ABCs of Mental Health > Teacher Resource > The Child with Unusual Behaviours > Self-Stimulation

The Child with Unusual Behaviours - Self-Stimulation

Table of Contents

Select Content to Display

PDF Export
- Export full subchapter to PDF
- Export only selected content to PDF

Submit Feedback


Section	Age	Indicator
Action	Early Childhood	Green
Belief	Middle Childhood	Yellow
Course	Early Adolescence	Red
	Adolescence

Repetitive Behaviours with no apparent function

At times, we all engage in repetitive behaviours that have no apparent purpose. However, there is a difference between the behaviours we display and can control and those that appear to be outside an individual's control.

For example, some of us may twirl our hair while talking to others, may touch our lips or face repetitiously, and may swing our foot to and fro. Individuals can generally monitor their own actions and bring these behaviours under immediate control when they wish to avoid embarrassment, or for other reasons.

On the other hand, some people who display self-stimulatory behaviours that are visible to others appear unable to bring these repetitious behaviours under voluntary control. This is particularly the case for children.

It is unclear why these behaviours occur in the first place, but they seem to be an attempt to either increase stimulation or reduce it. According to some authorities, self-stimulation appears to be rewarding in each own right, and this is why a person keeps doing it. Another explanation for why self-stimulation is maintained is because it is usually associated with very strong sensory consequences. For example, a young child may hit plates to produce noise, or a child may repeatedly and slowly sift sand to produce a pleasurable tactile sensation.

Mild self-stimulation in children may not be reason for concern. However, in children with developmental disabilities, self-stimulation may occupy large segments of the day, thereby preventing the child from acquiring useful skills.

Examples of repetitive behaviours with no functions:

Hair Twirling
Leg Swinging
Touching parts of the body repetitiously
Pacing
Skin picking
Tapping
Scratching
Nail biting
Hand Flapping
Sifting sand
Covering ears in an attempt to block stimulation
Echoing other people's speech
Mouthing objects repetitiously
Tearing paper repetitiously
Opening and shutting doors
Spinning the wheels of a toy car
Eye pocking
Jumping repeatedly on the spot
Humming
Flicking objects
Rocking
Head Hitting with fist
Self-Biting
Head Banging

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. 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.

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 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 school or home, 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.

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.
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.

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 doing well academically and has no peer-related difficulties.

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, self-biting, 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, teachers 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 and peer interaction difficulties, as well as rigid behaviour, is particularly worrisome. In this case, teachers would also likely observe academic and peer-related problems as well as varying degrees of cognitive impairment.

Self-abusive behaviours such as head-banging, head hitting or hand banging, rocking, ear-covering, self-biting, 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 academic 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 insufficient 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.

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-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.

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, engaging in the same behaviours repeatedly and non-functionally over short periods of time should alert teachers to the need for ongoing monitoring.
These behaviours are likely to co-exist with other difficulties of an academic and social nature.

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 exacerbated by stress. Examples are: head banging, particularly intense, self-biting, 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. 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.
Teachers will want to explore whether the young person is undergoing any kind of medication withdrawal.

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 to someone and note that one of you 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 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 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 engage in a myriad of other similar behaviours.

Many adolescents will masturbate. Typically developing adolescents know where and when to engage privately in this 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.

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 behaviour which may be even less socially acceptable. Therefore, when observing self-stimulating behaviours the staff must determine:

which behaviours they can live with, and
which behaviours 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 at home.

When making decisions about how to address such behaviours, teachers must consult with the parents to ensure that all cultural and religious factors are considered.

Research indicates that the severity of many self-stimulating behaviours among those with developmental disorders decrease with age. Stereotyped (repetitive, ritualistic) movements and restricted interests are less common among adults than among children. Self-injurious behaviours and compulsive behaviours appear comparable throughout all age groups. Ritualistic behaviours and the need for sameness seem to be more common among older individuals with developmental disorders. However, other research indicates different patterns of change over time. The only thing that is confirmed across studies is that some self-stimulating behaviours will remain consistent as the child ages, and some will change.

Adolescents may show some mild forms of self-stimulation, some of them specific to this age group, including masturbation.
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, nose-picking, 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.

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 over short periods of time should alert teachers to the need for ongoing monitoring.
These behaviours are likely to co-exist with other difficulties of an academic and social nature. For example, the more stressed the adolescent is, the more likely such behaviours will increase in intensity.

Self-stimulation that is intense, enduring and interferes with the youth's academic, communication and social activities is most concerning. This is particularly the case when the stimulation is not under the youth's control, is ongoing and is exacerbated by stress.
- Examples are head banging, self-biting, hitting hard with the hands on solid objects, 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 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 adults make attempts to have the adolescent 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.
Teachers will want to explore whether the young person is undergoing any kind of medication withdrawal.

All adolescents will self-stimulate. A portion of the population will have behaviours which cause concern. Teachers should be discussing their concerns with the adolescent, his or her parents and with colleagues 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.

This approach focuses on the relationship of self-stimulation to brain functioning, particularly the connection between the front part, 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.

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. 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. In this explanation, self-stimulation could be the result of negative attention seeking.
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.

Temperament

There does not seem to be much information as to the role of temperament for the presence of self-stimulation.
Children with low self control (low in self-regulation) and immediate and impulsive reaction to events (high in reactivity) are more likely to be adversely affected by self-stimulation.
As well, children who are anxious, inhibited and low in mood are more likely to engage in self-stimulation, particularly under conditions of stress.

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.

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.
Self-stimulation may also occur, but not to a great extent, in children displaying problems in attention focusing and impulsivity.

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.

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.

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.

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.

There is no cure for self-stimulatory behaviour. Improvement 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. A cost-benefit analysis may be undertaken, but this is beyond the jurisdiction of the teacher or school.

In Class

Do not draw attention to the behaviour:

For the majority of these behaviours, interventions need not be too intensive or intrusive. It is important not to demand that the child stop the self-stimulation, particularly in the case of younger children. This is because the self-stimulation may increase as a result of negative attention seeking on the part of the child. Not drawing attention to the child in the presence of classmates and friends is also crucial to reduce embarrassment in the child who self-stimulates.
Provide interesting activities:
Providing activities that will engage the child's interest and attention may, at least in the short run, terminate the self-stimulation. This is based on the view that children may self-stimulate because of boredom.

Connect with the parents:

For some forms of behaviour the teacher may consider the possible existence of a physical problem to which the parents may be alerted, particularly in the case of younger children. Repeated scratching or tapping body parts, such as the ears or the stomach, may be examples.

Consider referrals if necessary:

Children suspected of experiencing family problems, trauma or other forms of crisis should be referred to appropriate school personnel to address the main problem. If successful, such an approach may then reduce or eliminate the child's anxiety and self-stimulatory behaviour.

In the School

When the self-stimulation is mild and almost covert, it may not be necessary to involve the school principal.
If you believe that the self-stimulation is the result of a crisis based in the home, it may be helpful to mobilize the school to assist in providing support to the child.

With Family

Families may be aware that the child engages in some form of mild self-stimulation and may in fact inadvertently maintain the behaviour by paying attention to it.
It may be appropriate to alert the family to the need to refrain from reprimanding the child for mild self-stimulation, but rather to provide a supportive context, free of stress for the child.
Providing the child with functional and stimulating activities may go a long way to counter reliance on self-stimulation.

In Class

Follow up, monitor, and evaluate:

Behaviours in this category need to be followed up and monitored to determine their course. If they continue or become intensified, they need to be evaluated more formally, with involvement from members of the school team, including the school principal.

Eliminate positive consequences:

Consider whether the self-stimulation provides a pleasurable sensory experience for the child.
If so, the consequence may need to be eliminated to stop the self-stimulation. Input from experts may be necessary to set up a program that aims towards eliminating this form of self-stimulation. An example would be setting up a program for eliminating the sensory reinforcement of banging metal objects or sifting sand through the hands.

Explore developmental difficulties

If the behaviours are of high intensity or duration and are difficult to suppress, it may also be necessary to consider drawing the parent's attention to the possible existence of developmental difficulties, particularly in the case of the younger age group. The older child would most likely have been identified as presenting with such difficulties much earlier.

In the School

It is your judgment as to whether school personnel need to be involved. This will depend on the intensity, duration and the child's ability to suppress the self-stimulation. If there is mild expression, even though worrisome, it may require some time of observation and monitoring before the teacher decides whether the behaviour needs to be given greater attention.
If many children in a given school engage in self-stimulation, attention may need to be paid to the school environment to determine whether it provides a breadth of positive and rewarding activities and pursuits for the children through the day. It is possible that the children are bored, and that self-stimulation affords them an avenue of expressing pent-up energy.

With Family

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.

In Class

Act immediately:

Self-stimulation that takes the form of self-abuse, such as head-banging, self-biting, hitting hard body parts, and rocking, needs immediate attention. Parental notification is necessary.

Seek appropriate help:

The school psychologist and school principal, along with other relevant personnel, may need to be notified. Parents should be advised of the need to have the child seen by professionals.
The child 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 are not successful or in combination with them, the use of medication may be considered by the mental health professional involved with the family.

In the School

Self abusive behaviours that are of high intensity, long duration and are difficult to control by the child certainly need to be given attention by the school principal or support team, or both. These resource people can then follow the relevant procedures to ensure that the child's difficulties are evident to the parents.
It is also important to ensure that the child is not bullied and made fun of in the schoolyard

With Family

Communication with the parents is critical. Parents are most likely already 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 far too demanding of the 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.

In Class

Do not draw attention to the behaviour:

For the majority of these behaviours, interventions need not be too intensive or intrusive. It is important not to demand that the child stop the self-stimulation, particularly in the case of younger children. This is because the self-stimulation may increase as a result of negative attention seeking on the part of the child. Not drawing attention to the child in the presence of classmates and friends is also crucial to reduce embarrassment in the child who self-stimulates.
Provide interesting activities:
Providing activities that will engage the child's interest and attention may, at least in the short run, terminate the self-stimulation. This is based on the view that children may self-stimulate because of boredom.

Connect with the parents:

For some forms of behaviour the teacher may consider the possible existence of a physical problem to which the parents may be alerted, particularly in the case of younger children. Repeated scratching or tapping body parts, such as the ears or the stomach, may be examples.

Consider referrals if necessary:

Children suspected of experiencing family problems, trauma or other forms of crisis should be referred to appropriate school personnel to address the main problem. If successful, such an approach may then reduce or eliminate the child's anxiety and self-stimulatory behaviour.

In the School

When the self-stimulation is mild and almost covert, it may not be necessary to involve the school principal.
If you believe that the self-stimulation is the result of a crisis based in the home, it may be helpful to mobilize the school to assist in providing support to the child.

With Family

Families may be aware that the child engages in some form of mild self-stimulation and may in fact inadvertently maintain the behaviour by paying attention to it.
It may be appropriate to alert the family to the need to refrain from reprimanding the child for mild self-stimulation, but rather to provide a supportive context, free of stress for the child.
Providing the child with functional and stimulating activities may go a long way to counter reliance on self-stimulation.

In Class

Follow up, monitor, and evaluate:

Behaviours in this category need to be followed up and monitored to determine their course. If they continue or become intensified, they need to be evaluated more formally, with involvement from members of the school team, including the school principal.

Eliminate positive consequences:

Consider whether the self-stimulation provides a pleasurable sensory experience for the child.
If so, the consequence may need to be eliminated to stop the self-stimulation. Input from experts may be necessary to set up a program that aims towards eliminating this form of self-stimulation. An example would be setting up a program for eliminating the sensory reinforcement of banging metal objects or sifting sand through the hands.

Explore developmental difficulties

If the behaviours are of high intensity or duration and are difficult to suppress, it may also be necessary to consider drawing the parent's attention to the possible existence of developmental difficulties, particularly in the case of the younger age group. The older child would most likely have been identified as presenting with such difficulties much earlier.

In the School

It is your judgment as to whether school personnel need to be involved. This will depend on the intensity, duration and the child's ability to suppress the self-stimulation. If there is mild expression, even though worrisome, it may require some time of observation and monitoring before the teacher decides whether the behaviour needs to be given greater attention.
If many children in a given school engage in self-stimulation, attention may need to be paid to the school environment to determine whether it provides a breadth of positive and rewarding activities and pursuits for the children through the day. It is possible that the children are bored, and that self-stimulation affords them an avenue of expressing pent-up energy.

With Family

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.

In Class

Act immediately:

Self-stimulation that takes the form of self-abuse, such as head-banging, self-biting, hitting hard body parts, and rocking, needs immediate attention. Parental notification is necessary.

Seek appropriate help:

The school psychologist and school principal, along with other relevant personnel, may need to be notified. Parents should be advised of the need to have the child seen by professionals.
The child 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 are not successful or in combination with them, the use of medication may be considered by the mental health professional involved with the family.

In the School

Self abusive behaviours that are of high intensity, long duration and are difficult to control by the child certainly need to be given attention by the school principal or support team, or both. These resource people can then follow the relevant procedures to ensure that the child's difficulties are evident to the parents.
It is also important to ensure that the child is not bullied and made fun of in the schoolyard

With Family

Communication with the parents is critical. Parents are most likely already 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 far too demanding of the 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.

In Class

Do not draw attention to the behaviour:

For the majority of these behaviours, interventions need not be too intensive or intrusive. It is important not to demand that the child stop the self-stimulation, particularly in the case of younger children. This is because the self-stimulation may increase as a result of negative attention seeking on the part of the child. Not drawing attention to the child in the presence of classmates and friends is also crucial to reduce embarrassment in the child who self-stimulates.
Provide interesting activities:
Providing activities that will engage the child's interest and attention may, at least in the short run, terminate the self-stimulation. This is based on the view that children may self-stimulate because of boredom.

Connect with the parents:

For some forms of behaviour the teacher may consider the possible existence of a physical problem to which the parents may be alerted, particularly in the case of younger children. Repeated scratching or tapping body parts, such as the ears or the stomach, may be examples.

Consider referrals if necessary:

Children suspected of experiencing family problems, trauma or other forms of crisis should be referred to appropriate school personnel to address the main problem. If successful, such an approach may then reduce or eliminate the child's anxiety and self-stimulatory behaviour.

In the School

When the self-stimulation is mild and almost covert, it may not be necessary to involve the school principal.
If you believe that the self-stimulation is the result of a crisis based in the home, it may be helpful to mobilize the school to assist in providing support to the child.

With Family

Families may be aware that the child engages in some form of mild self-stimulation and may in fact inadvertently maintain the behaviour by paying attention to it.
It may be appropriate to alert the family to the need to refrain from reprimanding the child for mild self-stimulation, but rather to provide a supportive context, free of stress for the child.
Providing the child with functional and stimulating activities may go a long way to counter reliance on self-stimulation.

In Class

Follow up, monitor, and evaluate:

Behaviours in this category need to be followed up and monitored to determine their course. If they continue or become intensified, they need to be evaluated more formally, with involvement from members of the school team, including the school principal.

Eliminate positive consequences:

Consider whether the self-stimulation provides a pleasurable sensory experience for the child.
If so, the consequence may need to be eliminated to stop the self-stimulation. Input from experts may be necessary to set up a program that aims towards eliminating this form of self-stimulation. An example would be setting up a program for eliminating the sensory reinforcement of banging metal objects or sifting sand through the hands.

Explore developmental difficulties

If the behaviours are of high intensity or duration and are difficult to suppress, it may also be necessary to consider drawing the parent's attention to the possible existence of developmental difficulties, particularly in the case of the younger age group. The older child would most likely have been identified as presenting with such difficulties much earlier.

In the School

It is your judgment as to whether school personnel need to be involved. This will depend on the intensity, duration and the child's ability to suppress the self-stimulation. If there is mild expression, even though worrisome, it may require some time of observation and monitoring before the teacher decides whether the behaviour needs to be given greater attention.
If many children in a given school engage in self-stimulation, attention may need to be paid to the school environment to determine whether it provides a breadth of positive and rewarding activities and pursuits for the children through the day. It is possible that the children are bored, and that self-stimulation affords them an avenue of expressing pent-up energy.

With Family

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.

In Class

Act immediately:

Self-stimulation that takes the form of self-abuse, such as head-banging, self-biting, hitting hard body parts, and rocking, needs immediate attention. Parental notification is necessary.

Seek appropriate help:

The school psychologist and school principal, along with other relevant personnel, may need to be notified. Parents should be advised of the need to have the child seen by professionals.
The child 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 are not successful or in combination with them, the use of medication may be considered by the mental health professional involved with the family.

In the School

Self abusive behaviours that are of high intensity, long duration and are difficult to control by the child certainly need to be given attention by the school principal or support team, or both. These resource people can then follow the relevant procedures to ensure that the child's difficulties are evident to the parents.
It is also important to ensure that the child is not bullied and made fun of in the schoolyard

With Family

Communication with the parents is critical. Parents are most likely already 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 far too demanding of the 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.

Teachers must remember that the adolescents in their classrooms will have self-stimulating behaviours. Some of them are perfectly normal for typically developing adolescents and there is no need to do anything. If a particular behaviour is annoying to the teacher (e.g., the adolescent clicks their pen), the teacher should ask that the student to stop. It is probable that the behaviour will cease but that it will resurface at a later time because the adolescent has forgotten to control the behaviour. Self-stimulating behaviours are extremely self-reinforcing and even though it is possible to make them stop, it is not easy to achieve.

Some of the behaviours are not typical. This is the same for adolescents as it is for all other age groups. Teachers must determine either independently or with the consultation of others such as psychologists, counsellors, and behaviour specialists which behaviours should be ignored, which should be addressed and how they should be addressed.

One very common form of self-stimulating behaviour is masturbation. Many adolescents will masturbate. Typically developing adolescents know where and when to engage privately in this 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 it is a behaviour that 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 behaviour which may be even less socially acceptable. Therefore, when observing self-stimulating behaviours the staff must determine:

which behaviours they can live with, and
which behaviours must be stopped.

They must also 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 at home.

When making decisions about how to address such behaviours, teachers must consult with the parents to ensure that all cultural and religious factors are considered.

When the self-stimulation is mild and almost covert, and not self-harmful, it may not be necessary to do anything. The teacher may wish to draw the adolescent’s attention to the behaviour by talking with them privately. The adolescent may not be aware of what they are doing and may wish to change the behaviour. Back to top

It is the teacher’s judgment as to whether other school personnel (e.g., school principal, psychologist) need to be involved.
- This will depend on the intensity, duration, whether self-harm is inflicted, and the adolescent’s ability to suppress the self-stimulation.
- If the self-stimulation is mild, even though worrisome, it may require some time of observation and monitoring before the teacher decides whether the behaviour needs to be given greater attention.
If the teacher believes the self-stimulation is the result of a crisis based in the home, it may be helpful to consult with the principal to assist in providing support to the child.
One possible explanation for the behaviour is that the adolescent accidentally stumbled upon it and then got lots of attention for it, reinforcing it and making it continue.
- If that is the theory held by the teacher for the behaviour exhibited by the adolescent, then it will be necessary to analyze the behaviour to try to determine its function.
- If the teacher believes that the function 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.
- Other possible functions for the behaviour include getting sensory feedback or escaping a task or person by engaging in the behaviour.
Consider whether the self-stimulation provides a pleasurable sensory experience for the child. If so, the consequence may need to be eliminated to stop the self-stimulation.
- Input from experts may be necessary to set up a program that aims towards eliminating this form of self-stimulation.
- An example would be setting up a program for eliminating the sensory reinforcement of banging metal objects or sifting sand through the hands by removing such objects from the youth’s environment.
Providing activities that are structured and interesting to the adolescent will interfere with their tendency to engage in self-stimulating behaviours.
Teach the adolescent adaptive skills, sports activities, and/or games to give him or her a wider behavioral repertoire.
- Try to teach skills that will take advantage of the self-stimulating behavior with the goal of giving the adolescent a more socially acceptable way to self-stimulate.
- For example, if the adolescent lines up objects, teach him or her to organize book shelves in alphabetical order.
Allow the adolescent to earn time with their chosen non-harmful self-stimulating behaviour, since this will be a motivator for him or her.
- For example, if they complete a work task they may be given five minutes with their self-stimulating behaviour, for example a box of paper which they are allowed to tear.
Try to avoid any visual or auditory distractions.
- The classroom walls should be painted in a non-distracting colour and/or there should not be numerous and varied displays on the walls.
- Try to store the things you don’t need in another area. Televisions and other such equipment in the classroom may disturb the student’s concentration, causing anxiety or sensory overload which may lead to increased self-stimulating behaviours.
The adolescent may be engaging in self-stimulating behaviours because of anxiety over not knowing what to expect. Therefore, the behaviours may be reduced when they have more information about what is coming next.
- Visual supports such as a schedule of what to expect in the next period or what the steps are in completing a task may be helpful.
- A fidget toy to use as a transition item to get from place to place may calm the adolescent by letting them know where they are going.
It is also important to ensure that the child is not bullied and made fun of in the schoolyard.

Self-abusive behaviours that are of high intensity and long duration, and that an adolescent finds to be difficult to control certainly need to be given attention by the school principal or support staff including counsellors, psychologists, behavioural teachers, etc.
- These resource people can then follow the relevant procedures to ensure that the child's difficulties are evident to the parents and they can help develop a plan of intervention.
If a behaviour is injurious to the adolescent, then it cannot be ignored.
- There is some evidence that the pain threshold of many 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 harm themselves in hopes that the lack of attention they get for the behaviour will make the behaviour stop. However, codes of ethics as well as good teaching practices would not allow this to happen in a school setting. Strategies to terminate or lessen the behaviour must be investigated.

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, they should be monitored and discussed with colleagues. If they are dangerous, there must be intervention. Back to top