Repetitive Movements, Use of Objects, Speech

As stated in The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition: “Stereotyped or repetitive motor movements, use of objects, or speech (e.g. simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
MOVEMENTS
Rocking, spinning
Pacing, tiptoe walking
Hand flapping
OBJECT USE
Lining up toys
Watching objects that spin
Rolling objects between palms of hands
SPEECH
Echolalia
Humming
Singing

Repetitive Behaviors in Adult Autistics

Classic stims, such as spinning, rocking, and flapping, have become diagnostically and culturally synonymous with autism. Experience has taught autistics that engaging in stereotyped or repetitive motor movements, from here on referred to as “stimming” (short for self-stimulatory behavior), results in negative reactions from others, including ridicule, punishment, and avoidance. Experience has also taught autistics that stimming is an invaluable coping mechanism; it has inherent value and is healthy. As a result, autistic adults have coped by camouflaging their stimming in a variety of ways.

MOVEMENTS

Subtle, noticeable but not obviously odd, stimming is common. Autistic adults may play with their hair, press a thumb to a finger, bite the inside of their lips, or pop their knuckles or other joints. These repetitive behaviors are “acceptable” repetitive movements, like biting one’s nails or tapping a foot to the floor. Often, great attention is paid to how often one engages in subtle stimming and the reaction these subtle stims receive from others. This feedback allows the autistic to further calibrate the socially appropriate presentation of their stimming.

“If I need to stim but don’t want people to notice, I’ll often scratch my fingernails over my thumbprint, or play with my hair. It’s still soothing, but not obvious enough for other people to notice.”

Hidden stimming occurs when autistics try to obscure any type of stimming. The need to hide stimming stems from an understanding that stimming is “unacceptable”, “bad”, or “weird”, and attempts to extinguish the behavior. Some autistics have been taught to “stop” stimming; others have been encouraged to “replace” stimming with more socially appropriate approximations. Instead of flapping from the shoulders through the elbows to the wrists, a person may flap only from their wrists under a desk or tabletop.

“I will sometimes do a hidden hand flap where I shake my hands and try to hide it as like, shaking out tension in my wrists or arms, or drumming out a little rhythm or something. As long as I don’t get too wild, most of the time no one pays much attention.”

Some autistics stim freely but only in private. The definition of privacy varies, ranging from solitary spaces like a bedroom or bathroom stall to shared spaces with trusted individuals. Stimming in public has resulted in unwanted consequences. Controlling and containing the desire to stim is a difficult but often “necessary” skill autistics hone over years of practice.

“Oh man, when I’m alone, I really let out all of my stims. It’s awesome! I rock and flap, and flutter my fingers and wiggle my legs and it just lets me get out all my extra energy. Sometimes it is a way to “shake off” anxiety or other emotions that have built up throughout the day. It’s a profound release for me.”

OBJECT USE

Most autistics have collections of things, be that related to a hobby, special interest, area of expertise, or aesthetic. These collections may grow and change over time, or they may be exchanged with new objects, which could be related or totally unrelated to the original interest. These objects perform many functions: shared interest, entertainment, self-soothing, or visual stimming.

“I’ve always had collections, ever since I was a kid. Stuffed animals, cool rocks, My Little Pony toys, books, toy sheep, art supplies, office supplies, Lego, My Little Pony toys again, more books...you get the idea.”

Some autistics derive great pleasure from organizing. They create systems for organizing objects based on color, size, alphabetical/numerical, use, age, or type. Time spent reorganizing, straightening, and streamlining their collections is calming, entertaining, and enjoyable.

“Certain things in my house are organized certain ways. Books are shelved by topic, art and office supplies are in labeled drawers with like items together, and anything that can be organized as such is always in rainbow order. It’s soothing and ensures I can find what I am looking for when I need it.”

Autistics use objects to calm that otherwise may not be designed for that purpose. Before fidget toys and weighted blankets were trendy and available everywhere, autistic people were piling on heavy blankets for relaxation, self-soothing with putty, and fidgeting with various small objects. A soft toy can be calming when the ears are rubbed between one’s finger and thumb, a piece of satin ribbon can be soothing to thread between the fingers, and a pencil or pen can be very calming to chew or suck on.

“I didn’t own a single pencil in elementary school that survived my chewing on it. The more stressed I was, the more I chewed.. All my pencils were covered in teeth marks.”

SPEECH

Repeating the end of questions before answering them is a way to “bookmark” or “placehold” the portion of the conversation or the thought one is replying to. (“How do you feel, so and so?” How? Hmm…”) Autistics are constantly filtering information during a conversation (verbal information: words, direct and implied meaning, tone; nonverbal information: body language, facial expression, etc.). Repeating the word or words to which they are actually responding (“How?”) allows autistics a moment to process all of this information while also processing their response to the question, prior to answering. Autistics have learned through years of experience that responding to questions is a bit of a minefield. Answering too quickly can lead to giving the wrong answer if one has not considered the question carefully enough. However, taking too long to consider the question can potentially annoy one’s conversational partner and cause them to grow impatient, especially if the question was one they considered “simple”.

“If someone gives me too much information or asks too many questions at once, I will sometimes repeat parts of what they’ve said as I answer. Like if my husband says “Ok, so we’re gaming tonight at 7:30. Let me know ahead of time and we can update your character so you’re ready to go. Do you want to do anything for dinner?” This is too much to process all at once, so when I respond, it may sound like, “Gaming, 7:30? Ok. Dinner. No, not really, I just ate so I’m not hungry right now. Umm...Oh, Update? Yeah, I will let you know if I decide to play and want help. Thanks.”
From an early age, autistics learn to memorize dialogue for use in future conversations. Because social communication does not always come easily, autistics may copy grammar, syntax, and intonation from television shows, movies, books, YouTube, friends, and family. At times, this language is repeated without fully understanding its meaning. In such, autistics may appear to understand more than they actually do.

“As a kid, people always thought I was older than I was, based on the way I spoke. Adults thought I was precocious, kids made fun of me. In reality I was hyperlexic and read a lot, way above my grade level, and spent a lot of time with my parents and their friends. I learned words and dialogue from adults and books instead of kids my own age.”

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