How to Know if Child Stimming When Excited Is Autism

Stimming refers to self-stimulatory behavior. It can occur in the form of repetitive body or hand movements, sounds, phrases, words, moving objects, and other behaviors. Most often, stimming is talked about in the context of Autism Spectrum Disorder (ASD) or Attention Deficit Hyperactivity Disorder (ADHD). While the two conditions are different, people with Autism or ADHD can be more likely to experience sensory processing differences and may “stim” to self-regulate. One might also stim when excited or happy, among other reasons. For example, autistic children who hear a song they like might start to stim.

Although many autistic people stim, neurodevelopmental disorders like ASD or ADHD are not the only cause of stimming behavior. Anyone can stim, whether they're neurotypical or neurodivergent. Unless the specific stimming behavior someone engages in is harmful (in which case, it can be replaced with a healthier stim), there's nothing wrong with stimming. So, what should you know?

Let's discuss understanding stimming behavior in children, stimming as a typical behavior and why it happens, and factors to consider when evaluating stimming behavior in a child. We'll also talk about when to seek help for stimming.

Understanding stimming in children

Stimming can be used for emotional regulation or other reasons. Before we discuss how to detect whether or not stimming could be related to Autism, let's go over types of stimming behaviors and potential reasons kids might stim.

Types of stimming behaviors

There are different types or categories of stimming behaviors. Types and examples of common self-stimulatory behaviors include but aren't limited to the following:

• Body movements: Rocking, swaying, stepping from foot to foot, or bouncing.
• Hand movements: Flapping hands, flicking fingers, rubbing fingers together.
• Vocal stims: Repeating words, phrases, noises, or a line of a song.
• Visual stims: Staring at objects, like fans, spinning toys, or lights.

This is by no means an extensive list of what stimming might look like. Other examples of common stimming behaviors include but aren't limited to hair twirling, biting nails, or picking skin.

Reasons why children stim

Here are five possible reasons a child might stim, from emotional expression to coping with sensory experiences:

• Excitement. Many children stim to express excitement. For example, a child might wave their arms when given information that excites them.
• Regulating anxiety symptoms or emotional distress. Many people stim for the purpose of self-regulation when anxious or overwhelmed, regardless of whether they are autistic or not.
• For sensory input. Many people with conditions like ASD or ADHD have sensory differences, which can include sensory-seeking behaviors.
• Concentration. It is common for children with ADHD to engage in repetitive movements like shaking their legs or otherwise moving around to promote focus.
• To decrease sensory overload. While some stims could be to add or increase sensory input, others could be to cope with sensory overload.

Movement can release dopamine and may help relieve tension. Sometimes, therapists will even direct people to learn coping skills like shaking their arms by their side to aid self-regulation. Save for potentially harmful stims (e.g., head-banging), stimming can be a healthy mode of self-regulation.

Stimming as a normal behavior in children

Unless a specific stim is harmful, there is nothing wrong with stimming. Autistic children may be more prone to potentially harmful stims, like punching, excessive skin picking, or head-banging. If an autistic child does have a harmful stim (something that could hurt them or someone else), a professional such as an applied behavioral analysis (ABA) therapy provider or an occupational therapist can work to teach them replacement behaviors that aren't harmful. Otherwise, stimming isn't a bad thing and may even have various benefits.

Stimming as a way to self-regulate

One benefit of stimming is that it can help children self-regulate. For example, children may cover their ears if they hear loud noises or seek extra sensory input from a stim toy, fidget toy, or body movements to help them focus or calm down.

Stimming as a way to express emotions

Sometimes, kids use stimming behaviors to express emotions. For example, jumping, bouncing, or hand flapping are all examples of stimming behaviors children may use when excited. This is not limited to Autism.

Factors to consider when evaluating stimming in children

Autistic stimming vs. typical stimming behavior isn't always easy to separate. Sometimes, an autistic person will use stims that are common among the general population, like hair twirling. Other repetitive behaviors may be less common in non-autistic kids. Autism Spectrum Disorder is characterized by differences in communication, reciprocal social interaction, and restricted, repetitive patterns of behavior and interests. If a child stims but doesn't fit the criteria for ASD, stimming alone will not lead to an ASD diagnosis.

Developmental stage of the child

While older kids, teens, and adults may also stim, a child's developmental stage is worth considering when evaluating stimming behavior. Infants and younger kids might engage in specific stimming behaviors now but proceed to grow out of them later on. If you are concerned by a child's stimming, bring it up with their doctor at or prior to their next medical exam. Pediatricians should screen for Autism at 18 and 24 months, though some kids may get diagnosed later, especially if symptoms aren't clear enough at that time or if a provider is not well-versed in ASD.

Context of the stimming behavior

In determining whether stimming is related to Autism or not, one important factor could be the context of stimming behaviors. Why does the child stim? For example, do they tend to use certain behaviors:

• In stressful situations or when experiencing strong emotions?
• When they're excited?
• When focusing?

Often, children will stim without realizing it. Although stimming and fidgeting aren't synonymous, some of the behaviors can be the same. Fidgeting can be a symptom of ADHD, so if a child shows other signs of ADHD, getting an evaluation may be helpful.

When to Seek Help for Stimming Behavior

When are stimming behaviors worth seeking help for? Parents should seek help for their children through a medical exam or speaking with a medical provider in the following two instances.

If stims are harmful:

What if your child does use a potentially harmful stim, like head-banging? Working with an ABA therapy provider, an occupational therapist, or another trained medical professional may be beneficial, especially if the child does have an Autism diagnosis or is suspected to have ASD.

ABA therapy, occupational therapy, sensory integration therapy, and working with a speech-language pathologist for speech therapy are all common interventions for autistic people. Every autistic person is different, and recommended therapies are generally need-based. ABA providers or occupational therapists can teach kids a healthy replacement behavior (e.g., using stim or fidget toys) for a potentially dangerous stim using methods like positive reinforcement.

Children with more advanced verbal abilities may be able to explain why they use certain behaviors, like head-banging or punching, that could hurt them. This may help guide parents and medical providers toward the steps they should take next to help the child.

If the child shows other signs of ASD:

If a child shows other signs of ASD, you may seek an evaluation. Early detection and diagnosis can be important for an autistic child's skill development and overall well-being. Here are a few things to look out for:

• Developmental milestones: Not all kids with ASD have developmental delays. However, some kids will show notable developmental differences that could indicate ASD, like lack of eye contact or loss of eye contact, not responding to their name, or low interest in playing with other kids at 36 months (3 years).
• Social interactions and communication skills: Kids with Autism may show signs of social and communication differences in diverse ways. Not showing pleasure in social situations, trouble making and keeping friends, usual social initiations, poor pragmatic or social use of language, abnormally formal speech, and difficulty with social cues are just some examples. 
• Sensory processing issues: Kids with ASD can be hyper-responsive to sensory stimuli, under-sensitive to sensory stimuli, or both. Common sensory issues include trouble with certain clothes or fabrics, food textures, specific noises, or a high pain tolerance.
• Restricted interests: Many children with Autism have special interests. If they are old enough, you might notice that your child has an intense interest in a specific topic, like a TV series, video game, animals, medicine, cars, or something else. 

To learn more about the signs of Autism, please read our articles on recognizing the signs of Autism or early signs of Autism in toddlers (for younger kids). Researching Autism and the ways it can present in different populations (e.g., women and girls), if applicable to their child, can help parents understand the diagnosis better and feel more comfortable and confident when requesting an official assessment. 

Conclusion

Stimming, referring to self-stimulatory activity, is a common behavior. Examples of self-stimulatory activity include but aren't limited to repetitive body movements like rocking, hand movements (e.g., flicking fingers, hand flapping), and vocal stims, like humming and repeating words or phrases. It is important that parents don't jump to conclusions about stimming and Autism. Anyone can stim, regardless of their age, and it may not always indicate neurodiversity.

Sometimes, stims can be linked to emotional state. For example, typical stimming behaviors could include jumping or waving arms to express excitement. They can be used to address sensory needs, such as feeling over-or-under stimulated, to self-regulate during times of stress or anxiety, or to aid focus.

While some stims can be neutral and might even be healthy coping mechanisms, others may be harmful. Parents should seek options and support from medical professionals if a child uses potentially dangerous stims or may benefit from an Autism evaluation