Stimming, Repetitive Behaviors & Tics

When my son had his four year old checkup this year at the pediatrician I expressed my concerns with his repetitive clearing of his throat which began approximately six months prior and had only seemed to become more prevalent and more intense over the last few months.  As I began expressing my concerns, the pediatrician got a look on her face expressing that she knew exactly what this was.  She diagnosed him with a Behavioral Tic and explained that it is completely normal in these early toddler and preschool years for children to develop a behavioral tic.  She went on to describe the tic as being a form of a “security blanket” for children and also explained that they do go away on their own.  She advised us to completely ignore the behavior and not to talk about it at all and we would likely see it disappear relatively soon.  She warned us that the more you talk about the behavior, the more children seem to engage in it, planned ignoring was the best approach to alleviate the symptoms of a tic.  She also reported that times of stress, change in routine, and increased anxiety can cause tics to occur and/or become more pronounced for little one’s.

Hearing our pediatrician describe a behavioral tic as a “security blanket” type of strategy for children to calm their body and provide them with comfort during times of stress left me thinking about behavioral tics and their relationship to sensory processing and regulation.  From a sensory integration frame of reference it appears as though a behavioral tic can appear as a result of a child’s sensory processing challenges as a means to self regulate their sensory system.  For young children, these repetitive behaviors can be almost soothing and calming for them.  Then I began to think about how a behavioral tic may be related to sensory stimming type behaviors.

Tics are defined as brief and sudden unwanted, stereotyped, repetitive movements or sounds.  They can range from eye blinking, throat clearing,facial grimacing, to sniffing.  Similarly defined, Stimming is the repetition of physical movements, sounds, or words, or the repetitive movement of objects.  Common stimming related behaviors include hand flapping, rocking, excessive blinking, repeating noises, and spinning objects.  The definition of a tic and stimming appears to be almost identical when you look at them.  Both involve some form of repetitive behavior or movement, and both stimming and a tic are thought to be a child’s way of calming their body and regulating their sensory system during times of stress.

Stimming is commonly associated with the characteristics of several developmental disabilities including but not limited to autism; whereas, it appears as though tics appear to be considered a part of normal development in all children not just those with developmental disabilities.  The question that lingers in my head is why is there such a stigma present when discussing stimming versus behavioral tics.  Why is it that repetitive behavior that is associated with common developmental disabilities is known as stimming; while the same type of behavior in typically developing children is know as a behavioral tic?!

I think the common social perception of stimming related behaviors that I have experienced, is that these are behaviors that need to be prevented and “fixed.”  These behaviors are viewed as counterproductive to development, and the majority of treatments for stimming seeks to prevent the child from engaging in said behavior.  Let’s get back to the advice my son’s pediatrician gave us for addressing my son’s behavioral tic: planned ignoring.

if planned ignoring works for eliminating behavioral tic symptoms then it makes sense that it would work for its close counterpart, stimming too.  We ended up ignoring the behavior with my son, we stopped focusing on it and worrying.  We also began to provide my son with more sensory calming strategies to support his sensory needs and regulation.  And the pediatrician was right the planned ignoring combined with sensory supports focused on supporting my sons emotional well being rather than stopping the behavior worked to alleviate this behavior.

My recommendation is that we stop focusing on the unwanted behaviors and start focusing more on supporting our children’s sensory needs and social-emotional well-being.  It’s important to remember that behavior tics and sensory stimming result from stress on the sensory system; so it makes sense that making the child stop the behavior when they are not ready to or constantly bringing it to their attention will only add more stress on the senses.  Instead focus on supporting that taxed sensory system.