By Emma Ryan | The Learning Garden
When I took on a case with a 6-year-old boy several years ago, the client’s mother described that one of the behaviors she was worried about was his flapping, or his stereotypy.
Shortly after meeting him, I had seen the behavior she had described. After pushing a tower of blocks to the floor, the boy had stood back and watched as the blocks tumbled, and flapped his arms up and down while jumping. It was a physical expression of pure joy.
“He looks totally normal,” she said. “But when he does that, they know he’s different.”
She made complete sense. And I still said no — because I believe we’ve been asking the wrong person to change.
In Defense of This Mother
I have to defend this mother. She loves her son. She wants him to have the best life. She wants him to have friends and feel a part of the community. She has seen other children avoid her son, or laugh at him, and she sees the behaviors that precede that. She has tried to ignore the stares in the grocery store from other customers who think her child is “out of control” or “undisciplined.” And that is incredibly isolating.
So the reasons for her pleas make sense.
But I would not do it. In fact, I will very seldom design an intervention to target stereotypy behavior.
What Is Stereotypy?
Before I explain why I said no, it helps to understand what stereotypy actually is — because the word itself is clinical enough to make people forget we’re talking about a little boy who was happy about some blocks.
Stereotypy (which can also be known as self-stimulatory behavior or stimming) is a repetitive behavior. These behaviors help the individual to deal with emotions or stimulate their senses. Stereotypical behaviors can be verbal or they can be based in movement. Stereotypy mostly occurs when an individual becomes overly excited or upset, or when an individual is bored, tired, or sick. (Hint: If you are unsure whether a behavior is stereotypy or something else, check out my article on Behavior Function.)
Common examples of stereotypy in autistic individuals include hand flapping, body rocking, walking on toes, spinning objects, looking at light, lining up toys or objects, humming, echolalia (repeating words from a person, movie, or TV show), clicking the tongue, or sniffing certain scents.
People without autism can engage in stereotypy, too. Some common examples include leg bouncing, nail-biting, pacing, humming, singing when you’re alone, doodling, and knuckle-cracking. Nobody is designing behavior plans for those.
Why We Shouldn’t Reduce It
Doing so may block coping mechanisms. The client’s mother described that this behavior occurred when the client was very upset, in addition to times when he was overjoyed. The flapping behavior is an attempt at self-regulation. And for many individuals, regulation of this kind can be effective. Moreover, the stereotypy behavior is often far less disruptive than the alternative, unregulated response.
It forces masking. Masking is the act of hiding autistic traits in order to appear more neurotypical. Not only does this kind of forced masking affect an individual’s self-esteem, it can also contribute to exhaustion and overwhelm, because it requires that the individual constantly be on their “best behavior” to avoid making others uncomfortable.
It violates autonomy and self-expression. Inconvenience or mild annoyance are not good enough reasons to stop a person from being who they are and doing what helps them feel good. Who am I to decide who an individual is allowed to be if it is not harming me or anyone else?
The Ethics Behind the Decision
The Board of Certified Behavior Analysts has a strict code of ethics. The code dictates that BCBAs should first do no harm, and this includes protecting the welfare and rights of clients above all others. This means that my job, as a BCBA, is not to worry about whether Frankie thinks it is weird that my client flaps his hands during recess, or that Mrs. Johnson goes home and tells her husband that my client was “out of control” because he was flapping in the grocery store. My job is to ensure that my client is safe and that he learns the skills he needs to live a full life and be a productive member of society to the greatest extent possible.
Applied Behavior Analysis is a very powerful science. It is designed to be used to help others and improve their quality of life. It is not designed to create a world in which everyone is the same so no one ever has to feel any discomfort or uncertainty about social rules.
Exceptions
I qualified earlier that I would very seldom design an intervention to target stereotypy for reduction. The reason for this is that there are times when stereotypy poses a danger to the individual, or to others — and in those cases, an intervention is absolutely appropriate.
Stereotypical behaviors that can be dangerous to the individual or others include head-butting, skin-picking, hair-picking, and biting (self or others). It is important to note that the behaviors listed are not always stereotypy, and may serve other functions. Especially when dealing with dangerous behaviors, it is essential to conduct a thorough FBA to determine the function prior to implementing an intervention.
Additionally, sometimes stereotypy becomes so severe that it impacts the individual’s ability to attend to instruction. In these cases, it may be necessary to make changes to the environment to help the child to feel more calm. Adding exercise or other movement may assist in providing the sensory input the individual is craving. These behaviors don’t need to be eliminated, but they might need to be redirected or reshaped, in order to help the child to meet their learning goals.
When Stereotypy Isn’t Hurting Anyone
So here’s the thing: if it isn’t hurting the individual and it isn’t hurting anyone else, why does it need to be eliminated?
I don’t think it does. And many people would agree with me.
It’s Not Their Problem, It’s Ours
Here’s an idea. It’s not a new one, and it’s not all that radical. What if we flip things? What if, instead of my client — who is already doing the work of trying to learn how to decode emotions and social interactions and correct pronoun usage — we put the burden on Frankie and Mrs. Johnson? What if we ask them to expand their minds and employ some cognitive flexibility?
What if, together, we create a world where the next time my client flaps in his first grade classroom, his peer looks over, smiles and says, “I feel excited, too!”
It Starts with You
If you also want to create a world where Autistic kids and adults can stim freely, and without judgment, you can! You have the power to teach others (with, or without Autism) about stereotypy.
1-Start by teaching about how people respond to things in different ways.
2-Help demystify stimming by showing that it is something we all do!
3-Encourage them to be an advocate for themselves or for others!
Looking for a full resource to teach your students about stereotypy? Check out my Sensory Needs/Preferences Resource on TPT.
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