Stimming solutions, anyone?

[babyboomer]

I have a gentle little guy who has both Down syndrome and autism. He's shown slow but steady progress re: functional skills, but his stimming (flapping hands to chin, and/or turning around) is nonstop. He has a 1:1 and she's constantly gently slapping his hands down w/ "No! Down" ... and 3 seconds later, the stimming is back. Maybe the ONLY time he doesn't stim as much is when he's physically engaged in using the computer (switch) - as soon as the switch is hit, the stimming is back. Those hands just keep on stimming. He can walk, stim and move his head from side to side ... and get to the right place!

Is there anything - ANYTHING - that has worked in any manner to reduce the amount of stimming a child w/ autism may do? Any techniques at all? Any resources? When he stims, he misses out ... and he stims a whole lot!

HELP!

[peglem]

Are you sure its really stimming and not a movement disorder? People tend to assume its stimming if a person has autism, without really checking. If it is a stim, I think about the best you can do is find a more acceptable stim that serves the same purpose. But, I hope others here can help you more than that.

[Mother's Heart]

Various thoughts: (As a SPED teacher I expect you're already familiar with most of what I bring up here, but perhaps something will jump out as a possibility for your little one)

are you certain he misses out when he stims?
For my son...yes, sometimes stimming seems to interfere, but I've found that more often it is his means of focusing between actions.

When he meets someone new he 'sizes them up' by holding his arm out straight towards them and flipping his hand, directing his gaze down the length of his arm and through the motion of his hand....THIS is when he is looking them over. The same goes for looking at the moon or whatever else he is intertested in. I homeschool, and he stims in between questions....if he doesn't then he misses my stimulus. He appears to not be listening or noticing anything while he does this, but when I stop and wait he moves to respond more purposefully than when he doesn't stim.

When I DO want to decrease the stimming then touching his arm or gently/firmly moving it downward works.(if that's the stim, if it's his head, or running, or rocking I break the pattern another way) It seems to be enough to just break the pattern to interrupt the stim. This comes from years of doing it repeatedly, and at first my prompt had to be more intrusive but over time has come to where I seldom have to do more than just touch him now, or even gesture towards what I want him to attend to/do. LIke everything else, it just took a lot of patience and gentle persistence.

Another thing....he clearly sees what we are working on best if he isn't looking directly at it and indeed, can neatly write long passages without appearing to ever look at the page. It's not that he never studies things with a direct gaze, but he also sees things even when it really looks like it would be IMPOSSIBLE for him to see it from his position. When asked about this he explains that he CAN see it fine when he seems to be looking away...and that it's not 'like touch-typing', writing by feeling...he really DOES see it. It takes a conscious effort to remember not looking doesn't equate with not attending.

The aide at my son's former school repeatedly slapping his hand down and saying "no! Hands down"! is what first 'triggered' my son's outward aggression, when he finally had enough he hit her and gave her a bloody nose. All that holding his hands down did was frustrate him, and the verbal reprimand was painful to him. We've been fighting against the aggression battle ever since.

Giving him a replacement behaviour helps somewhat.

now, to turn from the behaviour mod approach to understanding underlying causes: Physical discomfort=increased stim

I think that allergy flares and illnesses very clearly increase stim. I think my son's hernia/GE reflux and chronic respiratory problems contributed. I also think that his meds, especially the asthma meds, were factors. Lack of sleep. Yeast overgrowth can increase stims. For some kids treatment with antibiotics increase stims.

Sensory Integration Problems may be a factor....often something like The Wilbarger Brushing Protocol and/or a sensory diet is implemented to battle stim. I think this helped my son in times past.

There are opposing points of view on whether one should try to stop stims or allow them. I think I've seen aggressively trying to stop stims have negative effects, but I've also seen my DS sink down into constant stim and that totally takes over all else. It seems to me that guiding the child out of it, (rather than forcing) is worthwhile.

[peglem]

Mother's Heart,

That was wonderful!

[Keggy]

I would let him stim.
I find that the stims do decrease when they are ignored... but this may not happen for you.
Did you know that it is easier to recall something when you have learned it with a movement?
As our kids develop we start to teach them from the waist up, and eventually as they get older, we teach to the head and then to one side of the brain (unless we are focussing on art and music, which are never given the same respect as math, reading etc)
We have had lots of discussions on this board about stimming in the past, all those posts are long deleted. But just think how hard it is for you to stop stimming (tapping your foot, smoking etc) and how much harder it is when someone tries to get you to stop.

[Isabelle]

babyboomer

the more you focus on his "stimm" the worse it will get, tell the aide instead of constantly slapping his hands saying 'no, down' keep his hands busy, that's the answer.
don't make his stimm something to be ashamed of, let him learn and in between let him indulged on his stimming. gradually as he gets older it will fade. if giving meds or drugs to 'control' his stimm it will become unstoppable and will take life of its own, even become self-injurious behaviour.

i know it happened to my son who is now 32

[Mother's Heart]

I agree with Isabelle, Give hands a task and ignore times when he does stim. Gradually he will likely become more interested in doing the task and that will override the stim.

babyboomer

the more you focus on his "stimm" the worse it will get, tell the aide instead of constantly slapping his hands saying 'no, down' keep his hands busy, that's the answer.
don't make his stimm something to be ashamed of, let him learn and in between let him indulged on his stimming. gradually as he gets older it will fade. if giving meds or drugs to 'control' his stimm it will become unstoppable and will take life of its own, even become self-injurious behaviour.

i know it happened to my son who is now 32

[babyboomer]

One of my little guy's parents came in after school for PT conference - the parents are the ones who felt the gentle hand slapping/"No!" was the way to go - they were doing it at home.

My guy can follow routine class commands re: where to go, stand/sit, put in/give me... knows where various places are located on campus - walks slowly (toe walker) but independendly ... while I definitely saw his rapport and warmth with his parent at the conference, he appears to be totally 'on his own' emotionally speaking at school - NO interaction with anyone else, ever, unless he needs/wants something. One of his goals this past year was to engage in more fun, interactive, 'social' activities with another person ... he's not 'into' bubbles, bouncing balls, using the slide ... he'll do PT activities because the PT gives him his lunch, bit by bit, when he does what she wants. The family really REALLY wants to find a way to reduce his stimming - and in the time I have worked with their son, I have not seen any decrease/change whatsoever.

We've tried giving him something sensorally interesting (as per OT) to hold, but he'll put it down and continue stimming.

What, exactly (or hypothetically) is the impetus to stim?

I had a thought --- have you heard of "Restless Leg Syndrome" - an uncontrollable urge to move one's legs? I wonder if there is any (at all) link.

[peglem]

I had a thought --- have you heard of "Restless Leg Syndrome" - an uncontrollable urge to move one's legs? I wonder if there is any (at all) link.

Yes, that's what I meant by it possibly being a movement disorder.

Is this the child you talked about who is on risperdal? If so, how were the stims before risperdal? (His parents should know) The reason I ask is that risperdal suppresses dopamine in the basal ganglia. Too much dopamine produces tremors (like parkinson's), too little would cause things like tics or restless leg syndrome.

At any rate- why are his parents so bent on extinguishing this? He either can't help it (movement disorder) or it serves some purpose for him. I don't think every child has the same "stim motivator". If you can find what motivates him to do it, you may be able to find something else that fulfills the same purpose...but if its a movement disorder, he may be able to momentarily supress it, but its just going to happen. And if that is what's happening, it must be very frustrating to have people constantly trying to make him control it.

[Keggy]

I don't feel a stim and rls are anything alike. A stim is like the need to drum your fingers, tap your foot..etc. RLS is a whole other feeling, very unpleasant. Stimming is actually pleasureful... but we all know this because we ALL stim.

Me thinks someone should tell the parents that their method of ending the stims is actually teaching the child to (gently) slap to get someone to stop doing something (which is very bad.)

He is stimming because he needs to do it. The brain is very complex, our childrens brains are wired differently then ours, they are a bit more amazing if you ask me. Shutting down his stimming would be akin to plugging up his ears. It will be a huge distraction for him, and will be the beggining of holding him back in all areas. You can not force a kid to act typical, and by trying to do so he is likely to develop in areas where he would have.

Those who try to stop him from stimming will cause him more anxiety, which in turn will increase his stimming.

[lisa6wks]

Babyboomer,
Self stimming is exactly what it says it is, it's the brain's way of getting the stimulation it needs but isn't getting through the conventional pathways. That's why some blind children will wave their hands in front of their faces. You can't really stop the self stimming, because it is self reinforcing. What you can do, is give the child time to self stim or give them other behaviors more functional which serve the same function as the self stimulatory behavior.

Does this child see an OT, he probably needs a sensory diet. Once you help the child get enough sensory stimulation, you may seem him start to be more available for education and socialization.

Lisa

[snapdragon928]

We don't stop the stimming in my son except when doing programs. At school they take away his kinex toy and box, which is a constant thing for him to have, In order for him to do any tasks. Right now he is refusing alot of tasks at school. I think the hand slapping is a gateway to aggressive behaviors, not that I haven't tried it. Yelling is too. So the constant stimming and his obsessive behaviors are really getting in the way of his functioning right now. I think there is a reason for the stimming, even though we can't figure it out, something is going on with in that is causing extra stress. We find alot of times when it is on the increase there is an illness or pain. Right now we can't find what it is. Or an emotional stress.

[peglem]

We find alot of times when it is on the increase there is an illness or pain. Right now we can't find what it is. Or an emotional stress.

This is so true. I think my daughter is often in pain, put can't express that in an nt way. If we treat for pain(ibuprofen) it usually helps, but sure would be nice to find the source of the pain instead of just trying ibuprofen to see if that helps.

[Mother's Heart]

My son flips objects....he is attracted to long slim objects that he can hold in his hands and flip back and forth. One of his favorites is the large plastic mcDonald's cups. He bends them where that fluting ends about two inches up and then holds it arm's length and then, back and forth, back and forth. It makes a popping sound.
When asked about this he says he likes it "because, it is something he can do, he has control of it, and it makes music, and the music is good!!!!" :)

btw: I've learned that those mcDonald's cups will be with us ETERNALLY in our sanitary landfills and everywhere else. They last forever. The first one he acquired lasted 10 months and he NEVER sat it down. It took a lot of flipping in that time. a LOT. Subway uses the same cups now too. :)

When he told me about his hands and arms "not having a name" when I'm not giving him deep pressure for writing I asked him if that had something to do with why he flipped his hands. He said he didn't know. Maybe we'll talk about it again someday and he may give me more insight.

[Mother's Heart]

Oh, and on the cup some more, He became so attached to it so quickly that it interfered with any tasks requiring two hands to do well. I didn't want him to lose mastery of some skills just because he preferred to hold that cup and ask for help with the task.:rolleyes: Whenever he asked me to help with a job heCOULD do himself if he had two hands, I would say "i'll hold your cup and you can do it". I worked with him by at first gently taking the cup from him and holding it until he finished the task with a promise to give it back....then began to prompt him to set the cup down, within reach, to complete the task. Then faded the prompt to a verbal one, then a gesture. He now on his own initiative, sets the cup, or whatever else is in his hand, down whenever he needs to use both hands for something. And he does it so smoothly, naturally...no awkwardness or apparent extra effort. In fact, he's BETTER about this now than he was in the ante-cup days. I think it actually TAUGHT him a developmental skill.


At first, when I would take the cup or prompt him I would explain why it was necessary to set it down, giving him a warning it was going to be away for a minute, and telling him he could pick it up again afterwards if he wanted to. I never just took it away from him without warning. And did it in a casual unhurried way when I did....and later when he had enough times under his belt I could just tell him to set it down without explaining why.

[frogmama]

If somebody smacked your hand every time YOU drummed your fingers, or twirled your hair, or chewed your pen, would it make you stop? Maybe, but it would also really pi$$ you off! And eventually you would smack them back! Well, I would anyway. ;)

In my experience, the reason most parents don't want their child to stim (whether they say it out loud or not) is because it makes them "look retarded". If you are still trying to make your kid "pass" for NT, you don't want them acting weird. I have argued with many teachers and paras over the years about allowing my son to stim. Bending wire coat hangers into weird shapes was once one of Matt's favorites, we always had to watch him around other peoples closets! He was very precise about how each bend went and how far, and then he would sight down the bends and along the curves. I always said he was bending reality and he could see other universes if he got the geometry just right. I still don't know the reason for that one, he faded it out on his own. Although every now and then he'll come across a wire hanger and just laugh and laugh....

If I can get to the reason or root of a stim activity, it almost always a good one. Kids don't just do it to annoy you, even if it feels like it some days. I worked with a boy who would shake his hands really hard so his fingers snapped together when he was supposed to be writing or doing other fine motor tasks. We were sure it had to hurt. We finally figured out it was a proprioceptive thing - when he could hear the snapping and feel the fingers touching each other so he knew they were his fingers so he could tell them what to do.

MothersHeart -
If your arms and hands "don't have names" (incredible description BTW!)you've got to give them a nametag - my brother wore compression gloves with the finger tips cut out, I've also seen wrist weights work. Something extra that you can SEE and feel (or even hear, bells maybe) to show you that yep, those things are yours.

[Mother's Heart]

quote:<< Mothers Heart -
If your arms and hands "don't have names" (incredible description BTW!)you've got to give them a nametag - my brother wore compression gloves with the finger tips cut out, I've also seen wrist weights work. Something extra that you can SEE and feel (or even hear, bells maybe) to show you that yep, those things are yours.>>

precisely right!

Compression gloves? (I've thought of devising my own 'squeezy' glove for him.) Tell me more?

I hadn't thought of putting an auditory component on the prf glove before....perhaps because auditory stim is so dificil para me to tolerate.
I wonder if temperature might also provide goodfeedback? might be harder to maintain but...hmm.

Though we've used different textured and weighted gloves, weighted pencils, wrist weights, the thing that has been most effective for him has been our hand holding/squeezing his while he writes. Not ideal, since it limits independent writing and it's hard not to interfere also.
His sister holds his hand in hers and he 'writes' with his finger in her palm. She generally mostly holds his finger and just sort of cups the rest of his fist in her palm...though she doesn't need to even be touching his hand, just his finger. This is how he writes fastest and longest. Unfortunately, this generally only works with her, so far. I think that's mostly because SHE can follow it and I can't. She is skilled with reading this type of writing because it is a classroom technique taught her to compensate for visual deficits. He goes so fast with her that it looks like he's just whacking at her palm with his fingers but for me he slows down, exaggerates the letters, and telegraphs his sentences. He KNOWS who's the smart one and who's not! :D ;)
This is the easiest way for us to communicate accurately and in a hurry, but a teenage sister is a pretty big ACD to take with you everywhere you go. But then again, she's the ONLY self--propelled ACD I've ever had. :D

Yes...I was quite pleased with his choosing to explain the lack of proprioreceptive feedback as 'his hand not having a name"

[Mother's Heart]

i see. I guess maybe you are referring to gloves used to treat arthritis and lymphedema?