Stimming!

What is “stimming” and what does it look like?

Stimming is when an autistic person engages in a repetitive behavior in order to self regulate and calm down. It can be auditory and verbal, tactile, visual, vestibular, or olfactory. I want to break those down into categories just to give you an idea of what each of those looks like in terms of what you may see someone with Autism doing.

First off, we have the verbal and/or auditory stim. This can be observed as someone who is saying the same word over and over again. My son likes to use the word “carrot” and I have no clue why that is the word he likes best. He will be in the car and start loudly saying, “carrot carrot carrot carrot” very quickly for what seems like forever. He also taken to humming Jingle Bells repeatedly to himself.

One example of an auditory stim is to take your hands, cover up your ears, and then quickly uncover and recover them. It can be snapping of the fingers, clapping your hands, tapping your ears, anything that either causes noise to occur or changes the sounds that you are receiving from around you.

Tactile stimming is in the form of touch. Killian responds well with deep pressure sensory input/output. He likes to crash into things and people. When he starts having a hard time processing things around him he likes to have big hugs where we squeeze him tight. Other tactile stims could be snapping a rubber band on the wrist, squeezing of the hand or other body part, massage, opening closing fists, hitting or slapping objects, and rubbing or scratching oneself.

The next stim is a visual stim. Killian loves glitter and fixates on it. I made him a glitter sensory bottle that he likes. For a couple of months, he was having trouble at school with staying in line and keeping up with the class because he would see small amounts of glitter that had fallen on the ground and he had to stop to find each and every piece. He would then come home off the bus over an hour later with it still in his hand. He had kept it there and would rotate his hand around so the light would catch the sparkles at different angles. Geodes are also a big source of excitement for him. It sparkles and shines with the addition to having different textures throughout.

More examples of visual stims may include watching your hands as they are flapped around, staring out blankly in a focused area, rapidly blinking, or changing the lighting in a room by flickering the switch. All of these are a way for the person to create a sensory input/output.

Vestibular, or more commonly known as the sense of balance, is another very common stim that you will see when someone with Autism is experiencing high levels of stress or agitation. Rocking back and forth or side to side, jumping up and down, and spinning. Killian loves to spin. I joke about how he doesn’t seem to have an equilibrium because he can spin around in circles for 10 minutes and when he stops is able to walk normal and shows no signs of being dizzy. Meanwhile, just watching him spin makes me dizzy.

Aromatherapy is a form of olfactory stimming. Recently, Killian’s therapist, Gina, brought out some awesome Mr. Sketch scented markers (hello elementary school flashbacks!) and he would spend the entire hour sitting quietly just sniffing all the different markers and lining them up in which order he liked them best. Since he is almost 5, he of course had a very colorful nose by the end of the session. They even decided to color on himself which made him over the moon. Other olfactory stims would be tasting and licking objects that are not meant for the mouth. When Killian was younger, not as often anymore but it still occurs, he would come up and start licking people’s arms.

Stimming is used to help a person calm themselves out of a stressful situation. It can be used to stimulate someone who is not getting enough sensory stimulation or it can act as a calming tool for one to fixate on in an effort to block out all of the input around them. It’s a form of easing anxiety and can also be a way of communication. It lets others know that they are felling distressed or frustrated and need help.

Unfortunately, some stims may be self-harmful. Excessive hair pulling (trichotillomania), hitting themselves, and scratching and pulling skin off (dermatillomania) are just a few examples of those destructive stims. These are the most painful for outsiders to watch.

Agony Autie has a fantastic video that is only a few minutes long that explains stimming and what those can look like for her.

Stimming has been dubbed as something bad because it is not in societies norm. However, even neurotypicals express stimmulatory behaviors in small ways that go unnoticed such as tapping the foot, shaking and leg up and down while at a desk, rapping your fingers on the tabletop, clicking of the tongue, or biting your lip. These behaviors have been made commonplace or are either so subtle that others around you are unaware of them occurring.

Telling someone with Autism to stop stimming is more destructive. Their actions are how they are able to process the outside world. Doodling on a paper may be a way that someone is able to take in the information being presented to them or avoiding eye contact is how they can focus on what is being said because if they were to look you in the eye, they would become distracted and end up not hearing a word you just said.

Occupational therapy is one way to help the person struggling with harmful stims adopt positive outlets of expressing overstimulation. Fidgets and other sensory tools along with some accommodations are great ways of creating a safe stim. In some cases, a doctor and parent may decide that medication is needed to help curb the severity of a behavior.

At the end of the day we all just want our loved ones safe and secure. But one thing to remember is that safety and security looks different for everyone.

-The Lazy Mama

 

 

A Letter To Everyone Who Says My Kid Seems Normal

Every time I talk to someone about Killian and how he has been diagnosed with High Functioning Autism, I get the same response. “Oh, but he seems just fine.” “Really? He seems like a normal 4 year old.” “But don’t all 4 year olds act that way?” “He’s fine, he will grow out of these behaviors.” And so on and so on.

You say that all kids have a hard time touching the inside of a pumpkin when carving a jack-o-lantern. You say that all 4 year olds have an attitude and tantrums. You say that all boys are hyper. You say that he talks just fine.

I want to tell you this.

Stop. Just stop.

I don’t need to hear your skepticism. You have spent 5 minutes with him. I spend 24/7 with him.

What you don’t know is that it took us an hour to help him touch the pumpkin guts. It took hand-over-hand to get him to do tiny finger pokes into the gooey mess. We held our son as he screamed and cried because touching the pumpkin innards caused his whole body to “shiver” when he touched it. You didn’t see the patience my husband had when creating elaborate stories about having to do surgery to save the pumpkin and needing to fix its heart. You didn’t see the mental exhaustion and frustration we endured to just have him stick his hand in a pumpkin.

What you don’t know is that for a year, he has been working on touching different textures and being able to just finger paint without the sensation hurting his body. What you don’t know are how many occupational therapy sessions it has taken for him to be able to accomplish this small act of a “normal” childhood.

What you don’t realize are all of the meltdowns we endure on a day-to-day basis. More than they typical toddler. I bet your child doesn’t scream and cry and tear away at his clothes because he got a few drops of water on the sleeves of his shirt while washing his hands. Or how I can’t take him to the splash pad with his friends to play because water got on his swim suit and having the clothes stick to his body causes him so much anxiety that you would think the world is literally coming to an end all around him. That he will have sudden bursts of emotion that don’t pertain to the situation he is in and become angry at everyone around him because they don’t understand what he is feeling or why it is happening.

You don’t see how he can be so calm and mellow and out of nowhere he is throwing his arms around while flicking his fingers together, kicking his legs, and yelling random sounds. You don’t feel his limbs hitting and kicking you so suddenly that you have no time to react and block the advances. You have never seen how he runs at full speed and crashes into the nearest object or how long it has taken to get him to only crash into soft objects like a bed or couch instead of the wall. You haven’t been tackled while doing the dishes by him because his body “felt like it was going to explode” if he didn’t get that hard pressure hitting his body.

You hear him having a conversation with you and using big words., but have you actually stopped to realize that he is only talking to you about the subject HE chose? Have you noticed how he won’t look you in the eye when he talks to you? Or what about the fact that he acts completely oblivious to your existence if you bring up a topic he has no interest in. And I’m sure you still haven’t noticed that if you initiate a greeting then he will get angry and growl at you, despite the fact that he was just in the happiest and friendliest mood.

What you don’t realize when making these comments to parents of kids who “look fine” on the outside or are having a good behavior day, is that you negate everything we have worked so hard for. You remind us of all the doctors who have told us that there is nothing wrong with our kid even though we know there is. You are basically telling us that we are overreacting and causing more stress and chaos in our lives than there really should be.

We have fought so hard to get to where we are today. We have gone through hours and hours of testings with specialty doctors, therapists, and school educators. We spend more time trying to help our kids succeed in the simplest tasks that to your kids has come so naturally. I’m sure your 4 year old can tell you he needs help. Mine can’t do that on his own. He throws the object and screams that he can’t do it. We have to tell him that when he can’t do something on his own that he has to ask for help. We have to coach him on how to ask for help. He will be 5 in 3 months and still has to be coached every single time. Not just here and there. Every. Single. Time.

So please. Before you start trying to tell me that you don’t think there is anything “wrong” with my son, think about how you are only seeing a tiny glimpse into our life. Remember how hard we, as parents, are struggling and fighting to make what you are seeing, an all-the-time occurence.

We really don’t need more people in our lives throwing skepticism our way. We just want to know that you care for us and will support us, even if it’s just with kind words.

-The Lazy Mama

When Sounds Hurt My Body

The other day when we got home from some random outing, we walked in the door and the dog went nuts. He was jumping all over the house like he had just ingested a gallon of coffee, jumping on the couch, running to the other side, jumping down, running to one child, then the next, all while barking. Oliver was screaming from excitement at every time the dog barked, which then made the dog bark again, most likely to the obscene disciples that child can reach when shrieking. Killian was laughing and yelling, “Ah! Kizzy! Kizzy is jumping! He’s jumping,” over and over again. I could feel my anxiety rising and rising as I’m trying to get the dog to hold still, Killian to stop repeating himself, Oliver to stop shrieking, and I am failing at each one.

I was losing my ever-loving mind.

My anxiety gets triggered by lots of sounds happening all at once or having the same sound(s) repeated over and over again. I feel like I am falling and drowning. Everything is caving in on me and there is no escape.

I love music. Classic rock is amazing, however, most songs I have to turn off because the instrumental solos are stuck on repeat of just a few chords and seem to go on with no end in sight and I start feeling suffocated. Guns and Roses is a great band, but I can’t listen to them because this happens in nearly every song they made.

So, when all of this loud chaos was happening and I couldn’t get it to stop, I lost my temper and screamed at my kids to shut up. Shut up is a no-no phrase in our house. Killian looked at me and started crying and ran off, Oliver just stood there and the dog froze. as my husband calls it, I had used my “demon voice” aka the “Mom has finally lost her shit and now everyone is in trouble” voice.

I felt really bad for scarring Killian and I immediately said sorry and that mommy was going to go into a time-out for saying something naughty. Really, I just needed a break from everything. But I knew that if I told him that I was going in time-out, it would show him that even mommies make mistakes and do something naughty at times.

Later, after I had calmed down, I got to thinking about how I react to sensory overload and how Killian is affected by the same thing but on a greater level at times. For instance, his clothes HAVE to be Cat and Jack or he starts to melt down. A friend gave me some cargo pants that her son had outgrown and Killian fought tooth and nail about how it hurt his skin. He said that it was to heavy, the pants felt to big on his legs, the button hurt, and he HAD to take them off NOW! Having tags on clothes makes him itch. If he even gets 1 drop of water on his clothes, he HAS to take them off because he can not stand to have that on him. Cat and Jack are an amazing brand of kid’s clothing that is specifically designed for kids with special needs and sensory issues. Everything is smooth, tagless, have a stretchy band and drawstring option in pants, and adaptive.

Killian has sensory processing disorder which makes some of his senses more sensitive and others lacking. His body craves deep pressure stimulation. He loves big hugs because having his body squeezed tight is calming to him. It will be 90º and he is wrapping himself in a giant comforter so he has that compression around his entire body. He loves to run and crash into people or the couch, pillows, and blankets. But if you were to run your fingertips lightly up and down his arm he will pull away like he just got burned.

Sensory processing refers to the way the nervous system receives messages from the senses and turns them into responses. For those with Sensory Processing Disorder, sensory information goes into the brain but does not get organized into appropriate responses. Those with SPD perceive and/or respond to sensory information differently than most other people. Unlike people who have impaired sight or hearing, those with Sensory Processing Disorder do detect the sensory information; however, the sensory information gets “mixed up” in their brain and therefore the responses are inappropriate in the context in which they find themselves. SPD is a neurophysiologic condition in which sensory input either from the environment or from one’s body is poorly detected, modulated, or interpreted and/or to which atypical responses are observed.

I recently was introduced to a wonderful YouTube activist who is shedding a much-needed light on Autism and other disabilities from a first person point of view. Her name is Agony Autie and she created a fantastic video about Sensory Processing Disorder . In the video she explains some of her triggers and what it feels like to her. Having your senses overloaded faster and easier than “normal” people can be very traumatic and confusing. I’m sure it can even become embarrassing for some. We don’t live in a sensory friendly world. We are having our sensory systems stimulated at all times of the day. From having the sound of an airplane flying overhead at the same time as the cracking of car tires over gravel, distant laughter, a nearby conversation, music playing on the speakers, the smell of coffee from the cafe’, onions from the restaurant next door, fries from another restaurant across the street, the warm sun mixed with the cool breeze on your skin. All of these things that I am currently being exposed to as I sit outside of Starbuck and write. Things that have no effect on me because I am naturally able to process the sensory input that I am receiving into categories of “important/needed/relative” and “unimportant/background/junk” files. I can have all of these sensory inputs attack my system and they get filtered through without any negative reactionary discord.

Those with SPD are unable to filter those olfactory augmentations. The brain becomes overloaded and everything is too much to handle. Some may cover their ears, close their eyes, or even curl up into a ball in order to block out the world around them that is causing so much harm to them. Agony Autie explains that some of these sensory inputs may have a very physical reaction to the person even if they are not tactile in nature. For instance, hearing specific words or sounds may cause your body to cringe and feel distressed. Or looking at a pattern may cause your eyes to swirl and your head begin to pound.

Something to help those with SPD is to create a sensory backpack that is filled with items to help block out the offensive stimuli and give them something else to replace it with. For instance, if the child (or adult) is easily offset by sounds, include a pair of noise canceling headphones in the backpack for them. If moving colors tend to calm them, include a liquid motion bubbler for them to focus on. Because Killian craves the deep pressure and physical resistance I put a couple of therabands in his backpack. Oliver puts EVERYTHING in his mouth, she he has a chewy necklace that he can chew on instead of licking every possible surface of the grocery store.

Unfortunately, we can not prevent stimuli from occurring, but we can warn the child about what to expect and be prepared for when it becomes too much to bear. Teaching them to recognize when the triggers are beginning to affect them negatively and how to safely and effectively let you or someone else know that they need help becoming regulated again. Once you start seeing the tell-tale signs that your child is becoming agitated, bring out the sensory backpack and ask them what hurts, or select something for them if they are unable to communicate with you.

There are two types of sensory processing challenges, and many kids experience a mix of the two. One is oversensitivity (hypersensitivity). This leads to sensory avoiding—kids avoid sensory input because it’s too overwhelming. The other is undersensitivity (hyposensitivity). This causes kids to be sensory seeking—they look for more sensory stimulation. Often, kids with sensory processing issues are oversensitive. They try to avoid sensations they find intolerable. But some kids seek more sensory input, not less. They may want to touch things and feel physical contact and pressure. They may also be undersensitive to pain and have an unusually high tolerance for it. That’s why they may prefer playing rough and not understand if they’re hurting someone. Some kids may be both sensory avoiding and sensory seeking. They may be oversensitive to some sensations, and undersensitive to others. A child’s reactions can also change from one day to the next, or even throughout the day, depending on the environment or situation.

Kids who are sensory avoiding may react to a wide range of triggers. These can include loud sounds, uncomfortable clothing, crowded spaces, or certain food smells or textures, among others. Whatever the trigger, the reaction can sometimes be extreme. Sensory overload can lead to sensory meltdowns. These are very different from tantrums because they’re out of the child’s control. Kids who are undersensitive to sensory input have the opposite situation. They often have a need for movement. And they may seek out input like spicy or sour tastes and physical contact and pressure.

Sensory processing issues aren’t a diagnosis on their own. But they often co-occur with two conditions: ADHD and Autism. Kids don’t have to have ADHD or Autism to have sensory processing issues, however. Some of the signs of ADHD may look similar to the signs of sensory processing issues. Kids with either of these conditions might need to be in constant motion, for instance. But the reasons would be different. Like kids with ADHD, kids with sensory processing issues may also experience anxiety. And while ADHD and autism often co-occur with sensory issues, they do not cause them.

There are a few tests professionals can use to identify sensory processing issues. These include Sensory Integration and Praxis Tests (SIPT) and the Sensory Processing Measure (SPM) checklist. In general, though, the behaviors kids show are very visible and evident. It’s important to observe your child and take notes to share with professionals who might identify your child’s challenges. Occupational therapists (OTs) are often qualified to identify and create treatment plans for sensory challenges in kids. Other professionals may be able to identify sensory processing issues, too.

There are no medications for sensory processing issues. But there are professionals that can help your child learn strategies to cope with sensory challenges.

OTs often work with kids with sensory issues. They help kids find ways to be less overwhelmed by sensory input. You may have heard of a treatment known as sensory integration therapy, but more often therapists might create what’s called a sensory diet. This is a tailored plan of physical activities. It helps kids learn to calm themselves and regulate their behavior and emotions. And that makes them more open to learning and socializing. Some of these activities are heavy work, a type of activity that pushes or pulls against the body.

Here are some things that might be included in a sensory diet:

  • Jumping jacks
  • Rolling on a therapy ball
  • Push-ups
  • Hopping up and down
  • Climbing ladders and going down slides

Child psychologists also work with kids who have sensory processing issues. They can use cognitive behavioral therapy to help kids talk through their feelings and frustrations caused by their challenges.

At school, your child might be able to get accommodations through a 504 plan. (If your child has an IEP for another issue, it could include accommodations for sensory issues, too.) The teacher may also give your child informal supports.

Classroom accommodations to help kids with sensory processing issues might include:

  • Allowing your child to use a fidget.
  • Providing a quiet space or earplugs for noise sensitivity.
  • Telling your child ahead of time about a change in routine.
  • Seating your child away from doors, windows or buzzing lights.
  • Allowing your child to take exercise breaks to self-regulate.

Right now, one of our main goals in OT, speech, and behavioral therapy is to get Killian to recognize on his own when his senses are feeling overloaded and how to ask for a break or signal to us that his brain needs a break to decompress if he is unable to verbally communicate those needs. I hope that we are able to come up with a solution before he begins Kindergarten so we can add it to the IEP for all of his instructors to be able to know and use when school begins to tax his little body and brain.

If you are needing help creating a sensory backpack or coming up with sensory friendly games and/or toys, Pintrest and a ton of amazing ideas. It’s where I went when creating Killian’s. Also, speak with your child’s therapist about seeing if their health insurance would cover the cost to provide you and your child with these tools. I recently learned that his does (though it can be a lot of paperwork and wait time).

-The Lazy Mama