July 20, 2012

Vocal Self-Stimulation!

Vocal stimming can occur for a variety of reasons. Depending upon the vocalizations, if it has a rhythmic pattern to it, children simply enjoy the sound of the vocalizations, the vibration they feel from vocalizing, and the cause and effect from being able to control the rhythmic pattern of stimulation. And then for other children, vocal stimming can used to calm the child when over-aroused, and alert the child when under-aroused. It can occur when they are over-excited, or again when bored. It is used to calm and organize the nervous system. It can also be a coping skill for blocking out unwanted stimulation. I find that vocal stimulation is often just a fun rhythmic pattern that is fun to produce, listen to, and feel. It is predictable and easy for the child to control. In some cases where the vocal stimming is repeating words or phrases, it can also be a way for the child to practice saying words in fun patterns.

Self stimulation is one of those behaviors that is not inherently bad, but may be annoying or interfering at certain times, and under certain conditions. For example it may be fine to vocal stem at home, but not at the movies. It is not the behavior itself that is bad, just undesirable at certain times and places. What you want to do is teach the child under what conditions it is allowable (at home, when alone, etc.), and which conditions it is not allowed (classroom, movies, group activities, etc). Help the child learn when it is allowable, and when and where it is not appropriate. You don’t have to stop the behavior, just teach when and where it is appropriate.

1. Make a few rules around engaging in vocal stim. You might want to write a social story around when it is appropriate and when it is not. Make sure to acknowledge and validate the importance the stimming has for the child, while teaching him when and where it is appropriate.

2. Review these rules frequently, especially before entering into events where vocal stim is not acceptable. Let him know when it is not acceptable, but also when and where it will be allowable. If the setting, or activity, has a place and time for which the child can engage in the stimming, then review that with him.

3. At the times when vocal stimming is not appropriate, try and provide a oral substitute like chewing gum. If you frequently use chewing gum, then it can become a cue that “When I chew gum I do not stem”. Tell the child to chew instead of vocalize. Stay close by and periodically praise the child for not stemming. If the child starts to stem, calmly redirect him to stop and chew his gum instead. If the child is older you might want to use a gestural cue like putting you finger up to your mouth to signify "stop stemming." If he stops, wait a minute and then praise him for not stemming. If he keeps stemming, "stop the action" until he stops, or briefly move him away from the fun activity until is stops. Over time the child learns when it is appropriate and when it is not appropriate to stem. However, I tend not to use punishment, only redirect, and reinforce desired behavior.

4. When entering stressful situations, if the vocal stimming is used to either mask or avoid stimulation, or to cope with being overwhelmed, than identify an safe area where the child can go to stem and regroup as needed. By very aware of your child’s state of being, and whether the vocalizing is for fun or coping with stress. Respect the need behind the stimulation before trying to suppress it.

I usually try to attack an issue cognitively, emotionally, and behaviorally. So, in this case you want to (cognitively) work with him in understanding the effect his behavior has on others (social story) as well as there is a time and place for stemming, recognize the (emotional or sensory) function the behavior serves for him, and try to provide an appropriate alternative behavior (chewing gum) to take it's place.

Many children on the spectrum are attracted to repetitive, rhythmic patterns. For them the rhythmic sound and vibration, and the sense of controlling it, is very inviting. For these children it holds strong sensory value for them. At the times when the vocal stim is allowable, try engaging in the vocal stimming with your child. Use it to “engage” with the child, imitating and animating his vocalizations. This shows the child you value what he is attracted to, and wish to share the experience with him. Once you have his interest, try to add little variations to it, and see if you can get him to copy you. Try to expand the pleasant vocalizations for greater enjoyment.

We all have our own forms of self stimulation (biting nails, playing with our hair, doodling, tapping our feet, humming, smoking, etc.), which serves the function of regulating our nervous system. Most self stimulation, unless it is injurious, is functional and adaptive, and not inherently bad and something to suppress. However, over time the child learns what self stimulation is allowable in public, and which stim needs to occur in privacy. Never stop the behavior, without providing a substitute, and teach when and where it is appropriate. We will all live more comfortably, while respecting each other’s individual needs.


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