Stimming in Individuals with Autism: Hand Flapping Behavior

“I flap my hands when I am happy. I flap my hands when I am content. I flap my hands a lot when I get excited about something. I have as many different ways of flapping and twisting and ruffling and fluttering my hands as I have emotions and emotional combinations that wash over and through me. My hands are like barometers of my emotional climate.” Said the individual with autism. 

Officially, hand flapping is a type of stereotype, which basically refers to any repetitive motion without an obvious reason. On the other hand, in the autism world, hand flapping can be a way of communication or to make sense of their world. It may mean that the child is struggling to understand or incorporate what he or she is feeling and sensing. Because of this reason, hand flapping is one of the core diagnostic criteria of autism spectrum disorder.

For us, for other people around them, this behavior could be found awkward and difficult to understand. Nevertheless, hand flapping may serve an important function for individuals with an autism spectrum disorder, like other stereotypical behaviors such as rocking and stimming. However, it does not mean that every individual on the spectrum has to exhibit this behavior.

That behavior tells us that the child is not getting the appropriate sensory input that he or she needs at that time.  It could be that he or she just needs to get up and move. It could also mean that his or her sensory processing mechanisms are confused and they are not receiving signals the way they should be.  If the child shows a lot of self-stimulatory behaviors, parents or caregivers may want to look into finding help for the child’s sensory processing needs.

Hand flapping is one of the first signs something is different about the child for many parents and caregivers in order to understand their children has autism spectrum disorder. Obviously, in the beginning, this behavior seems quirky but cute. That’s why it is common for parents to refer their children as a little bird. However, as the child grows, the situation becomes apparent which is the behavior is not common and there is something wrong. This is the time when many parents and caregivers get concerned.

Children on the spectrum could have a distinctive style to hand flapping behavior. If the child is prone to this behavior, caregivers may notice some important points in order to take their children to see a pediatrician.

•    If they have quick flapping motions of the hands, usually bending from the wrist.

•    If their hands usually, but not always, held high enough for the child in order to see in his or her field of vision.

•    If there is a hand flapping which is accompanied by a bouncing step, spinning, hopping, or kicking of the legs.

•    If there is a high-pitched, repetitive noise or phrase accompany the hand flapping.

•    If hand flapping continues from a few seconds to several minutes.

•    If there is a lack of eye contact or meaningful interaction during hand flapping.

Why Individuals with Autism Do Hand Flapping?

It is not the case that everyone on the spectrum flaps their hands. Some of them may walk on their tiptoes, others may have other repetitive behaviors that they practice, such as twisting string, or complex body movements, and others may flap their hands.

Hand flapping is a form of a stimming behavior in autism which is a self-stimulating outward expression that child can exhibit. It is a common observation for children with autism along with other motor behaviors such as jumping or head turning but it is not always the case.

Hand flapping associated with autism spectrum disorder does not always cause for concern. It only becomes an issue if interferes with learning, results in social exclusion or it is destructive. It can be dangerous in some very rare cases.

Any kind of autism spectrum disorder or Asperger’s Syndrome stimming behavior is linked to some form of stimulating their senses. Because it helps to balance and regulate those children’s nervous system by bringing balance and in many cases relaxation.

The stimming behavior, in this case, hand flapping, helps the person with autism cope with overwhelming sensory input and emotion, whether positive or negative. So a person may stim when excited or under the stress and anxiety of having to cope with.

This behavior could be a coping mechanism that can serve plenty of purposes. If previous episodes of the behavior resulted in wanted attention, it may become a way to continue getting attention.

It usually is done in order to increase arousal. It is a way for the children with autism to self-stimulate when they feel under-aroused or to calm themselves down. The child with autism may be over-aroused by being excited, anxious, or scared and will stimulate to help calm their nervous system. On the other hand, they may want to calm or balance their nervous system when they feel excited, startled, bored, or overwhelmed.

It can look different depending on what the stimming is being used to do at that particular time. Because individuals with autism spectrum do not receive enough sensory cues on their own, they tend to engage in stimming behavior like hand flapping.

Moreover, hand flapping behavior is a way for an individual with an autism spectrum disorder in order to feel aware of their own body. Hand flapping in autism is often observed when they try to balance their nervous system.

There may be clapping because children and teens with autism spectrum disorders are hypersensitive to the world around them, and this behavior can calm them, because it only allows them to focus on one thing and eliminates some sensory overloads.

They are undersensitive to the environment around them and hand flapping can stimulate their underactive senses. Also, they are anxious most of the time and this behavior might calm them down by focusing their attention on the stim.

How Can You Help Individuals with Autism to Reduce or Stop Hand Flapping?

“No one should try to stop hand flapping because it is part of who we are. Would you like it if everyone were trying to make you stop smiling? Or tucking your hair behind your ear? Or putting your sunglasses on top of your head? Or crossing your legs when you sat? That is what people are doing to us when they try to make us stop flapping our hands: they are trying to force us to stop moving in ways that are natural, healthy, and comfortable to us.” Said individual with an autism spectrum disorder.

Autism spectrum disorder and hand flapping, which is one form of stimming, go hand in hand most of the time, but if the behavior is detrimental to learning or if it interferes with the person’s daily life, there are some steps can be taken in order to reduce the behavior. Even in this situation which is changing the behavior, caregivers should keep in mind that hand flapping is definitely a normal behavior for a child with autism.

Hand flapping by itself of course, not bad behavior. On the other hand, it can cause some other behaviors which are harder than the behavior itself to cope with. It could be self-harming. It could be something interfere with education. It could be something to prevent making friends.

It usually does not harm the child with autism but it is normal to worry about how it affects the child’s learning and socializing, in short, their lives. Skill development, environment changes, and behavior changes can help to reduce or stop.

It is s easier to manage stimming, in this case, hand flapping, if parents can figure out the reason behind the behavior. It is a form of communication. It is important to understand what the person with stimming trying to say to us. It is a little bit hard to reduce, however, caregivers may be able to reduce or change hand flapping behavior depending on the child’s developmental age or severity of the disorder. If they are concerned about the child’s behavior, there are some ideas that can be tried.

•    A child with autism should be assessed by an occupational therapist who has experience in sensory integration dysfunction. This therapist is trained in order to help the child with autism make sense of his or her sensory experiences in ways that are more socially accepted.

•    There is a structure called setting boundaries is reported by some parents as it works well for children with autism. Parents should encourage the child to take a hand flapping break at different time points in the day. However, they should be careful about not sending the message that the child is doing something wrong by flapping his or her hands.

•    Caregivers or parents should point out the hand flapping behavior to the child with autism when it is happening. This warning can help the child become more aware of the behavior and how the child is feeling at the time. This information can help some children with autism regulate this behavior.

•    Caregivers can teach the child that there are a time and place for hand flapping or any kind of stimming behavior. For example, they can say that after school is the time and the bedroom is the place to do.

Parents should keep in mind that if they cannot change the hand flapping behavior, they may be able to change the feelings about this behavior. It is important to remember that behavior is not inherently wrong. It is a symptom. It is a sign. It is not the problem itself.

If parents find hand flapping behavior is causing them to feel upset or anxious about their children, they might benefit from an occasional break or a chance to discuss this feeling with a professional, a pediatrician or an autism support group.

Regardless of whether the child’s hand flapping behavior indicates autism spectrum disorder, it is important to discuss any behavior concerns with a pediatrician or an expert related to autism. Resources and next steps for handling this issue will be provided to those parents by their child’s pediatrician.

If a child is flapping but is not bothered by it and is still able to function well in day-to-day life, then there is no need to replace it with something else. In the other hand, if it is needed, caregivers can help the child diminish his or her reliance on flapping by teaching him or her replacement behaviors that are less harmful, less distracting, and less noticeable to other people around them.

Identifying the behavior: The first thing to do is to define what the behavior is. For example, any stimming behavior is defined by carers. Then, the times during which the behavior appears are written. It is also noted what happened before, during and after the behavior. During this behavior, the emotional reaction or the mood of the child should also be noted. In this way, they can help them find some ideas about other behaviors they may try to change.

Trying replacement behaviors: Carers should try other behaviors that will replace safer or less distracting ones. After the child with autism gets used to the new behavior, it can be tried to teach them a behavior that always looks more normal. Carers will want several different replacement behaviors to find the best one for the child. Keep trying these changing behaviors until one of them sticks to the child or resonates.

Teaching how to use replacement behaviors: If the child is able to do some of the strategies on his or her own, keep showing him/her how to do it and then let him/her try by himself/herself.  Keep practicing until he/she can do it with just a verbal reminder.  Then, every time he/she starts doing the behavior, remind him/her in order to use the new behavior.

Changing the environment: If the child with autism finds the environment over stimulating, he or she might need a quiet place to go or need just one activity to focus at a time. In other respect, if the child with autism needs more stimulation, he or she might benefit from for example music playing in the background, a variety of toys and textures, or extra playtime outside. For those kids who need extra stimulation, there are sensory rooms in some schools. In those rooms, there could be some equipment for them to bounce on, swing on or spin around on. Also, there could be some material for them to squish in their hands and visually stimulating toys.

Working on anxiety: Carers would be more beneficial if they watch when and how much the child with autism is doing stemming behavior. Because they can be able to work out whether the child is stimming because he or she is anxious. Then they can look at the child’s anxiety level and causes of anxiety.

Encouraging physical activity: Physical activity can engage the child with autism with other people around him. This may distract them from doing their stimming behavior. After exercise, they can usually focus on their work better. There is also less motivation for stimming behavior. Carers can try short physical activity sessions throughout the day to break up other activities.

Many adults on the spectrum learn to inhibit the immediate needs to stim until they can go off privately to meet those needs. They learn when and where it is appropriate to flap their hands. They learn that they do not have to give it up totally. On the other hand, they can learn when and where to do it over time. When in public, they can learn other, less obvious and more socially appropriate ways to substitute for hand flapping.

Psychological Methods in Order to Reduce or Stop Hand Flapping Behavior

Besides those, there are some methods in order to reduce hand flapping behavior. Sensory integration therapy and applied behavior analysis (ABA) is one of them. Sensory integration therapy provides an outlet that can lessen the desire to engage in repetitive behaviors and hand flapping is one of those behaviors. Thus, this approach can be helpful. Also, applied behavioral analysis (ABA) can be very effective to reduce. ABA includes redirection, rewarding, overcorrection and self-regulation. 

Redirection: Caregivers can redirect the individual’s attention away from the hand flapping behavior which can offer relief. If there is too much attention on flapping, it becomes an area of focus, and maybe an obsession. A parent can prefer to say “show me quiet hands” rather than saying “no flapping” in order to redirect the attention of the person. The focus is on the desired behavior rather than hand flapping itself.

Rewarding: Caregivers can reward the child if he or she stops hand flapping when they ask to do, and they reward the child when he or she is not hand flapping. Rewards might include basic things such as a sticker or time to play with a favorite toy. On the other hand, hand flap itself can be used as a reward for doing something else that is positive. So, this behavior can be a great motivator.

Differential reinforcement of other behaviors (DRO): It involves catching the individual when he or she is not flapping. In this method, an individual receives praise for desired behavior. Caregivers can prefer to say “nice, quiet hands.” instead of saying “no flapping!”. The focus is on the desired behavior rather than hand flapping itself.

Overcorrection: It is a good method which is not only for people on the spectrum. Whether on the spectrum or not, many people learn well from overcorrection. This involves focusing on the behavior and exaggerating that. In case of hand flapping, each time the person flaps, caregiver says “no flapping!” and guides the person’s hands in an exaggerated flapping motion for a few seconds.

Self Regulation: It includes some replacement behaviors for hand flapping behaviors. For example, shaking rattles, tambourines or poms-poms; prompt to “use words” rather than acting out; put hands in pockets; taking deep breaths or using other relaxation techniques.

Autism spectrum disorder and hand flapping behavior are strongly connected to each other, and it is important to recognize that the child, teen or adult may have difficulty quitting the habit. This is especially true when the person with autism is excited or anxious. Just as a normally developed person paces to relieve anxiety, a person with autism spectrum disorder may be likely to flap.

What Could Be the Other Stimming Behaviors?

Everybody stims in some way. Being a diagnostic criterion for autism doesnt mean that it is always related to autism. It is not a bad thing but it should be addressed when it is disruptive to others and interferes with quality of life.

Besides hand flapping, there are some other stimming behaviors that both normally developed people and people with autism have. Common stimming behaviors could be biting fingernails, twirling hair around fingers, cracking knuckles or other joints, drumming fingers, tapping a pencil, jiggling foot and whistling. Even normally developed people could exhibit these behaviors.

In a person with autism spectrum disorder, stimming might involve rocking, flapping hands or flicking or snapping fingers, bouncing, jumping, or twirling, pacing or walking on tiptoes, pulling hair, repeating words or phrases, rubbing the skin, scratching, repetitive blinking, staring at lights or rotating objects, licking, rubbing, or stroking particular types of objects, sniffing at people or objects and rearranging objects.

Other than those behaviors, there are some repetitive behaviors that can cause physical harm. These behaviors include head banging, punching, biting, excessive rubbing, scratching at the skin, picking at scabs or sores and swallowing dangerous items. In the case of autism, some of them could be invisible and end with death. So, caregivers should be very careful in severe cases.

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