Written by Dr. John Carosso
The general conceptual idea is that kiddos with autism have difficulty filtering and processing stimuli in the environment; it’s just too much stimuli coming from all the different senses and that overload causes them to self-regulate with stims. Consequently, children may find the SSB to be very comforting. In fact, they find the behavior to be calming and an important part of their day, especially when they feel stressed.
Yes, the sensory aspects are often spread over different senses, such as visual, auditory, factory, tactile, and kinesthetic. In that respect, a child may be seen putting objects in front of their eyes, or to the sides, which is called ‘peripheral gazing’. The sensory aspect can also be auditory; the child may want to hear something over and over, a particular sound or a song, or may want to hear the fast-forwarding and rewinding of videos (which also has a visual aspect). Tactile is also common where kiddos want to touch people’s hair, feel certain items and textures, but may also be tactilely defensive where they can’t wear certain clothing given it’s just too irritating, which makes getting dressed in the morning a challenge. Olfactory may not quite as common as the tactile or visual, but these kiddo’s may want to smell everything, or experience everyday smells as especially noxious. Then there is taste and texture issues can be a real problem during mealtime. We then move into kinesthetic, proprioceptive, and vestibular that all sort of go together; the jumping, hopping, spinning, bouncing that is so common.
A common replacement behavior for the kinesthetic-based SSB is a trampoline, as opposed to hopping in the classroom. Children may be provided a particular time and place where they can jump on a trampoline. However, it’s important to be careful because there are behavioral and avoidance tendencies to consider. In that respect, if a kiddo has learned that jumping out of their seat during an unfavored math assignment will result in being permitted to jump on a trampoline then, while there may in fact be a valid sensory issue, the kiddo may also just not want to do the math assignment. Attention seeking too can be an issue; if three people attend to the child when they stim; well, that’s cool, so they’re going to keep stimming in the classroom. Consequently, we must be careful not to secondarily reinforce attention-seeking.
In the next post, I’m going to discuss the extent to which SSB are ‘defense mechanisms” and the subsequent implications. Stay tuned.
Written by Dr. John Carosso
As you do your own research about “self-stimulatory behaviors” or SSB’s, you’ll find a tremendous amount of information that can be quite helpful. However, it also can be very confusing. You’re going to hear many things about this aspect of autism that often-times is contradictory. In fact, even what “stims” are called can be rather confusing and you may wonder if they’re all talking about the same thing? In that respect, you will see SSB referred to as self-stimulatory behaviors, self-stims, stims, stereotypical behaviors, stereotypies, stereoautomies, tics, preservative behaviors, self-reinforcing behaviors, compulsive behaviors, OCD. In fact, it’s not entirely uncommon to see a kiddo diagnosed with obsessive compulsive disorder, when in actuality it’s a stim. You’ll see the aforementioned acronym “SSB”, which is “self-stimulatory behavior”, not to be confused with “SIB”, or “self-injurious behavior”; however, SSB can be self-injurious. Again, it gets really confusing with so many different names and aspects for the same thing.
SSB can include lots of behaviors such as hand-flapping, toe-walking, spinning, pacing, obsessing, lining-up objects, being very particular, and other compulsive tendencies. In that respect, sometimes OCD is confused with stims, but there are clear differences and I’ll delineate in another post.
Not so much. In fact, the contributing factors of SSB are quite confusing because they are so multifaceted. In that respect, you’ll most often see, in your research, that self-stimulatory behaviors are caused by sensory issues; either the child is sensory-seeking or sensory-avoidant, or overwhelmed by sensory information. You also read of avoidance tendencies, i.e. the child will stim to avoid an unfavored task. There is also ‘attention seeking’ as a cause of SSB. So again, it can be rather confusing and challenging given any specific rationale will greatly impact treatment considerations.
Sure, of course, but the treatment too can be difficult because there are many opinions including that SSB should be interrupted; punished, or in some way shaped into something else. However, others suggest that we should not interrupt these behaviors because they are defense mechanisms and the kiddo needs the self-stimulatory behaviors to cope. Some suggest that, subsequently, if you prohibit them, the behaviors only worsen.
Interestingly, children with autism will often say that carrying-out SSB is very important to them; that it’s self-soothing. Again, that aspect impacts the treatment processes in that we may subsequently indulge such behavior at specific times and in some places.
The neuro-diversity model suggests that society needs to adapt, not the individuals with autism. In that respect, some may suggest that autism is not a disorder and that society needs to be more tolerant. Ultimately, there tends to be a middle-ground in that, if the SSB is interfering with the child’s ability to function, then we’ll need to modify the SSB to some extent. However, if the SSB is an occasional hand-flap then, in fact, society may need to ‘just deal with it’ given we all have our quirks.
Here’s the challenging part about this: none of these aspects or terms is necessarily wrong. All these nuances, including the labels, and whether SSB is caused by sensory issues, or avoidance tendencies, or attention-seeking needs is not necessarily wrong. In that respect, SSB is extraordinarily child specific; so, for one kiddo we may very well transition the SSB into something more adaptive. However, for another kiddo we may indulge the behavior. Yes, it’s multifaceted and, in my experience, of all the aspects of autism, SSB’s are the most challenging because they are so complex and multifaceted.
I’m going to break this down a bit more for you in upcoming posts where we take a look these factors and treatment aspects. Stay tuned for more.
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