Let's Talk About Stimming by Dr. Jerry Kartzinel

This month I have been asked to address stimming behaviors as they relate to Autism.  Stimming is defined as repetitive body movements, formally called Stereotypy. These self-stimulatory repetitive movements of the body can be as simple as a lateral gaze or as obvious as running back and forth or jumping and clapping.  Stimming behaviors can involve any body part, but the key is to look for repetition.  The treatment of these behaviors will depend greatly on the cause of the behaviors.

Final Common Pathway

Stimming behaviors tend to result from a variety of causes.  I have removed rice from one child’s diet and all stimming stopped.  In another child, it was severe constipation, and in another, they were actually seizures!  So you can clearly see that it is important to consider that the repetitive behaviors you are seeing may be actually due to a problem that can be fixed, and multiple problems can lead to the same external behaviors (stimming in this case).

Let’s Look for Patterns – this is NOT a complete list, just a good place to start
•    In order to get clues about stimming behaviors, maybe we can discern when they escalate:
•    Before bowel movements – constipation
•    At school, when out shopping, with certain people or tasks– situational
•    After school – situational
•    After food – diet related
•    In the evening –  tiredness
•    When demands are being placed – anxiety
•    Random times throughout the day, without known cause, abruptly leaving – seizure
•    All the time, from waking to sleep: allergies, inflammation, infection (bowels, sinus, etc)
•    Any combination of above

Let’s Get this Started
The first step is addressing the bowels. The goal here is to have one to two daily bowel movements.  Constipation can be a very big problem for many of our children we see in the clinic.  You can read about my approach to constipation, as well as chronic diarrhea at www.mendingautism.com. You will need the support of a physician to obtain stool cultures to help diagnose and treat abnormal gut bugs (yeast, bacteria, and parasites).  If they are present, they must be eradicated if we hope to be successful with controlling stimming behaviors.

Don’t Forget about Diet!
Diet changes are up next.  I had a patient become super stimmy after eating some corn chips in my office.  I asked mom about this, and since he ate these throughout the day, she had not put 2 + 2 together until I pointed it out.  Corn was this child’s nemesis!  Really, it can be just about any food.  Once again, we may need the help of a physician to obtain a food allergy profile that may indeed give us clues as to which food or foods we need to remove.  If this is just not available, you can remove all gluten and dairy (100%!), corn, rice, citrus and REALLY lower the daily amount of sugar taken in…even natural “sugar”…consumption of sugar must really be limited.

At Home
The home environment may also be a source of behaviors in children  New carpets, furniture, paints, etc all can contribute to an environmental toxic overload, through off-gassing, which translates into stimming.  Allergies, such as house dust mite, mold, pets, cigarette smoke, etc can also contribute to stimming behaviors.  I recently had a child react very negatively to mom’s new car!  Anything “toxic” to these children can contribute to stimming, and don’t forget perfumes and hair sprays can be toxic to some of our children.
Electronic toys and TV can be great provokers of stimming behaviors.  It may be the end of a show and the TV credits are rolling, it may be the show itself, or any of the electronic toys with buttons or apps on the iPad.  The best remedy I have found to mitigate stimming behaviors induced by these sources is the REMOVAL of these toys.

Anxiety is another really big source for stimming behavior in children.  This cause is a little easier to figure out, as the behaviors tend to escalate in situations the child perceives as anxiety-producing.  Anxiety can be a symptom of adrenal fatigue and the body’s inability to produce enough cortisol. Cortisol levels can be measured in the saliva and to see if this may indeed be contributing to your child’s anxiety.  There are natural approaches that can help with adrenal fatigue such as vitamin C and herbs such as Ashwagandha and valerian root extract.

Finally, there are some stimming behaviors that the children just prefer to do.  These stims may last many years, even into adulthood.  I like to see if we can contain, rather than “stop” these stims by directing when and where it might be more appropriate to stim, such as in one’s bedroom.  I met with one young man at Disney, and the trees were all lit up, he expressed that he would love to just rock and stim on the lights, but knew it was “inappropriate.”

Stimming behaviors in children on the autism spectrum are very common.  Many of these behaviors can be minimized if the underlying causes are addressed and corrected.  When excessive body motions are reduced, these children become more teachable and responsive to their interventions and therapies, and thus, autism improves dramatically.

Child reading calmly reduced stimming