February 29, 2012

What does stimming look like?

I spent so many hours Googling videos of stimming when Chipmunk was two.  I’m serious.  Hours.  It was so scary seeing him seemingly possessed by these unfamiliar, repetitive movements.  Every single day–during play, during mealtime, in the bath–he’d stim.  He’d squeeze and arrange.  Squeeze and arrange.  The most upsetting thing was that I couldn’t find any kids online doing the exact same thing.  It would be similar sometimes, but not similar enough to soothe my upset (hormonal, pregnant) brain.  When his first 15 minute appointment with a developmental pediatrician ended in a curt non-diagnosis of, “No, he doesn’t have autism,” it was even scarier to me.  Then what was it, if not stimming?

Four years later, we know that’s exactly what it was.  And I understand now that stims can take many forms.  While hand flapping is one that nearly everyone recognizes as a sign of children on the autism spectrum, stims can be much more subtle that that.  They can be vocal, they can involve movement, then can be an imperceptible tensing of a muscle.  My son stims with his toys and obsessions, almost as if he’s playing.  It started with cars and French fries (admirable obsessions), and progressed to dinosaurs and other small toys, and then to Legos, and then went a little freestyle with his hands alone.  His Star Wars hands.

We know not to worry about his stims, and the only time they’re “controlled” at all is at school, when he’s told that his Star Wars hands have to be quiet so they don’t bother his friends.  He can move his hands and squeeze things and do what he needs to do as long as he doesn’t growl and whoosh loudly.  (It’s pretty damn loud.)

If you think you’re observing stimming behavior in your child and you haven’t had an evaluation or gotten a diagnosis yet, my advice is to film your child whenever you can.  Try not to draw too much attention to it or make a big spectacle out of it.  Just grab a small camera (your phone is fine) and save those videos.  I uploaded them to a private account that I could link doctors to.   Every doctor we’ve seen over the past few years has been very grateful for visual documentation of behaviors that have continued from 18 months to now, at almost six-years-old.

I took this video today, when I was really surprised to see a lot of stimming crop up while we waited in the waiting room at the immunologist.  Chipmunk is severely allergic to oak and it’s oak season in a major, ugly way around here.  I’ve noticed that when he’s itchy and uncomfortable and his allergies get bad, he stims more often.  In this video, you can see a subtle, body-clenching, breath-holding stim (every time the Angry Birds hit the pigs.)  Looks like we have another stem-obsession correlation on deck.

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  • Shriekhouse

    The angry birds stimming… how do you distinguish that from just *concentration*? I’m honestly curious, as my son does something similar. He also does Star Wars noises & gestures ALL THE TIME OMG, but to me it seems more in keeping with a normal kid-obssession. Do you have vids of Chipmunk’s Star Wars Hands you could share? And/or the whooshing growling sounds? Mine also does a droning/grunting thing when eating or concentrating that I am now wondering about. So far he’s just been diagnosed with ADHD and possibly anxiety disorder but I keep having this nagging sense there is something else going on.

    How does it work for Chipmunk to stop his star wars hands at school – is it just the rule and he can self-regulate within it, or does he need a lot of reminding, or…? What does stimming *feel* like to him? Like good, calming, or is he unaware of it altogether?

    Sorry for the questionapalooza. This post just has me so intrigued. And also inspired – you’ve done so much work to understand and help your son. I hope I can do as much for mine.

    • http://www.mommymelee.com Maria Melee

       In this video, he’s only doing the actual stimming/squeezing RIGHT when the birds hit.  You can see him tense up and his free hand goes rigid.  Otherwise it’s totally just him concentrating on an iPhone game like kids do!

      http://www.youtube.com/watch?v=Mt4n_nDB1xY Here you can see him playing with legos.  The stimming comes into play as he does a repetitive blaster noise and waves them in front of his eyes (seeking visual stimulation, his occupational therapist thinks.)

      He doesn’t stop his hands at school, but he stops the noises.  He seems pretty conscious of stimming but doesn’t say anything other than that it feels good.  He’s definitely aware on some level, and is sometimes embarrassed and will shut his door so he can do it without us hearing or seeing him.

      From fall of 2010, here’s a video that more clearly shows the OBVIOUS stim.  Many times if you didn’t see something like this and didn’ tknow him, you wouldn’t even notice the rhythmic tensing up. http://vimeo.com/14324698

      • Shriekhouse

        Thanks for sharing those additional videos. It’s funny, on the face of it my kid plays very similarly to Chipmunk in the Angry Birds video (tensing/breath-holding in anticipated game outcome to his input) and in the noises and gestures when playing with his star wars legos (maybe not so sequential or about the arranging, but still, the noises, handling/looking at each one). But not the more obvious car-squeezing one. Still, something here is resonating. I’ll take your advice and start videoing more to share with his therapist.

        I’m sorry Chipmunk is sometimes embarrassed. It seems like such a good thing, stimming – a harmless way to self-soothe and organize one’s nerves. Or is current thinking that we should try to help kids wean themselves from it? 

  • layla

    This is so kind of you; a post like this could save people so much time and anquish. You seem like a truly beautiful person and so willing to share and explore. Thank you. I did not have this exact issue, but I know if I did- I would be beyond grateful for this post. Sharing is everything and knowledge is power. Thank you!

    • http://www.mommymelee.com Maria Melee

      Thank you so much!

  • http://awholelotofnothing.net Angie [A Whole Lot of Nothing]

    You are an amazing mother. By doing all the research and being so assertive, you have no idea how much you are helping him.

    • http://www.mommymelee.com Maria Melee

       Thank you, love.

  • Josette Plank

    One of my children – a bright, but “complicated” child when younger – would do everything from hand-flapping to chewing hands to making a throat “gulping” noise to not being able to sit on a chair without balancing it on one or two legs while completely engrossed in whatever else was going on. The chair balancing thing in particular was like watching a Cirque du Soliel act. And when I pointed it out, the child was completely unaware it was even going on.

    I never did much research on it – other than to double check with me pediatrician on the hand-flapping – so now I’m intrigued. I had read someone once that some kids who do this outward repetitive stuff were usually working out complicated stuff in their heads, and that the movements were a way for the body to sort of have something to do, while the brain was otherwise engaged. I don’t know if there is any scientific backing to that, but it made sense enough to me at the time and with the child in question.

    Said child is now a teen, and many of the behaviors have disappeared into more socially acceptable ticks and fidgets. Also, kiddo is involved in a high level of sports about 15-20 hours a week, and I think this may have made a difference as well.

    ETA: Ugh. I can never figure out these sign-in choices. I used to be at h.a.l.u.s.h.k.i, now I’m at josetteplank.com Sorry!

    • http://www.mommymelee.com Maria Melee

       That chair balancing thing would give me a heart attack.  Chipmunk has a friend who does that an I am always picturing busted heads (because a classmate busted his head when I was in fourth grade). 

      I think for a lot of kids it’s actually a sensory processing thing.  That’s what two my son’s OT’s have said.  It’s just complicated, unique ways of getting the input needed to get through the day or feel good or relax or cope with boredom or deal with anger–just all the stuff people need to cope.  I bite my nails to the quick and have since I was a tiny kid.  I play with my hair.  I can’t stand having anything on my hands, even lotion or nail polish.  They say one in 20 kids has significant sensory issues, and those can exist without any other comorbid disorders.  With Chipmunk it’s part of this complicated picture of the sensory stuff, social dysfunctional stuff and repetitive behaviors.

      I also think a lot of high functioning kids skate by (they certainly did when I was a child) without ever having (or maybe not even needing) interventions. 

  • Anonymous

    My daughter developed tics mid year last year and like you I spent hours searching youtube to figure out what exactly she was doing. I hadn’t heard of stimming before so this is really interesting to me. And I totally agree, when I mentioned my daughter’s symptoms to her doctor they were sort of brushed aside, but when I sent this video (http://www.flickr.com/photos/51413927@N04/5762670578/in/photostream) she immediately set us up with a neurologist.

    I wonder what the difference between tics and stimming is. Tics begin with a tightening and loosening of muscles, but in my daughter’s case escalated in to eye blinking and some pretty intense arm movements. It was heart breaking watching her because I just didn’t know what was going on in her brain to make her do what she was doing. What I learned is that this develops in a lot of kids in 1st and 2nd grade (maybe even Kindergarten with her) and that it’s often due to the stress of getting acclimated to school.

    Amazing how when we are pregnant with babies we just kind of assume things are going to be okay as long as we’re doing our best to keep them safe. It’s really hard to accept that some of this is out of our control…and not our fault. 

    • http://www.mommymelee.com Maria Melee

      He’s had different doctors diagnose his squeezing and its variants as a chronic motor tic, stereotypic movement disorder, and stimming.  I think tics and stims are super similar, but the difference as I understand it is ability to stop/start/control it.  At least with Chipmunk, he can definitely stop if he wants to or if he needs to, though it APPEARS involuntary.  It took until he was older for him to be able to communicate that he can do it when he wants and he can stop.  But I know there are kids who can’t control stims so I have no idea.  Our first evaluation was with a neurologist too.

      It’s an interesting thing for sure, and from what I’ve been told it can be almost impossible to tell the difference in some cases.

      Your video definitely looks like a tic to me though, only from what I’ve seen surfing YouTube hehe.  I’ve read that a lot of kids with motor tics do grow out of them.  I think you’re spot on that it can be related to stress.

  • conv

    Hi. Just found your blog, when searching for my son’s stimming. My son (3) does this tensing up a lot. Def a stim, but my question is: Is your son diagnosed with anything now? They say my son has SPD but coupled with a speech delay, I am concerned there is more to it. Sorry if you answered this in another post.

    • http://www.mommymelee.com Maria Melee

       Hi!

    • http://www.mommymelee.com Maria Melee

       Augh, sorry, comment fail!  Anyway, Hi!  My son’s OT said that kids with SPD can actually stim as a way of trying to get sensory input.  She thinks that’s at the root of my son’s stimming, but I have never been super concerned with “why” as long as it’s not harmful or disrupting too much at school.  He was DX with Asperger’s when he was five.  (That’s really early for that dx, and it could be that when he’s older, the label would be “removed,” but for now it’s really important for us with insurance so I’m very grateful that was the conclusion his neuropsych had.)

      Good luck with your little guy!  Have you thought about working with your local Early Steps type organization for an evaluation?  Their services are free and they might be able to point you in the right direction if there’s more going on.

  • Anisregi

    Hi, for some reason I came to your page, and looking at your video I see   what your son does…it  looks like a tic, a PANDAS/ PANS tic…