibling, chronic illness in a family member, unemployment and poverty in the family are thought to be associated with self-stimulation because of the stress they bring to the child. Child neglect or abuse is another adverse circumstance. In this case, the behaviour is likely to be mild.

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Self-stimulation is common in many individuals with developmental disabilities; however, it appears to be more common in autism. Children and adolescents with a developmental disability who have self -stimulatory behaviours are often said to show autistic characteristics.
It is thought that children or adolescents with autism often use self- stimulation to help them regulate their behaviour in an environment that they find stressful. Children with autism often have difficulties interpreting sensory information. They can be over-sensitive or under-sensitive to sensations. For over-sensitive children and adolescents, self-stimulation is believed to be a way they can bring some balance into their world. Running backwards and forwards may disturb others around the child or the adolescent. They are not necessarily seeking attention. Self-stimulatory behaviour is seen as their way of coping with a stressful situation.
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  • Children's interpretation of what is happening to them will affect how they react to the urge to self-stimulate. For example, some children exposed to parental discord may not interpret this as threatening, while others may.
  • Many disabilities are associated with self-stimulation, although the percentages of children in each disability category are not well established. As a general rule, it is well documented that children with peer interaction or communication difficulties and rigidity are more likely to engage in self-stimulatory behaviour.
  • Self-stimulation almost always occurs in children with developmental difficulties, including Down syndrome. The more severe the cognitive and developmental delay in the child, the greater the likelihood that the child will engage in self-stimulation.
  • Self-stimulation may also occur, but not to a great extent, in children displaying problems in attention-focusing and impulsivity.
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  • Although in some cultural and religious groups repetitious behaviours may occur in the context of worship, such as kneeling repetitiously or rocking, these behaviours can be easily differentiated from self-stimulation.

General Note of Caution

Although milder forms of self-stimulation may be explained by learning theory, temperament, family problems or cultural factors, these factors cannot explain the more severe forms of self-abusive forms of self-stimulation. Some biological factor may be responsible for them.
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  • Children of separation and divorce, children who have lost a parent or other family member, or children who are physically or sexually abused have a greater likelihood to display some self-stimulatory behaviours.
  • The same is the case for children in the context of crisis, such as children of war or major catastrophes.
  • Self-stimulation may also occur when the environment is grossly under-stimulating, such as in institutions that are poorly staffed.
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  • Interventions to address self-stimulating behaviours are similar for all age groups.
  • There is no cure for self-stimulatory behaviour. Improvement of problematic self-stimulating behaviours can be achieved by both non-medical and medical interventions.
  • Medical interventions involve the use of some form of medication for controlling the mental health condition the self-stimulation is related to. In many of these mental health conditions, there is no specific medication that would control self-stimulation or self-abusive behaviour in all children. Furthermore, many of the relevant medications have side effects that need to be seriously considered by the family. Analyze the costs (risks) and benefits of medication in consultation with your physician.
  • Families may be aware that the child engages in some form of mild self-stimulation and the family may in fact inadvertently maintain the behaviour by paying attention to it. The family should try to refrain from reprimanding the child for mild self-stimulation, but rather provide a supportive context, free of stress for the child. If the behaviours reduce after this, the likelihood is great that they were being maintained by the negative attention paid to them.
  • Providing the child with functional and stimulating activities may go a long way to counter the child’s reliance on self-stimulation.
  • Families who are aware of the presence of rather extensive self-stimulation in their child need to be vigilant and ready to seek professional attention for the child if the behaviour continues and even intensifies.
  • Parents are most likely aware that there is a problem in their child that is of broader scope than just the self-stimulation. They may need to seek out a comprehensive assessment of their child's needs and follow professional advice as to the best course of action for the child.
  • Intensive self-stimulation and self-abusive behaviour may signal stress in the child from a variety of sources. It is important for the family to understand these stresses. In a child with a developmental problem, for example, parents may be placing too many demands on their child. They may be unaware that the child may suffer from a physical condition that may impact his or her functioning and increase the self-stimulation or self-abusive behaviour. They may not appreciate that high noise levels adversely affect their child. The parents may be asking the child to engage for long time periods in demanding cognitive tasks that are above the child's level of ability.
  • Sleep and nutrition are important for all children, particularly those children with special needs. Parents need to ensure that their child does have a restful sleep and appropriate nutrition.
  • Act immediately if the self stimulation takes the form of self-abuse. Behaviours such as head-banging, self-biting, hitting hard body parts, and rocking need immediate attention. Parents need to have the child seen by professionals. Your child or adolescent may require more comprehensive assessments, including an assessment of cognitive communication and social skills and overall developmental functioning.
  • Special interventions, some involving the use of learning theory principles may be necessary to deal with these behaviours. If strategies based on learning theory or in combination with them are not successful, the use of medication may be considered by the mental health professional involved with the family.
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Many children, especially those with a developmental disability, use self stimulation as a way to calm themselves. Behaviours such as rocking, humming, playing with an object may not be harmful. If the behaviour does not interfere with your child’s ability to pay attention and participate in meaningful activities at home and in the school then the behaviour is best ignored.

If your child becomes overexcited and is flapping his or her hands, try to refocus your child to a calming activity without drawing attention to the over excited behaviour.

It is important to remember the principles of reinforcement and understand that:
  • Giving negative attention to any behaviour will result in an increase in that behaviour.
  • Ignoring or calm redirection are the best options for young children who show infrequent self stimulatory behaviours.

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If self stimulation interferes with your child’s functioning, the following steps may be useful.
1. Help your child refocus his or her attention. Finding socially acceptable replacement behaviour will provide your child with an alternative to the self stimulatory behaviour.
  • For the child who wants to jump up and down, take him or her for a fast walk.
  • If your child is flapping her hands, have her hold a squishy toy.
  • For the child who is constantly humming, playing soft music may help.
Observe your child and know his or her favourite toys. Keep one with you at all times so you can redirect his or her attention with the toy. For example for a child who is intensely interested in Thomas the Tank Engine, carry one of the trains in your pocket and hand it to your child  when necessary to help them refocus their attention in a more appropriate manner than engaging in self-stimulatory behaviour
 
2. Find a socially acceptable alternative for a self-stimulatory behaviour. If your child chews their shirt and licks objects, provide them with a chew tube. An occupational therapist can provide suggestions for items such as chewellery. For the child who jumps up and down, try having a mini trampoline that he or she can jump on regularly throughout the day. Finger tapping may be an acceptable replacement behaviour for arm flapping. Providing a replacement behaviour provides your child with a socially way to get the sensory input he or she needs.
Both alerting and calming activities can provide socially acceptable alternatives to help reduce self-stimulating behaviours. Alerting and calming activities support children to learn and interact by helping them stay focused, calm and organised. For a child who engages in sensory-seeking self-stimulation such as spinning, jumping and other movements, try introducing two sensory items, such as play dough and a textured ball. Present the child with one of the items hourly and count the number of self stimulatory behaviours that occur in the following 30 minutes. If the self-stimulatory behaviours decrease, incorporate the sensory items into your child’s daily schedule to help reduce self-stimulating behaviours.
For a child who shows frequent self-stimulatory behaviour of pinching the skin on the arms usually in relation to transitions, provide a transition object such as a square of cloth with different textures sown on it. Have a number of these objects available. Prompt the child to get the transition object several minutes prior to a transition. Encourage the child to use the object instead of picking at his or her skin. Praise the child for using the blanket. You will be able to fade (gradually reduce) the prompts as your child becomes familiar with the use of the transition object.
3. Allow your child to engage in self-stimulation for a specified time as part of his or her daily schedule. If your child is attending preschool or school, it may be a calming strategy to allow them to engage in a self-stimulating behaviour for 10-15 minutes when they come home from school or preschool. For the child who likes to read the advertisements in the newspaper, allow him or her to do this for a specified period of time.
4. Try to reduce the amount of stress in your child’s environment. Self-stimulatory behaviours are often preceded by an event that is stressful to your child. Observe your child and establish what events and situations are stressful for him or her, and attempt to structure your home environment to reduce stress. This will help reduce self stimulatory behaviours.
If your child is demonstrating self-stimulatory behaviours described at this level, it is likely that you will be receiving support from professionals. Consult professionals involved with your child on the best course of action. Consider consultation with your team and an occupational therapist to develop a programme to meet your child’s unique sensory needs.  
Teaching your child to understand how they are feeling will help them be aware when they are under or over stimulated. Work with your child to find activities that improve how they feel. The programme How Does Your Engine Run?: Leader's Guide to the Alert Program for Self Regulation, Revised Edition provides a framework for teaching children socially acceptable ways of seeking sensory input.
To help your child manage frustration, change and demands of situations he or she finds difficult without resorting to self-stimulatory behaviours, introduce a relaxation routine. A basket of fidget toys paired with soothing music may help reduce self stimulatory behaviours.
Square breathing (www.best-self-help-sites.com/breathing-exercise.html) is another technique that may help your child relax. Consult your occupational therapist to help set up a routine that will meet your child’s individual needs.
Consult an occupational therapist to help set up a sensory diet to address your child’s need for stimulation and provide both alerting and calming activities. Introducing a sensory diet into your child’s daily activities may help reduce self-stimulatory behaviours. This is not a “diet” related to foods you should serve, but rather it involves an activity plan, designed specifically for your individual child, that provides the sensory input your child needs to be focused and organised. Children who engage in self-stimulatory behaviours may benefit from both alerting and calming activities. Alerting and calming activities built into your child’s day
  •  increase his or her alertness and attention span
  • may decrease sensory seeking and sensory avoiding behaviours
  • decrease frustration
  • support his or her ability to handle transitions.

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If a behaviour is injurious to the child, it cannot be ignored. There is some evidence that the pain threshold of children with developmental disorders is higher than it is for their typically developing peers. Therefore, there is a theory that it is ok to allow the person to hit or bite or scratch themselves in hopes that the lack of attention they get for the behaviour will make the behaviour stop. However, strategies to terminate or lessen the behaviour must be investigated; parents should consult with the school, family physician, and/or consulting agencies to get advice on how to proceed.

Research provides support for the reduction of self-stimulatory behaviours while developing communication, cognitive, and social skills through Applied Behaviour Analysis (ABA) in an intensive intervention programme. This programming reinforces positive and functional behaviours and reduces behaviours that interfere with learning.

Consult an occupational therapist to help set up a sensory diet to address your child’s need for stimulation and provide both alerting and calming activities. Introducing a sensory diet into your child’s daily activities may help reduce self stimulatory behaviours. This involves an individually designed activity plan that provides the sensory input your child needs to be focused and organised. Children who engage in self stimulatory behaviours may benefit from both alerting and calming activities. Alerting and calming activities built into your child’s day.
  • increase his or her alertness and attention span
  • may decrease sensory seeking and sensory avoiding behaviours
  • decrease frustration
  • support his or her ability to handle transitions.

Medication is sometimes prescribed for self-injurious behaviour in children. Often a combination of medication and behavioural therapy and other treatment services, such as occupational therapy, helps to control and decrease self-injurious behaviour. The use of medication would need to be discussed with your physician.


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Back to top

Many children, especially those with a developmental disability, use self-stimulation as a way to calm themselves. Behaviours such as rocking, humming, playing with an object may not be harmful. If the behaviour does not interfere with your child’s ability to pay attention and participate in meaningful activities at home and in the school then the behaviour is best ignored. If your child becomes overexcited and is flapping his or her hands, try to refocus your child to a calming activity without drawing attention to the over-excited behaviour.

It is important to remember the principles of reinforcement and understand that giving negative attention to any behaviour will result in an increase in that behaviour. Ignoring or calm redirection are the best options for children who show infrequent self stimulatory behaviours.
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If self-stimulation interferes with your child’s functioning, the following steps may be useful.
1. Help your child refocus his or her attention. Finding socially acceptable replacement behaviour will provide your child with an alternative to the self stimulatory behaviour.
  • For the child who wants to jump up and down, take him for a fast walk.
  • If your child is flapping his hands have him hold a squishy toy.
  • For the child who is constantly humming, playing soft music may help.
Observe your child and know his or her favourite objects. Keep one with you at all times so you can redirect his or her attention with the object.
 
2. Find a socially acceptable alternative for a self-stimulatory behaviour. If your child chews their shirt and licks objects provide them with a chew tube. An occupational therapist can provide suggestions for items such as chewellery. For the child who jumps up and down, try having a mini trampoline that he or she can jump on regularly throughout the day. Finger tapping may be an acceptable replacement behaviour for arm flapping. Providing a replacement behaviour provides your child with a socially way to get the sensory input he or she needs.
Both alerting and calming activities can provide socially acceptable alternatives to help reduce self-stimulating behaviours. Alerting and calming activities support a child to learn and interact by helping them stay focused, calm and organised. For a child who engages in sensory -seeking self-stimulation such as spinning, jumping and other movements, try introducing two sensory items, such as play dough and a textured ball. Present the child with one of the items hourly and count the number of self-stimulatory behaviours that occur in the following 30 minutes. If the self-stimulatory behaviours decrease, incorporate the sensory items into your child’s daily schedule to help reduce self-stimulating behaviours.
For a child who shows frequent self-stimulatory behaviour of pinching the skin on his or her arms (usually related to transitions), provide a transition object such as a square of cloth with different textures sown on it. Have a number of these objects available. Prompt the child to get the transition object several minutes prior to a transition. Encourage the child to use the object instead of picking at his or her skin. Praise the child for using the object. You will be able to reduce the prompts as your child becomes familiar with the use of the transition object.
 
3. Allow your child to engage in self-stimulation for a specified time as part of his or her daily schedule. If your child is attending school, it may be a calming strategy to allow them to engage in a self- stimulating behaviour for 10-15 minutes when they come home form school. For the child who likes to read the advertisements in the newspaper, allow him or her to do this for a specified period of time.
4. Try to reduce the amount of stress in your child’s environment. Self-stimulatory behaviours are often preceded by an event that is stressful to your child. Observe your child and establish what events and situations are stressful for him or her and attempt to structure your home environment to reduce stress. This will help reduce self stimulatory behaviours.
If your child is demonstrating self-stimulatory behaviours described at this level, it is likely you will be receiving support from professionals. Consult professionals involved with your child on the best course of action. Consider consultation with your team and an occupational therapist to develop a programme to meet your child’s unique sensory needs.  
Teaching your child to understand how they are feeling will help them be aware when they are under or over stimulated. Work with your child to find activities that improve how they feel. The programme How Does Your Engine Run?: Leader's Guide to the Alert Program for Self Regulation, Revised Edition provides a framework for teaching children socially acceptable ways of seeking sensory input.
To help your child manage frustration, change and demands of situations he or she finds difficult without resorting to self stimulatory behaviours, introduce a relaxation routine. A basket of fidget toys paired with soothing music may help reduce self stimulatory behaviours. Square breathing (www.best-self-help-sites.com/breathing-exercise.html) is another technique that may help your child relax. Consult your occupational therapist to help set up a routine that will meet your child’s individual needs.
Consult an occupational therapist to help set up a sensory diet to address your child’s need for stimulation and provide both alerting and calming activities. Introducing a sensory diet into your child’s daily activities may help reduce self stimulatory behaviours. This “diet” does not relate to food, but rather it involves an individually-designed activity plan that provides the sensory input your child needs to be focused and organised. Children who engage in self-stimulatory behaviours may benefit from both alerting and calming activities. Alerting and calming activities built into your child’s day.
  • increase his or her alertness and attention span
  • may decrease sensory seeking and sensory avoiding behaviours
  • decrease frustration
  • support his or her ability to handle transitions.
 
Discuss your child's self-stimulating behaviours with the teacher.  Tell the teacher which self-stimulating behaviours you use as motivators for your child, and which ones you are trying to fade out and replace with others.  Provide duplicate favourite objects for your child to use at school. Back to top

If behaviour is injurious to the child, it cannot be ignored. There is some evidence that the pain threshold of children with developmental disorders is higher than it is for their typically developing peers. Therefore, there is a theory that it is ok to allow the person to hit or bite or scratch themselves in hopes that the lack of attention they get for the behaviour will make the behaviour stop. However, strategies to terminate or lessen the behaviour must be investigated; parents should consult with the school, family physician, and/or consulting agencies to get advice on how to proceed.

Research provides support for the reduction of self-stimulatory behaviours while developing communication, cognitive, and social skills through Applied Behaviour Analysis (ABA) in an intensive intervention programme. This programming reinforces positive and functional behaviours and reduces behaviours that interfere with learning.

Consult an occupational therapist to help set up a sensory diet to address your child’s need for stimulation and provide both alerting and calming activities. Introducing a sensory diet into your child’s daily activities may help reduce self-stimulatory behaviours. This involves an individually designed activity plan that provides the sensory input your child needs to be focused and organised. Children who engage in self-stimulatory behaviours may benefit from both alerting and calming activities. Alerting and calming activities built into your child’s day
  • increase his or her alertness and attention span
  • may decrease sensory seeking and sensory avoiding behaviours
  • decrease frustration
  • support his or her ability to handle transitions.


Medication is sometimes prescribed for self-injurious behaviour in children. Often a combination of medication and behavioural therapy and other treatment services, such as occupational therapy, helps to control and decrease self-injurious behaviour. The use of medication would need to be discussed with your physician.

Discuss your child's self-stimulating behaviours with the teacher. Tell the teacher which self-stimulating behaviours you use as motivators for your child, and which ones you are trying to fade out and replace with others. Provide duplicate favourite objects for your child to use at school.

Back to top
Back to top

Many youth, especially those with a developmental disability, use self-stimulation as a way to calm themselves. Behaviours such as rocking, humming, playing with an object may not be harmful. If the behaviour does not interfere with your youth’s ability to pay attention and participate in meaningful activities at home and in the school then the behaviour is best ignored. If your youth engages in a self-stimulatory behaviour, try to refocus him or her to a calming activity without drawing attention to the self-stimulatory behaviour. It is important to remember the principles of reinforcement and understand that giving negative attention to any behaviour will result in an increase in that behaviour. Ignoring or calm redirection are the best options for youth who show infrequent self-stimulatory behaviours. Back to top

  • One possible explanation for the behaviour is that the youth accidentally stumbled upon it and then got lots of attention for it. Attention, whether negative or positive, reinforces the behaviour and increases the likelihood of it continuing. If the parent believes the function of the behaviour is to get attention, the strategy would be to ignore the behaviour in the hope and expectation that the lack of attention will make the behaviour dissipate.
  • Providing activities that are structured and interesting to the youth will interfere with their tendency to engage in self-stimulating behaviours. The youth may be anxious because they don’t know what to expect, and that anxiety may result in more frequent and intense self-stimulating behaviours. Provide information about what is coming next and what the expectations are; this information may be presented using pictures or text as well as orally. 
  • Allow the youth opportunities to earn time with their self-stimulating behaviour. They might be required to complete a task and then have a limited amount of time engaging in the behaviour; for example, after placing their dishes in the dishwasher after supper they would be allowed a few minutes to twirl string.
If self-stimulation interferes with your youth’s functioning, the following steps may be useful.
1. Help your youth refocus his or her attention. Finding a socially acceptable replacement behaviour will provide your youth with an alternative to the self-stimulatory behaviour. If your youth has high activity levels and jumps up and down swinging in a hammock or on playground swings, then doing cartwheels, swimming, dancing and doing jumping jacks are possible replacement behaviours
 
2. Find a socially acceptable alternative for a self-stimulatory behaviour. If your youth chews their shirt and licks objects, provide them with a chew tube. An occupational therapist can provide suggestions for items such as chewellery. For the youth who jumps up and down, try having a mini trampoline that he or she can jump on regularly throughout the day. Finger tapping may be an acceptable replacement behaviour for arm flapping. Offering a replacement behaviour provides your youth with a socially acceptable way to get the sensory input he or she needs.
Both alerting and calming activities can provide socially acceptable alternatives to help reduce self-stimulating behaviours. Alerting and calming activities support a youth to learn and interact by helping them stay focused, calm and organised. For a youth who engages in sensory seeking self-stimulation, such as spinning, jumping and other movements, try introducing two sensory items, such as play dough and a textured ball. Present the child with one of the items hourly and count the number of self-stimulatory behaviours that occur in the following 30 minutes. If the self-stimulatory behaviours decrease, incorporate the sensory items into your youth’s daily schedule to help reduce self-stimulating behaviours.
For a youth who shows frequent self stimulatory behaviour of pinching the skin on his or her arms, usually in relation to transitions, provide a transition object such as a squishy ball. Prompt the youth to get the ball several minutes prior to a transition. Encourage the youth to use the ball instead of picking at his or her skin. Praise the youth for using the ball. You will be able to reduct the prompts as your youth becomes familiar with the use of the transition object.
3. Allow your youth to engage in self-stimulation for a specified time as part of his or her daily schedule. It may be a calming strategy to allow them to engage in a self stimulating behaviour for 10-15 minutes when they come home form school.
4. Try to reduce the amount of stress in your youth’s environment. Self-stimulatory behaviours are often preceded by an event that is stressful to the young person. Observe your youth and establish what events and situations are stressful for him or her, and attempt to structure your home environment to reduce stress. This will help reduce self-stimulatory behaviours.
If your youth is demonstrating self-stimulatory behaviours described at this level, it is likely you will be receiving support from professionals. Consult professionals involved with your youth on the best course of action. Consider consultation with your team and an occupational therapist to develop a programme to meet your child’s unique sensory needs.  
Teaching your youth to understand how they are feeling will help them be aware when they are under or over stimulated. Work with your youth to find activities that improve how they feel. The book The Incredible Five Point Scale www.5pointscale.com provides a framework for teaching youth about regulating their own behaviour.
To help your youth manage frustration, change and demands of situations he or she finds difficult without resorting to self stimulatory behaviours, introduce a relaxation routine. A basket of fidget toys paired with soothing music may help reduce self-stimulatory behaviours. Square breathing (www.best-self-help-sites.com/breathing-exercise.html) is another technique that may help your youth relax. Consult your occupational therapist to help set up a routine that will meet your youth’s individual needs.
Consult an occupational therapist to help set up a sensory diet to address your youth’s need for stimulation and provide both alerting and calming activities. Introducing a sensory diet into your youth’s daily activities may help reduce self stimulatory behaviours. This “diet” is not related to food, but rather it involves an individually designed activity plan that provides the sensory input your child needs to be focused and organised. Youth who engage in self-stimulatory behaviours may benefit from both alerting and calming activities. Alerting and calming activities built into your youth’s day
  • increase his or her alertness and attention span
  • may decrease sensory seeking and sensory avoiding behaviours
  • decrease frustration
  • support his or her ability to handle transitions.
 
Discuss your youth's self-stimulating behaviours with the teacher.  Tell the teacher which self-stimulating behaviours you use as motivators for your youth, and which ones you are trying to fade out and replace with others.  Provide duplicate favourite objects for your youth to use at school if appropriate.
Back to top

If behaviour is injurious to the youth, it cannot be ignored. There is some evidence that the pain threshold of children and adolescents with developmental disorders is higher than it is for their typically developing peers. Therefore, there is a theory that it is ok to allow the person to hit/bite/scratch themself in hopes that the lack of attention they get for the behaviour will make the behaviour stop. However, strategies to terminate or lessen the behaviour must be investigated; parents should consult with the school, family physician, and/or consulting agencies to get advice on how to proceed.
Research provides support for the reduction of self-stimulatory behaviours while developing communication, cognitive, and social skills through Applied Behaviour Analysis (ABA) in an intensive intervention programme. This programming reinforces positive and functional (purposeful) behaviours and reduces behaviours that interfere with learning.

Consult an occupational therapist to help set up a sensory diet to address your youth’s need for stimulation and provide both alerting and calming activities. Introducing a sensory diet into your youth’s daily activities may help reduce self-stimulatory behaviours. This involves an individually designed activity plan that provides the sensory input your child needs to be focused and organised. Youth who engage in self-stimulatory behaviours may benefit from both alerting and calming activities. Alerting and calming activities built into your youth’s day
  • increase his or her alertness and attention span
  • may decrease sensory seeking and sensory avoiding behaviours
  • decrease frustration
  • support his or her ability to handle transitions.


Medication is sometimes prescribed for self injurious behaviour in children and adolescents. Often a combination of medication and behavioural therapy and other treatment services, such as occupational therapy, helps to control and decrease self-injurious behaviour. The use of medication would need to be discussed with your physician.

Discuss your youth's self-stimulating behaviours with the teacher. Tell the teacher which self-stimulating behaviours you use as motivators for your youth, and which ones you are trying to fade out and replace with others. Provide duplicate favourite objects for your youth to use at school if appropriate.
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Back to top

If the behaviour does not interfere with the social interactions the adolescent has with their peers and it does not affect their daily living, then it is best to ignore the behaviour. It is fine for the parent to draw the adolescent’s attention to the behaviour in case the adolescent wishes to try to change it, but it is not necessary for the parent to try to change the behaviour. Back to top

  • One possible explanation for the behaviour is that the adolescent accidentally stumbled upon it, and then got lots of attention for it. The attention reinforced the behaviour and caused it to continue. If the parent believes the function of the behaviour is to get attention, the strategy would be to ignore the behaviour in the hope/expectation that the lack of attention will make the behaviour dissipate.
  • Providing activities that are structured and interesting to the adolescent will interfere with their tendency to engage in self-stimulating behaviours. The adolescent may be anxious because they don’t know what to expect, and that anxiety may result in more frequent and intense self-stimulating behaviours. Provide information about what is coming next and what the expectations are; this information may be presented using pictures or text as well as orally.
  • Allow the adolescent opportunities to earn time with their self-stimulating behaviour. They might be required to complete a task and then have a limited amount of time engaging in the behaviour; for example, after placing their dishes in the dishwasher after supper they would be allowed a few minutes to twirl string.
  • Discuss your adolescent's self-stimulating behaviours with the teacher. Tell the teacher which self-stimulating behaviours you use as motivators for your adolescent, and which ones you are trying to fade out and replace with others. Provide duplicate favourite objects for your adolescent to use at school if appropriate.
Back to top

If behaviour is injurious to the adolescent then, unlike the Yellow Light behaviours, it cannot be ignored. There is some evidence that the pain threshold of many youngsters with developmental disorders is higher than it is for their typically developing peers. Therefore, there is a theory that it is ok to allow the person to hit or bite or scratch themself in hopes that the lack of attention they get for the behaviour will make the behaviour stop. However, strategies to terminate or lessen the behaviour must be investigated; parents should consult with the school, family physician, and/or consulting agencies to get advice on how to proceed.

Discuss your adolescent's self-stimulating behaviours with the teacher. Tell the teacher which self-stimulating behaviours you use as motivators for your adolescent, and which ones you are trying to fade out and replace with others. Provide duplicate favourite objects for your adolescent to use at school if appropriate.

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Self stimulating behaviours are sometimes typical and sometimes not. If they are typical for the age of the adolescent (e.g., pen-clicking, twirling hair, twiddling thumbs) there is probably no need to intervene.

If the behaviours cause concern (e.g., rocking, hand-flicking) they should be monitored and discussed with professionals. If they are dangerous (e.g., head-banging, self-biting) there must be intervention.
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