Looking at Self-Stimulation

Each day, a good portion of our energy is spent in self-stimulation. Just look at the people around you. You are in a room with your family watching television or at a meeting with a group of co-workers. Although you are all seemingly engaged in the same activity, your daughter or colleague is playing with her hair. Your son or your office-mate is shaking his leg and tapping out rhythms on the arm of the chair. Your husband is flipping channels with the remote or your boss is flipping papers. If you ask them what they are doing, they would likely reply that they are watching television or having an important meeting. They would be less likely to say they were channel surfing, twirling their hair, practicing the drum part for “Wipe Out,” or fanning their papers.

Each of us, even those of us with more intact central nervous systems, tolerates differing degrees of stimulation. Look at the difference in the preferred musical tastes (and intensity levels) between the teenager and the fifty-year-old. Although many teenagers enjoy megawatt rock concerts with all the trimmings, older adults are more inclined to seek softer music or silence in a dimly lit room. In the same way, children who have visual impairments and additional impairments, including those who are deafblind, vary in the amount and intensity of stimulation they need.

If we come to accept that self-stimulation is an important and valid activity for individuals without disabilities, then we must begin to revise our thinking about addressing self-stimulatory behaviors in individuals who have sensory impairments.

Some Questions to Consider In Addressing Self-Stimulatory Behaviors:

Can this behavior be stopped?

In looking for the answer to this question, first take a look at yourself. Try this little exercise: identify one of your own deeply cherished self-stimulatory behaviors such as cracking your knuckles, humming, sliding a charm on your necklace, etc. Try to keep track of how many times during the course of a 24 hour period you engage in this behavior. Then spend the next 24 hours refraining from this behavior. If you succeed, then try to extinguish that particular behavior for a month. Stop this behavior under all kinds of circumstances: times of stress, times of idleness, etc. Once you have completed this exercise, answer the question for yourself. Your answer will either be a resounding “no” or a “maybe, if” depending on your particular success in completing the exercise.

Extreme measures would have to be taken to “stop” a child from accessing his own face with his own hand.

Children who have visual impairments and additional impairments, including those who are deafblind, participate in self-stimulatory behavior (just like you and me) to calm, to energize, to get feedback, etc. Most of the time you can’t completely extinguish self-stimulatory behaviors, and perhaps you shouldn’t, because it does serve a purpose.

Can this behavior be redirected?

Many parents find that their child is more likely to participate in self-stimulatory behaviors when he/she is idle or stressed. Interacting with your child in some way may break up the self-stimulation. If the behavior appears in response to stress, finding ways to help him relax (e.g., massage, being wrapped up in a quilt, etc.) may reduce the amount of time spent in the behavior you find inappropriate or harmful. If your child is left alone, however, it is likely he/she will re-engage in this activity as soon as the opportunity presents itself.

Can this behavior be “contained”?

Some behaviors may present problems because they are considered socially inappropriate in specific places. Those of us who are smokers have learned to refrain from our favorite self-stimulation behavior on flights, but we all know exactly where to go in the airport for that last cigarette before the flight leaves.

With some effort, many children can learn to remove themselves to their bedroom or a private place when engaging in self-stimulation that is not considered socially acceptable. Using calendar symbols to represent this favored activity and scheduling the activity as part of the child’s day may help the child refrain from this particular self-stimulatory behavior for increasingly longer periods of time and stay involved in other kinds of activities.

Can this behavior be modified or expanded?

Self-stimulatory behaviors are valuable because they tell you how your child takes in information. If your child likes to burrow down inside the cushions of the couch, be held or hugged a lot, enjoys massage, etc., you can assume that he is motivated by information he receives proprioceptively. If your child likes to vocalize, listen to music, or bang things together next to his ear, you can assume he is motivated by information he receives through hearing.

These behaviors can be used as a way to explore the individual’s preferred sensory channels for receiving information from the world. With this information, we can identify preferred sensory experiences around which we can develop more “mainstream” leisure activities that our children will also come to view as “leisure.” For example, if a child enjoys the visual sensation of lights, we can find age-appropriate toys that might be motivating to him. In addition to familiar toys such as Lite-Brite, consider lava lamps, continuous wave machines, lighted drafting tables for drawing, and even some Nintendo-type games. You might also consider extracurricular events such as visiting arcades, decorating with lights for appropriate holidays, or lying in a hammock under a tree watching the play of light through the leaves.

Take time to observe the types of self-stimulation that your child participates in and when these behaviors occur. Watch him/her and make notes about what you see and when you see it. Then try to see if there is any pattern to these behaviors that would give some insight to the type or types of stimulation he/she prefers and the purpose it serves. At the same time, note what types of activities he/she finds aversive.

When you have a good understanding about your child’s preferences, begin to brainstorm ways that you can offer other stimulatory activities. Sometimes your child’s favorite self-stimulation activity can also be modified or expanded in a way that will make it more socially acceptable. For example, everyone knows “nail-biters,” but do you recognize them when they become “the manicurists?” Several of my friends substitute the more acceptable behavior of nail care for their favorite activity of nail biting. They carry a complete manicure set with them at all times and can often be seen in meetings quietly filing or clipping a nail. They buff, cream, and polish. They examine their nails for chips, snags, splits. They are rewarded by others who admire their efforts instead of being held in low esteem as nervous nail-biter types.

Ask for help from your child’s teacher, physical therapist, occupational therapist, and others. Look at children of the same age and try to find toys or activities that may make the self-stimulatory behavior appear more “normal” and/or socially acceptable. You should realize, however, that generally your child will need support from you to seek out these more acceptable behaviors. Their first preference will usually be for the behavior they have developed on their own.

Can the environment be engineered to make this behavior safer?

People who like to jump off things are great examples of engineering the environment to make a dangerous self-stimulatory behavior safer. These folks (skate-boarders, skydivers, skiers, etc.) have developed elaborate ways of placing themselves in extremely dangerous activities and surviving. We have industries based on protective clothing and equipment that will allow them to hurl themselves through space and make a safe landing.

Frequently, the best you can do is to provide protection for children who put themselves in danger of bodily harm by participating in self-stimulation activities that are excessive to the point of creating physical danger to themselves or others. Splints, helmets and other devices sometimes must be used temporarily to protect the child and others around him/her.

In addition to providing protection from the effects of the behavior, it is important to look at the cause of the behavior. Often, these behaviors erupt in response to real physical problems that the child is not capable of communicating to you. These behaviors might indicate pain or decrease of sensation, as in the case of retina detachment or ear infections. It’s very important to the health and safety of the child to seek out appropriate medical examinations when this type of behavior emerges or escalates.

Emotional and environmental conditions may also provoke increases in self-injurious behaviors. One individual I knew exhibited a dramatic increase in self-stimulatory behavior after the death of her father. The amount and intensity of the behavior posed concerns for her safety and the safety of others. Since there was no physiological basis for her behavior, the family spent a lot of time with her looking at pictures of her dad, going to the cemetery, and trying to participate in activities that were associated with her father. After a period of time, the behaviors decreased to levels that were comparable with the period before her father’s death.

Changes in schedules or moving to a new environment can also bring about increases in self-stimulatory behavior. Helping the child anticipate these changes and providing as much consistency as possible through familiar routines during times of change may help reduce this type of behavior.

Conclusion

Like you and I, children who have visual impairments and additional impairments, including those who are deafblind, have a need to participate in self-stimulatory activities. Because their behaviors may appear very different from our own and can interfere with learning or become dangerous, they are often viewed negatively by other people. Changing our perception about these behaviors may help us respond to them in a better way.

There are a number of ways to intervene. Keep the child involved with others during the course of the day. Help him/her contain the behavior or engineer the environment in a way to make the behavior safer. Schedule times in the day for your child to engage in the preferred activity. Look at ways the behavior can be adapted so it will appear more “normal.” Use the information these behaviors tell you about your child’s preferred channels of sensory input as a way to develop recreational and social pursuits that may be enjoyable for him/her, even if these activities will not entirely meet his/her “leisure” needs. Finally, accept that you will probably never completely extinguish the behavior without having it replaced by another self-stimulatory behavior. Self-stimulation is common to all humans and serves an important purpose.

Additional Reading:

Stereotypical Behaviors and Self-Stimulation. Retrieved from Active Learning Space
https://activelearningspace.org/principles/social-and-emotional-development/stereotypical-behavior-self-stimulation