Sunday, August 28, 2011

Stims

A common trait found in children with autism is self-stimulatory behavior, often known as “stims,” and Alex has exhibited a variety of these stims over the years. Because many of these children have sensory integration dysfunction or sensory processing disorder--namely problems with their senses being either excessively or under sensitive to stimuli--they often develop coping skills to help them deal with the world around them. For example, children with highly acute hearing, including Alex when he was younger, will often cover their ears when they hear a noise that bothers them. If children crave sensory input, they may engage in movements to help them sense their bodies in space, such as rocking back and forth, a common behavior seen in children with autism, and one we observe in Alex at times. While these behaviors appear unusual, they are necessary to help calm the child by blocking unwanted input or coping with a need for movement or touch.

From the time he was born (and even before that, as we saw on his in-utero sonogram images), Alex sucked his thumb and continued to do so until he was about five years old. Although this oral stimulation behavior is common in many children (I also sucked my thumb until I was five years old.), he combined it with an unusual tactile stim we called “tagging.” While sucking his right thumb, he would reach around with his left hand and grab the tag at the back of the neck of his clothes and rub it. At first, we wondered if he was bothered by the feel of the clothing tags and that was the reason for pulling on them, but we noticed that he actually seemed to like the sensation of the slightly raised letters sewn on the tags. In fact, sometimes he would instead grab the clothing tag of whomever was holding him. I remember Ed’s brother came to visit when Alex was little and jokingly commented that he was leaving while all of his clothing tags were still intact. Now that so many clothes are made tagless, I’m not sure what Alex would have done without the additional sensory input of the tag to touch. After Alex was diagnosed with autism, I read about using a NUK baby gum stimulator brush on the roof of the child’s mouth to address the oral sensory needs. The brush is made of rubber with little raised nubs, and I was able to find one easily at Walmart as part of a baby oral care kit. Alex really liked having the NUK brush rubbed on the inside of his mouth and seemed to find this sensory integration exercise calming.

In addition to thumb sucking, Alex also had a habit of chewing on things. When he still sucked his thumb, he would often chew his shirt collars if he was using his hands and couldn’t suck his thumb. Also, after he stopped sucking his thumb, he chewed on his shirt regularly, apparently as a substitute for sucking his thumb. This necessitated changing his shirt numerous times throughout the day and often eventually resulted in chewing holes in his shirts. Eventually we were able to help Alex stop chewing his shirts by having him instead chew on rubber tubing his occupational therapist provided. However, if he couldn’t find his “chewie,” he would chew on anything handy—pens, toys, plastic ends of drapery and blind pull cords, and even removing his socks so that he could gnaw on them. This stim vastly improved once all of his permanent teeth erupted, so it may have been in response to teething pain. However, until his wisdom teeth completely came through the gums, he continued some chewing behaviors until his mid-teens. Fortunately, now we rarely see any oral motor issues with him, and he doesn’t seem to need any oral stims to calm himself. In my next blog entry on Wednesday, I’ll write about tactile stims Alex has had and overcome through the years.

“So be truly glad. There is wonderful joy ahead, even though you have to endure many trials for a little while.” I Peter 1:6

2 comments:

K. C. said...

I'm glad you and Ed were able to find things to help him with his need for oral stimulation. Lottie still sucks her thumb and chews on her clothes. I'm not fond of the chewing, but as long as she needs comfort, I don't mind the thumb-sucking. Being a kid can be hard. :)

Pam Byrne said...

I completely agree, K.C.! I always appreciated that my mom never nagged me about sucking my thumb, and when I quit, it was my decision. Similarly, Alex seemed to know when he was done sucking his thumb. I'm sure Lottie will quit when she's good and ready, too. :)