Stimming: What It Is and Why It Helps

What is stimming, and what does it look like?

Stimming, short for self-stimulatory behavior, is a repetitive, usually rhythmic movement or sound. Autistic adults interviewed in 2019 described it as body movements such as hand-flapping, finger-flicking, pinching, feet flexing, spinning and playing with a necklace, and as sounds such as muttering, grunting, whistling and singing.⁠¹ In the diagnostic manuals the same behaviors appear as stereotyped or repetitive motor movements, use of objects or speech, one of the four types of restricted and repetitive behavior in the autism criteria.⁠^5,14 Many autistic adults have reclaimed these behaviors as stimming.⁠¹

Stimming is common in autism. A meta-analysis of 37 studies found a median prevalence of motor stereotypies of 51.8% in autistic people, higher in younger children, people with lower IQ and those with more severe autism.⁠⁶ In video of play sessions, more autistic children had stereotypies than children with other developmental conditions, though none was on its own proof of autism. Autism was linked in particular with hand, finger and gait stereotypies, lower nonverbal ability with head and trunk movements, and the authors describe stereotypies as shaped by the environment.⁠¹⁷

What are the types of stims?

Stims are usually grouped by the sense or the part of the body involved. These examples come from autistic adults and from the CDC’s and WHO’s descriptions of autism.⁠^1,4,14

Do non-autistic people stim too?

Yes. In a survey of 340 adults, autistic people reported more stimming than non-autistic people, but some non-autistic adults stimmed as well.⁠² Rocking and hand-flapping are common in infancy and become less common as children grow.⁠¹ Repetitive movements can also continue in typically developing children: in a clinic group of 100 such children with motor stereotypies, the movements had continued in 94% at follow-up.⁠⁸ Repetitive behaviors rise with sensory hypersensitivity in typically developing children too, not only in autism.⁠¹⁸

Is stimming voluntary or controllable?

Partly. Many autistic adults said stimming felt involuntary and unconscious, at least when it started, while others used it deliberately to head off distress; one woman began waving her hands on purpose in crowded elevators and found it staved off panic.⁠¹ A neurology review calls stereotypies semi-voluntary.⁠³ Whether a person stims also depends on whether they feel it is socially safe to do so.⁠¹

Why do people stim? Regulation, focus and emotion

The clearest evidence comes from asking autistic people. In interviews and focus groups with 32 autistic adults, Kapp and colleagues found two themes: stimming as a self-regulatory mechanism, and stimming as lacking social acceptance but able to become accepted through understanding.⁠¹ Participants named four triggers that fed into each other: an overwhelming environment, sensory overload, noisy thoughts and uncontainable emotion.⁠¹ A survey of 340 adults found the same pattern: stimming regulated, allowed positive and negative emotional expression and served as a cognitive distraction.⁠²

Most participants described stimming itself as comfortable or calming, and none consistently disliked their stims, as opposed to the reactions they drew.⁠¹ A neurology review summarizes first-person accounts the same way: stereotypies are described as relaxing and as helping people focus and cope in overwhelming sensory environments.⁠³

Why do autistic people stim more than others?

Sensory differences seem to be a large part of the answer. In the 340-adult survey, autistic people reported both greater sensory sensitivity and more stimming than non-autistic people.⁠² In children, sensory hypersensitivity predicted every kind of repetitive behavior measured, and once it was taken into account, an autism diagnosis added nothing further to the prediction.⁠¹⁸ Over-responsivity to sensory input is one of the features most consistently raised in autism.⁠¹⁹

How does stimming help with sensory regulation?

By giving the person something predictable to focus on. One participant explained that rotating his wrist gave him a single point of focus he controlled, blocking excess input and letting him think at the pace of the movement; another closed his eyes to cut out extra stimuli.⁠¹ None of the 32 adults described too little sensory input as a cause of stimming; many attributed it to sensory overload.⁠¹ That fits a study of 114 children in which sensory hypersensitivity predicted repetitive behaviors, in autistic and typically developing children alike.⁠¹⁸ One review proposes that stereotypies improve sensory processing and attention by regulating brain rhythms, a hypothesis still to be tested.⁠³

Can stimming express joy and other emotions?

Yes. Some autistic adults stim when excited or happy and others when anxious, and several described different forms for each: hand-flapping with open hands and arms out when happy, with hands kept close when distressed.⁠¹ Because a particular stim can go with a particular feeling, people close to someone can learn what it means.⁠¹ In two surveys of 131 and 117 autistic adults, most said stimming was part of their friendships with other autistic people and that they could tell what another autistic person felt from their stims.⁠⁷

Does stimming help with focus?

Many people say it does. Autistic adults described stimming as helping with concentration and learning.⁠¹ Research on ADHD points the same way for movement more broadly: in boys aged 8 to 12, more movement during working memory tasks predicted better performance for those with ADHD and slightly worse performance for typically developing boys, and the authors warn against overcorrecting movement during that kind of schoolwork.⁠²⁰

How is stimming related to sensory processing?

Closely. Sensory hyper- or hyporeactivity sits next to repetitive movements among the autism criteria, sensory hypersensitivity predicts repetitive behaviors, and autistic adults often name sensory overload as a reason they stim.⁠^1,5,18 Sensory over-responsivity, under-responsivity and seeking are all more common in autistic people than in others.⁠¹⁹

Stimming vs sensory seeking: what is the difference?

They overlap but are not the same. Sensory seeking, or sensory craving, describes a need for more sensory input than usual; in the craving pattern the stimulation leaves a child disorganized rather than satisfied.⁠²¹ The stimming that autistic adults describe runs the other way: it is a response to too much input or emotion, and it calms.⁠¹ The two can look alike: one adult in the interview study pressed his fingers together for sensory feedback, and sensory seeking is itself raised in autism.⁠^1,19

Relatedsensory seekingover-responsivitymonotropismsensory activities

Which conditions involve stimming?

Stimming is best known in autism, where repetitive movements are one of the diagnostic criteria and about half of autistic people have motor stereotypies.⁠^5,6 It is not limited to autism: the CDC notes that some people without autism have some of these behaviors.⁠⁴ Children with motor stereotypies and no autism often have other conditions; ADHD was reported in 30% of one clinic group and clinically elevated attention problems in 63% of another, with anxiety in 73%.⁠^8,10 In ADHD, movement itself may help some children work, which is one reason researchers caution against overcorrecting it.⁠²⁰ The ICD-11 also has a separate diagnosis, stereotyped movement disorder, for repetitive movements that need clinical attention in their own right.⁠¹⁴

What happens when stimming is suppressed?

It costs the person something. Autistic adults described resentment, anger, nervousness, frustration, belittlement, shame and confusion when told to stop stimming, and even those who could hold their stims back described the effort as depleting.⁠¹ One woman who hid her stims said suppressing them left her more on edge.⁠¹ In a larger survey, social pressure was the main reason for suppressing stims, and suppression had a negative effect on emotions and thinking.⁠² Autistic adults suppress stims almost entirely for outside reasons, such as avoiding judgment, even though most find stimming a positive experience.⁠⁷

Suppressing stims is part of masking, or camouflaging: in a study of 92 autistic adults, people described minimizing stims and their reactions to sensory overload to make their autism less obvious, and exhaustion was by far the most consistent consequence.⁠¹¹ The study that defined autistic burnout warns of the dangers of teaching autistic people to mask, and found unmasking associated with recovery.⁠²³

What is wrong with “quiet hands”?

“Quiet hands” is a practice that teaches children to suppress hand-flapping, and autistic activists decry it, arguing that stims are coping mechanisms and opposing efforts to eliminate stimming that causes no injury.⁠¹ The adults Kapp interviewed objected to treatment that aims to eliminate stimming, and one, who had once taught her own students to hide their stims, came to describe therapy that trains children to stop stimming as abuse.⁠¹

How do autistic adults want others to respond to stimming?

With understanding. In Kapp’s interviews, acceptance gave people the freedom to stim openly, and understanding, from family who knew why they stimmed or colleagues who had it explained, was what turned stims from a source of conflict into something accepted.⁠¹ One participant drew the line that gave the study its title: she could understand others stopping a stim that harmed or annoyed someone else, but if it had no bearing on anyone else, people should be allowed to do what they like.⁠¹ Being told to stop as an adult made one man feel belittled, as if he were five years old and in trouble.⁠¹ Researchers surveying autistic adults suggest that programs to build social and communication skills consider ways to include stimming rather than remove it.⁠⁷

What does the evidence show about trying to stop stimming?

It is thin. A systematic review of behavioral interventions for stereotypic and repetitive behavior in autism found only ten single-case studies with 17 participants; they reported decreases, but few identified what the behavior did for the person, and the authors called the evidence preliminary and urged caution.⁠¹² Kapp and colleagues note that therapies continue to treat stimming despite lacking strong evidence of efficacy or ethics.⁠¹ A 2021 neurology review generally recommends against techniques that aim to suppress stereotypies in autism.⁠³

Autistic adults and the neurodiversity movement support treating a stim only when it is injurious. Kapp and colleagues note that this matches the DSM-5, where an injurious stim calls for a separate diagnosis of stereotypic movement disorder, and the ICD-11 frames the same diagnosis around stereotypies severe enough to need clinical attention, such as through self-injury.⁠^1,14 When a behavior does need to change, behavioral practice starts by working out what it does for the person and teaching a replacement that serves the same purpose.⁠²⁴

Does stimming go away with age?

Usually not entirely, though it often lessens. In 192 children followed from age 2 to 9, repetitive sensory and motor behaviors stayed relatively high in autistic children, improved more in children with higher nonverbal ability, and followed very different paths from child to child.⁠⁹ Younger age is linked with more stereotypies in autism.⁠⁶

Studies of children without autism tell a similar story. Movements continued in 94% of 100 children followed for an average of almost seven years, persisted in all but one of 49 older children and teenagers though less often and for shorter spells, and were present in all of 65 children in a 2026 study, with lower intensity in older children.⁠^8,10,25

What changes most is visibility. Autistic adults recalled stimming freely as young children and then hiding or changing their stims by secondary school, once they noticed others judging them.⁠¹

When should you worry about stimming?

When it causes injury, harms other people or is severe enough to need clinical attention in its own right.⁠¹⁴ Autistic adults themselves distinguish these stims from the rest: they wanted no self-injurious stims and tried to avoid stims that hurt others, while defending stims that harm no one.⁠¹ Stimming is only a negative experience, autistic adults report, when it is self-injurious or stigmatized.⁠⁷

The approach matters. The useful questions are what the behavior does for the person and what could meet the same need; a functional behavior assessment rests on the premise that behavior communicates something.⁠²⁴ Functional communication training, for example, teaches a child to ask for a break when the behavior was a way of escaping demands.⁠²⁴

Can pain or illness cause self-injury?

Yes, and it is easy to miss in a child who cannot say what hurts. An expert panel advised that problem behavior in autistic people may be the main or only sign of an underlying medical condition, including some digestive disorders.⁠¹⁵ Children with self-injury showed more pain behaviors in everyday routines than children without it.⁠¹⁶ In one documented case, a child’s self-injury happened only during ear infections.⁠²⁶ The panel adds that autistic people deserve the same thoroughness in a medical workup as anyone else.⁠¹⁵

What does an assessment of self-injury involve?

Usually a medical check and a functional behavior assessment. The assessment gathers information about what happens just before the behavior, the behavior itself and what follows it, to work out what the behavior achieves for the person; the functions most often found are getting attention, getting something wanted, escaping or avoiding a demand or situation, and internal stimulation.⁠²⁴ Treatment is then built around that function, for example by teaching another way to get the same result.⁠²⁴ In severe cases, protective equipment such as helmets or gloves may be used to reduce injury, with the aim of restricting movement as little as possible.⁠²⁴ Medication can help manage some co-occurring symptoms of autism, including head banging or hand biting, though no medication treats autism itself.⁠²⁷ An expert panel adds that integrating behavioral and medical care may help most when a medical problem is behind the behavior.⁠¹⁵

Which other signs are worth raising with a professional?

• A stim that hurts someone else. One adult learned she had been pinching around her husband’s nails until he was sore.⁠¹
• A stim the person finds unhelpful. One man said pressing his fingers together could get him into a loop that made them leathery.⁠¹
• A sudden change. In autistic people, problem behavior can be the main or only sign of a medical condition.⁠¹⁵
• Signs of anxiety or attention problems. Conditions that come with repetitive movements often affect daily life more than the movements do.⁠¹⁰

How can parents support a child who stims?

Mostly by making room for it and reducing what drives it. Autistic adults said acceptance through understanding was what let them stim openly, and that the reactions of others, not the stims themselves, were the problem.⁠¹

1. Let harmless stims be. Autistic adults describe them as calming and helpful, and a 2021 review recommends against suppressing them.⁠^1,3
2. Help others understand. In interviews, understanding from family and colleagues was what made stimming acceptable; one man’s explanation at work let him worry less and work better.⁠¹
3. Watch what comes before an increase. Overwhelming surroundings, task demands, tiredness and emotion all change how much people stim.⁠¹
4. Adjust the environment. Quiet spaces, headphones, fidget tools, movement breaks and flexible seating reduce the load that drives stimming.⁠^21,28
5. Swap, do not remove, a stim that causes problems. Adults describe replacing a stim with one that gives similar feedback, and replacement skills work best when they serve the same purpose.⁠^1,24
6. Avoid making a child feel watched. Negative attention made adults self-conscious, and many stimmed freely only in private or with accepting family.⁠¹

How can schools make room for stimming?

The adjustments recommended for neurodivergent adults at work and for children with sensory differences at school carry over: fidget tools, movement breaks and flexible seating, a quiet place to go, warning before loud noises, and headphones for background noise.⁠^21,28 Planned sensory breaks for walking, spinning or swinging help some children stay organized.⁠²¹ For children with ADHD, researchers caution against correcting movement during schoolwork that relies on working memory.⁠²⁰ Where a stim distracts other children, the adults Kapp interviewed describe two approaches that worked for them: changing it into a quieter form that gives similar feedback, as one man did by turning arm stims into dancing and sport, or doing it out of view, which they also describe as costly when it is forced on them.⁠¹ Explaining what a stim is for helps: understanding was what turned stimming from a source of conflict into something accepted.⁠¹

Frequently Asked Questions

Sources

1. Kapp SK, Steward R, Crane L, Elliott D, Elphick C, Pellicano E, Russell G. ‘People should be allowed to do what they like’: autistic adults’ views and experiences of stimming. Autism. 2019;23(7):1782-1792. PMID 30818970. Checked October 11, 2026.
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   The abstract: “‘Stereotyped or repetitive motor movements’ are characterised as core features in the diagnosis of autism, yet many autistic adults (and the neurodiversity movement) have reclaimed them as ‘stimming’”; autistic adults “objected to treatment that aims to eliminate the behaviour”. Interviews and focus groups with 32 autistic adults: “we identified two themes: stimming as (1) a self-regulatory mechanism and (2) lacking in social acceptance, but can become accepted through understanding”; stimming was “commonly expressed through body movements (variously described as hand flapping, finger flicking, hair pulling or pinching, feet flexing, spinning, necklace playing) but also vocalisations (e.g. muttering, grunting, stuttering, whistling, singing). Many participants said they experienced it as involuntary and unconscious, at least at the beginning of the behaviour.” “no participants consistently and inherently disliked their stims (as opposed to their social consequences). Indeed, most participants described stimming itself as comfortable or calming”; one participant described “attending to a single point of focus over which one had control, to self-regulate by blocking or reducing excessive input” by rotating his wrist; another closed his eyes “to cut off additional stimuli”; another said waving her hands “actually managed to help me stave off some panic attacks”, “like if I’m in a crowded elevator”. Four subthemes: “overwhelming environment, sensory overload, noisy thoughts and uncontainable emotion”; “None of the participants described instances of too little sensory input or sensory hyposensitivities as a causal factor for stimming”; “Some participants described stimming in response to positive emotional states (e.g. excitement) and others in response to negative emotional states (e.g. anxiety)”; two participants “detailed that hand flapping due to positive states involves hands open and arms out in a waving-like motion, unlike hands and arms kept further down towards oneself”; “particular stims always responded to a particular emotion, which meant that the behaviours may have effectively communicated the person’s feelings”; “Stimming served a communicative, as well as a regulatory, function.” “Participants described feeling a variety of resentful emotions when told by others to stop stimming, including anger, nervousness, frustration, belittlement, shame and confusion”; “Other participants reported transmuting stims into a more socially acceptable form that provided similar feedback. For example, Ethan replaced arm stims with dancing”; one woman taught her students to hide stims, admitted suppressing her own made her feel “just sort of more on edge”, and said of training children to stop stimming, “to me it was abuse”; one man “repeatedly pressed his fingers together when anxious for sensory feedback” until they became “leathery”; another had pinched around her husband’s nails until he was “really sore”; “Participants professed no desire for self-injurious stims and largely wished to avoid stimming in ways harmful to others”; “even those who said they could suppress their stims described depleting, effortful costs”; “Task demands and physical and mental states (e.g. energy levels and emotional well-being) also reportedly influenced stimming”; “stimming became less socially acceptable as one got older”, with stims hidden or transmuted by secondary school; one participant avoided noise “by sitting in her car during her lunch break for ‘peace and quiet’”; “Several only stimmed freely when they had total privacy”; “Acceptance enabled participants the freedom to stim openly”; one participant could understand efforts to stop stimming “if it’s harmful to somebody else or it’s annoying to somebody else, but if it’s absolutely got no bearing on another person whatsoever I think people should be allowed to do what they like”; told not to stim as an adult, another feels “belittled”, as though he is “five”; “Understanding held the key to acceptance of non-harmful stimming” (an e-mail explaining his stimming at work “boosted his productivity as he worried less about stimming”); “We also extend the literature by providing accounts that suggest stimming helps with concentration and learning.” From the introduction: activists “decry practices such as ‘quiet hands’ (which teaches the suppression of hand flapping)” and “therapies continue to treat stimming despite lacking strong evidence of efficacy or ethics”; from the discussion: “Our participants’ perspective is consistent with the practice of making stims a target of treatment only when injurious, which (according to the DSM-5) would call for a co-occurring diagnosis of stereotypic movement disorder”, and “Behaviours like rocking and hand flapping typify infancy but become less common as children get older”.
2. Charlton RA, Entecott T, Belova E, Nwaordu G. “It feels like holding back something you need to say”: autistic and non-autistic adults accounts of sensory experiences and stimming. Research in Autism Spectrum Disorders. 2021;89:101864. doi:10.1016/j.rasd.2021.101864. Checked October 11, 2026.
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   The abstract: an online survey of “340 adults (160 with an autism diagnosis, 139 suspected autistic, 41 non-autistic)”; “Autistic (diagnosed and suspected) individuals reported greater sensory sensitivity and more stimming than non-autistic adults. Stimming is also performed by some non-autistic adults.” “Stimming was a self-regulatory mechanism that allowed for positive and negative emotional expression, and cognitive distraction. 3) Social pressure was a reason for suppressing stimming but this had a negative effect on emotions and cognition.”
3. McCarty MJ, Brumback AC. Rethinking stereotypies in autism. Seminars in Pediatric Neurology. 2021;38:100897. PMID 34183141. Checked October 11, 2026.
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   The abstract: “Stereotyped movements (‘stereotypies’) are semi-voluntary repetitive movements that are a prominent clinical feature of autism spectrum disorder. They are described in first-person accounts by people with autism as relaxing and that they help focus the mind and cope in overwhelming sensory environments. Therefore, we generally recommend against techniques that aim to suppress stereotypies in individuals with autism.” “We hypothesize that stereotypies improve sensory processing and attention by regulating brain rhythms”.
4. Centers for Disease Control and Prevention. Signs and Symptoms of Autism Spectrum Disorder. Page reviewed May 16, 2024. Checked October 11, 2026.
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   Examples of restricted or repetitive behaviors include “Flaps hands, rocks body, or spins self in circles”, “Repeats words or phrases over and over (called echolalia)” and “Has unusual reactions to the way things sound, smell, taste, look, or feel”; “It is important to note that some people without ASD might also have some of these symptoms.”
5. Centers for Disease Control and Prevention. Clinical Testing and Diagnosis for Autism Spectrum Disorder. Page reviewed May 8, 2025, reproducing the DSM-5 criteria. Checked October 11, 2026.
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   “a child must have persistent deficits in each of three areas of social communication and interaction ... plus at least two of four types of restricted, repetitive behaviors”; the first is “Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases)” and the fourth “Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g. apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).” “no single tool should be used as the basis for diagnosis”; tools “rely on two main sources of information’parents’ or caregivers’ descriptions of their child’s development and a professional’s observation of the child’s behavior.” Specialists include “neurodevelopmental pediatricians, developmental-behavioral pediatricians, child neurologists, geneticists, and early intervention programs that provide assessment services.”
6. Melo C, Ruano L, Jorge J, Pinto Ribeiro T, Oliveira G, Azevedo L, Temudo T. Prevalence and determinants of motor stereotypies in autism spectrum disorder: a systematic review and meta-analysis. Autism. 2020;24(3):569-590. PMID 31552746. Checked October 11, 2026.
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   The abstract: “Thirty-seven studies were included and the median prevalence of motor stereotypies in ASD was 51.8%, ranging from 21.9% to 97.5%. The most frequent determinants associated with a higher number of stereotypies in ASD were a younger age, lower intelligence quotient, and a greater severity of ASD.”
7. Morris IF, Sykes JR, Paulus ER, et al. Beyond self-regulation: autistic experiences and perceptions of stimming. Neurodiversity. 2025;3:27546330241311096. doi:10.1177/27546330241311096. Checked October 11, 2026.
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   The abstract: autistic adults “(Study 1 N = 131; Study 2 N = 117)”; “Participants reported stimming to be sometimes positive and sometimes negative, with stimming only being a negative experience when it was self-injurious or stigmatized. Despite frequently being a positive experience, participants purposefully suppressed stimming (‘masking’), which was done almost exclusively for extrinsic reasons (e.g. to avoid judgment from others). The majority of participants felt stimming (1) was an important part of their friendship with other autistic people, (2) helped them connect with other autistic people, and (3) that when they saw other autistic people stimming, they could tell what they were feeling.” The lay abstract: “interventions to enhance social and communication skills in Autistic individuals should consider ways to incorporate stimming.”
8. Harris KM, Mahone EM, Singer HS. Nonautistic motor stereotypies: clinical features and longitudinal follow-up. Pediatric Neurology. 2008;38(4):267-272. PMID 18358406. Checked October 11, 2026.
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   The abstract: “100 typically developing children with motor stereotypies”; “The mean length of follow-up was 6.8 +/- 4.6 years.” “At most recent follow-up, movements had continued in 94% of the sample (62% for >5 years). Only six children reported complete cessation of movements”; “Nearly half the children in this cohort exhibit other comorbidities, including attention-deficit-hyperactivity disorder (30%), tics (18%), and obsessive-compulsive behaviors/obsessive-compulsive disorder (10%).”
9. Richler J, Huerta M, Bishop SL, Lord C. Developmental trajectories of restricted and repetitive behaviors and interests in children with autism spectrum disorders. Development and Psychopathology. 2010;22(1):55-69. PMID 20102647. Checked October 11, 2026.
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   The abstract: 192 children referred for autism at age 2, followed at 3, 5 and 9; “For children with ASD, RSM scores remained relatively high over time, indicating consistent severity, whereas IS scores started low and increased over time”; “Having a higher nonverbal intelligence (NVIQ) at age 2 was associated with milder concurrent RSM behaviors and with improvement in these behaviors over time”; “Trajectory analysis revealed considerable heterogeneity in patterns of change over time”. RSM is “repetitive sensorimotor” behavior.
10. Oakley C, Mahone EM, Morris-Berry C, Kline T, Singer HS. Primary complex motor stereotypies in older children and adolescents: clinical features and longitudinal follow-up. Pediatric Neurology. 2015;52(4):398-403. PMID 25661287. Checked October 11, 2026.
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    The abstract: 49 participants aged 9 to 20; “In all but one individual, stereotypies persisted at the time of phone follow-up”; “clinically elevated levels of anxiety (73%), attention-deficit hyperactivity (63%)”; “Primary motor stereotypies typically begin in early childhood and, although reduced in frequency and duration, persist at least through the teenage years. Repetitive movements are associated with a variety of comorbidities that often have a greater functional impact than the stereotypic behavior.”
11. Hull L, Petrides KV, Allison C, Smith P, Baron-Cohen S, Lai MC, Mandy W. “Putting on my best normal”: social camouflaging in adults with autism spectrum conditions. Journal of Autism and Developmental Disorders. 2017;47(8):2519-2534. PMID 28527095. Checked October 11, 2026.
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    Responses from 92 adults: “Respondents described attempting to minimise their self-soothing or ‘stimming’ behaviours, and their responses to sensory overstimulation, in order to make their condition less obvious to others”; “By far the most consistent consequence of camouflaging described by respondents was exhaustion. Camouflaging was frequently described as being mentally, physically, and emotionally draining”.
12. Patterson SY, Smith V, Jelen M. Behavioural intervention practices for stereotypic and repetitive behaviour in individuals with autism spectrum disorder: a systematic review. Developmental Medicine & Child Neurology. 2010;52(4):318-327. PMID 20412248. Checked October 11, 2026.
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    The abstract: “Ten single case studies examining 17 participants”; “Overall, studies reported decreases in SRBs using behavioural interventions and some collateral increase in desirable behaviours”; “Only a small number of intervention studies for SRBs explicitly state the function of the behaviour”; “Evidence supporting SRB interventions is preliminary in nature, and caution should be used in choosing and implementing SRB intervention practices for individuals with ASDs.”
13. Steenfeldt-Kristensen C, Jones CA, Richards C. The prevalence of self-injurious behaviour in autism: a meta-analytic study. Journal of Autism and Developmental Disorders. 2020;50(11):3857-3873. PMID 32297123. Checked October 11, 2026.
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    “data from 14,379 participants in thirty-seven papers were analysed to generate a pooled prevalence estimate of self-injury in autism of 42% (confidence intervals 0.38-0.47). Hand-hitting topography was the most common form of self-injury (23%)”; “females obtained higher prevalence rates than males”.
14. World Health Organization. 6A02 Autism spectrum disorder. ICD-11 for Mortality and Morbidity Statistics, release 2026-01, with the clinical descriptions and diagnostic requirements. Checked October 11, 2026.
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    Essential features include “Repetitive and stereotyped motor movements, such as whole body movements (e.g., rocking), atypical gait (e.g., walking on tiptoes), unusual hand or finger movements and posturing. These behaviours are particularly common during early childhood.” and “Lifelong excessive and persistent hypersensitivity or hyposensitivity to sensory stimuli or unusual interest in a sensory stimulus, which may include actual or anticipated sounds, light, textures (especially clothing and food), odors and tastes, heat, cold, or pain.” “Co-occurrence of Autism Spectrum Disorder with other Mental, Behavioural or Neurodevelopmental Disorders is common across the lifespan. In a substantial proportion of cases, particularly in adolescence and adulthood, it is a co-occurring disorder that first brings an individual with Autism Spectrum Disorder to clinical attention.” “Self-injurious behaviours (e.g., hitting one’s face, head banging) occur more often in individuals with co-occurring Disorder of Intellectual Development.” Boundary with ADHD: “Specific abnormalities in attention (e.g., being overly focused or easily distracted), impulsivity, and physical hyperactivity are often observed in individuals with Autism Spectrum Disorder”; “Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder can co-occur and both diagnoses may be assigned if diagnostic requirements are met for each. Attention Deficit Hyperactivity Disorder symptoms may sometimes dominate the clinical presentation such that some Autism Spectrum Disorder symptoms are less apparent.” Boundary with stereotyped movement disorder: “Although such stereotypies are typical in Autism Spectrum Disorder, if they are severe enough to require additional clinical attention, for example because of self-injury, a co-occurring diagnosis of Stereotyped Movement Disorder may be warranted.”
15. Buie T, Campbell DB, Fuchs GJ 3rd, et al. Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report. Pediatrics. 2010;125(Suppl 1):S1-S18. PMID 20048083. Checked October 11, 2026.
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    The abstract: “individuals with ASDs deserve the same thoroughness and standard of care in the diagnostic workup and treatment of gastrointestinal concerns as should occur for patients without ASDs”; “A central difficulty in recognizing and characterizing gastrointestinal dysfunction with ASDs is the communication difficulties experienced by many affected individuals”; “Care providers should be aware that problem behavior in patients with ASDs may be the primary or sole symptom of the underlying medical condition, including some gastrointestinal disorders. For these patients, integration of behavioral and medical care may be most beneficial.”
16. Courtemanche AB, Black WR, Reese RM. The relationship between pain, self-injury, and other problem behaviors in young children with autism and other developmental disabilities. American Journal on Intellectual and Developmental Disabilities. 2016;121(3):194-203. PMID 27119211. Checked October 11, 2026.
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    The abstract: 51 children; “Significant group differences between children with and without self-injury were found for the NCCPC-R total scores. The frequency and severity of self-injury, aggression, and stereotypy were also highly correlated with the total scores”; “individuals with self-injury may have enhanced expressions of pain.”
17. Goldman S, Wang C, Salgado MW, Greene PE, Kim M, Rapin I. Motor stereotypies in children with autism and other developmental disorders. Developmental Medicine & Child Neurology. 2009;51(1):30-38. PMID 19087102. Checked October 11, 2026.
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    The abstract: videos of 277 children, 129 with autism; “More children with autism had stereotypies than the NADD comparison children”; “Autism contributed independently to gait and hand/finger stereotypies and NVIQ <80 to head/trunk stereotypies”; “Stereotypies are environmentally modulated movement disorders, some highly suggestive, but not pathognomonic, of autism.”
18. Schulz SE, Stevenson RA. Sensory hypersensitivity predicts repetitive behaviours in autistic and typically-developing children. Autism. 2019;23(4):1028-1041. PMID 30244585. Checked October 11, 2026.
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    The abstract: parents of 114 children, 49 autistic; “sensory hypersensitivity is strongly related to the core autism spectrum disorder symptom of repetitive behaviours. This relationship was not specific to autism spectrum disorder; repetitive behaviours significantly increased with sensory hypersensitivity in typically-developing individuals as well”; “autism spectrum disorder diagnosis did not add any predictive influence above and beyond sensory hypersensitivity”.
19. Ben-Sasson A, Gal E, Fluss R, Katz-Zetler N, Cermak SA. Update of a meta-analysis of sensory symptoms in ASD: a new decade of research. Journal of Autism and Developmental Disorders. 2019;49(12):4974-4996. PMID 31501953. Checked October 11, 2026.
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    The abstract: “Fifty-five questionnaire studies included 4606 individuals with ASD”; “Compared to typical controls, effect size was large and significant for SOR, SUR, and Seeking but heterogeneous”; “Compared with developmental disorders (DDs) groups, effect size was significantly positive for SOR and Seeking; whereas compared with other clinical groups, only SOR was significant. These findings highlight the core nature of sensory symptoms in ASD and particularly SOR.”
20. Sarver DE, Rapport MD, Kofler MJ, Raiker JS, Friedman LM. Hyperactivity in attention-deficit/hyperactivity disorder (ADHD): impairing deficit or compensatory behavior? Journal of Abnormal Child Psychology. 2015;43(7):1219-1232. PMID 25863472. Checked October 11, 2026.
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    The abstract: boys aged 8 to 12 with ADHD (n = 29) and typically developing children (n = 23); “higher rates of activity level predicted significantly better, but not normalized WM performance for children with ADHD. Conversely, higher rates of activity level predicted somewhat lower WM performance for TD children.” “implications for selecting behavioral treatment targets to avoid overcorrecting gross motor activity during academic tasks that rely on phonological WM.”
21. Cleveland Clinic. Sensory Processing Disorder (SPD). Health Library, last updated March 20, 2025. Checked October 11, 2026.
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    “SPD commonly affects people with neurodevelopmental and neurodivergent conditions, like autism spectrum disorder and attention-deficit/hyperactivity disorder (ADHD). But you can also have SPD without any other condition.” “Currently, SPD isn’t an official medical diagnosis.” “Researchers estimate that about 1 to 3 out of every 20 people in the general U.S. population have sensory processing disorder. These estimates are higher for people with neurodevelopmental conditions.” Sensory craving: “you need and seek out sensory information for stimulation. But getting the stimulation results in disorganization and doesn’t satisfy the craving.” Common symptoms include “Feeling discomfort in certain types of clothing and fabric” and “Reacting to sudden movements, touches, loud noises and/or bright lights”. “There’s a strong link between sensory processing disorder and neurodivergence.” “your child’s pediatrician may refer you to an occupational therapist. These professionals can assess your child for SPD by watching them interact with certain sensory experiences. They’ll also ask about your child’s symptoms, behavior and medical history”; at school a child may need “Access to headphones to block out background noises while they work” and “A designated break to do a sensory activity, like walking, spinning or swinging”.
22. Jurek L, Duchier A, Gauld C, Henault L, Giroudon C, Fourneret P, Cortese S, Nourredine M. Sensory processing in individuals with attention-deficit/hyperactivity disorder compared with control populations: a systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry. 2025;64(10):1132-1147. PMID 40250555. Checked October 11, 2026.
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    The abstract: “30 studies (reported in 32 publications) encompassing 5,374 participants were included, with 23 studies focusing on children and 7 focusing on adults. Patients with ADHD presented with significantly more severe sensory atypicities than the control group in multiple domains: sensory sensitivity ..., sensory avoiding ..., low sensory registration ..., and sensory seeking”; “Heterogeneity was high in all analyses. Only 9 studies were deemed at overall low risk of bias.” “Even though available ADHD clinical guidelines do not specifically mention the need to assess sensory processing in ADHD, this meta-analysis suggests that this should be systematically explored in the evaluation of children and adults referred for ADHD.”
23. Raymaker DM, Teo AR, Steckler NA, Lentz B, Scharer M, Delos Santos A, Kapp SK, Hunter M, Joyce A, Nicolaidis C. “Having all of your internal resources exhausted beyond measure and being left with no clean-up crew”: defining autistic burnout. Autism in Adulthood. 2020;2(2):132-143. PMID 32851204. Checked October 11, 2026.
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    The abstract: “Autistic adults described the primary characteristics of autistic burnout as chronic exhaustion, loss of skills, and reduced tolerance to stimulus”; they described “acceptance and social support, time off/reduced expectations, and doing things in an autistic way/unmasking as associated in their experiences with recovery”; and the authors highlight “the potential dangers of teaching autistic people to mask or camouflage their autistic traits”.
24. Minshawi NF, Hurwitz S, Fodstad JC, Biebl S, Morriss DH, McDougle CJ. The association between self-injurious behaviors and autism spectrum disorders. Psychology Research and Behavior Management. 2014;7:125-136. PMID 24748827. Checked October 11, 2026.
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    Self-injurious behaviors are “behaviors that an individual engages in that may cause physical harm, such as head banging, or self-biting”; “An FBA is built on the premise that behaviors serve a communicative function for an individual”; in functional communication training, “the new skill taught must serve the same function as the problem behavior for the child. For example, this may entail teaching a child to ask for a ‘break’ to replace SIB maintained by escape from demands”; “information is gathered about the antecedents, behaviors, and consequences surrounding a specific behavior in order to hypothesize the function of that behavior”; “the common functions of behavior are: social attention, access to tangible rewards, escape or avoidance of activities or situations, and internal stimulation”; “Protective equipment is often used in cases of severe SIB in order to reduce the likelihood of bodily injury”; “the physical restraint used should inhibit movement as minimally as possible while avoiding SIB”.
25. Singer HS, Mills CC, Pellicciotti J, Mahone EM. Reconsidering the clinical outcome, effect of sex, and diagnostic criterion of primary complex motor stereotypies in children. Pediatric Neurology. 2026;177:62-67. PMID 41633217. Checked October 11, 2026.
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    The abstract: 65 children followed up; “Stereotypy severity was reduced in older individuals, primarily due to decreased Motor Intensity scores”; “Although stereotypical symptoms were present in all subjects, there was an apparent age-related reduction in movement intensity.”
26. O’Reilly MF. Functional analysis of episodic self-injury correlated with recurrent otitis media. Journal of Applied Behavior Analysis. 1997;30(1):165-167. PMID 9103992. The abstract: one child with moderate developmental disabilities; “Results indicated that self-injury occurred only during periods of otitis media. Otitis media may have served as an establishing operation related to escape from ambient noise.” Checked October 11, 2026.
27. Centers for Disease Control and Prevention. Treatment and Intervention for Autism Spectrum Disorder. Page for families. Checked October 11, 2026.
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    “Occupational therapy can also include” “Sensory integration therapy to help improve responses to sensory input that may be restrictive or overwhelming.” TEACCH “is based on the idea that people with autism thrive on consistency and visual learning”; “daily routines can be written or drawn and placed in clear sight” and “Verbal instructions can be complemented with visual instructions or physical demonstrations.” “There are no medications that treat the core symptoms of ASD.” “Some medications treat co-occurring symptoms (those that happen along with ASD)”; medication “might help manage high energy levels, inability to focus” or behavior “such as head banging or hand biting”.
28. Harvard Health Publishing. What is neurodiversity? By Nicole Baumer, MD, MEd, and Julia Frueh, MD. November 23, 2021. Checked October 11, 2026.
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    “Neurodiversity describes the idea that people experience and interact with the world around them in many different ways; there is no one ‘right’ way of thinking, learning, and behaving, and differences are not viewed as deficits.” “rather than making assumptions, it is best to ask directly about a person’s preferred language”. Workplace adjustments for sensory needs: “Sound sensitivity: Offer a quiet break space, communicate expected loud noises (like fire drills), offer noise-cancelling headphones.” “Movements: Allow the use of fidget toys, allow extra movement breaks, offer flexible seating.” “Try to give advance notice if plans are changing, and provide a reason for the change.”

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your child. Sensory processing concerns are best assessed by an occupational therapist who can evaluate your individual child.