Vocal stimming is a common autistic and ADHD behavior. It includes the repetition of vocal sounds such as humming, clicking, or repeating phrases and comes in various forms and intensities. These vocalizations may play a variety of roles, such as regulating sensory reactions, facilitating self-soothing behavior to aid focus, and sometimes for communication. Discovering the potential causes of vocal stimming is vital in order to promote acceptance and empathy toward people with this phenomenon.
What's in the article:
Beyond the noise: understanding vocal stimming in neurodiversity
Triggered to hum: exploring the why and how of vocal stimming
From fidgets to hums: a guide to managing sensory needs through stimming
What is vocal stimming?
Vocal stimming or vocal stereotypy involves repetitive vocalizations that do not constitute spoken language. These sounds may be rather diverse, ranging from simple humming or clicking as well as throat clearing to a more complicated behavior such as echolalia (repeating words and phrases) and palilalia (repeating one's own words). Although anyone can stim at times, it is generally more frequent among individuals with neurodivergent conditions such as ADHD and autism.
Studies have revealed that vocal stimming presents different features in people with autism spectrum disorder (ASD) and those diagnosed with ADHD. In ASD, vocal stimming is often more frequent and intense and will often involve echolalia or scripting in a form that interferes with normal social behavior. In contrast, vocal stimming in the case of ADHD is far less acute and has intermittent episodes characterized by spontaneous vocalizations such as humming or verbalizing thoughts. While it can still affect social dynamics, its impact is generally perceived as less disruptive.
Keep in mind, this is just a small glimpse into the diverse world of stimming. Everyone has their own reasons for it, and accepting these different expressions is all about recognizing our shared humanity.
What triggers vocal stimming?
While the exact triggers for vocal stimming can vary significantly depending on the individual, research suggests some common themes in people with ADHD and autism:
- Sensory overload. Both conditions are linked with hypersensitivity to sensory stimuli. In situations of overstimulation, sights, sounds, smells, tastes, or touch can trigger stimming to help manage and regulate these inputs. In this regard, a person with autism could hum while in an environment that is noisy to help them block out any distractions.
- Emotional regulation. Vocal stimming may be used as a method to control anxiety, help manage stress, or function as a self-soother during emotional activation. For example, a person with ADHD can click their tongue to relieve discomfort or frustration.
- Focus and attention. In ADHD, stimming can at times act as a concentration and focus enhancer, especially for any repetitive tasks. Through the rhythmic nature of sounds, it acts as a stabilizing effect while improving cognitive performance.
- Boredom and restlessness. An under-stimulated person with ADHD may resort to vocal stimming when they find themselves bored. The sounds can keep them stimulated internally and help combat restlessness.
- Habit and reinforcement. In certain instances, vocal stimming may develop into a conditioned behavior motivated by the effects it has on sensory control, self-soothing, and/or concentration. The behavioral phenomenon becomes ingrained and repeated even when the initial stimulus factor disappears.
Spotting stimming in children
Vocal stimming should not be considered only as a disruptive behavior in children. It often fulfills vital functions for neurodivergent children such as coping with sensory overload (ASD) or helping focus on a task in ADHD.
Before intervention, understand the 'why': Is it self-regulation or emotional expression? Is it attention assistance? The emphasis is on the needs, not just noise.
Should you stop it? Generally, no. The act of suppressing stimming can lead to anxiety and frustration. Pay attention to the function.
What you can do:
- Observe. Note the frequency and location of stimming. Does it occur in noisy surroundings, during anxiety, or with any particular activity?
- Seek professional guidance. Seek advice from a pediatrician, therapist, or any other specialist who is aware of neurodiversity. They can diagnose underlying needs and offer suggestions for intervention.
- Offer alternatives. Consider substitutes that satisfy the needs of the stimming; for instance, sensory tools or fidget objects, relaxation techniques.
- Create a supportive environment. Create a non-judgmental environment where the child feels safe to share without fear.
- Address disruptions. If the stimming causes significant disruption of daily life, work with professionals to create strategies that minimize interference while respecting the needs of the child.
How to manage vocal stimming
The first step in managing vocal stimming should be to understand the underlying needs and work toward positive alternatives rather than just trying to suppress the behavior.
Individualized strategies unlock the 'why' behind stimming as they provide tailored solutions to address specific needs and promote positive alternatives.
One important step is identifying the triggers. Working with a healthcare specialist, individuals can pinpoint behaviors, and environmental factors like certain settings or emotions, that provoke vocal stimming. This understanding helps in crafting tailored management strategies to address these specific needs.
Another strategy is addressing the needs, where instead of addressing the behavior itself, you explore ways in which you could address the underlying needs it meets. This may include applying sensory tools for sensitization issues or anxiety management methods along with focusing strategies for ADHD.
Replacement behaviors are an integral part of treating stimming that provide people with healthy substitutes for meeting sensory needs, managing emotions, and enhancing attention. Here are three effective strategies to consider:
Response interruption and redirection (RIRD). This approach involves gently interrupting the stim and offering a more reinforcing alternative, such as a calming activity or fidget object, to fulfill the underlying need of the behavior. By breaking the habit and providing better options, RIRD helps individuals develop new coping mechanisms and regain a sense of control.
Positive reinforcement. This method aims to increase desirable behaviors by pairing them with rewarding consequences. For those with ADHD and autism, positive reinforcement involves identifying the function of the stim and suggesting alternative, reinforced behaviors. Token systems, tailored social praise, and structured choices are effective in encouraging the use of alternative coping skills while reducing maladaptive stimming.
Habit reversal training. Similar to muscle training, HRT strengthens alternative responses to replace unwanted behaviors like stimming. Therapists identify triggers and cues, supporting the development of alternative responses such as using fidget toys or relaxation techniques. Through systematic practice and positive reinforcement, individuals gradually rely less on stimming, empowering them to face challenges independently.
In addition to therapies, lifestyle adjustments can provide significant support. Aerobic exercise, for instance, has shown promise in the reduction of vocal stimming among individuals with autism, possibly due to its mood-enhancing, stress-reducing, and concentration-boosting effects.
Adequate sleep is also crucial, as it supports emotional regulation and reduces sensory over-responsiveness, potentially decreasing the need for stimming. Likewise, poor dietary habits can impact mood and energy levels, influencing stimming behaviors, so proper nutrition is essential.
Finally, relaxation techniques like mindfulness and deep breathing can effectively manage symptoms of stress and anxiety, offering further avenues for reducing stimming tendencies.
How to deal with the stigma
Stimming, which is often viewed as strange or even disruptive, needs to be reframed by society. It will need education and advocacy to cultivate understanding and acceptance. Raising awareness regarding the functional roles of stimming in autism and other neurodevelopmental conditions will debunk myths and challenge biases. Fostering open dialogue and inclusive spaces where differences are valued breaks down negative stereotypes.
Supporting the individuals who stim, as well as their families by providing them with resources and empowering guidance, will no doubt equip them to navigate social situations with confidence. Acceptance of neurodiversity is a major step and by this, stimming should not be considered as a cause for stigmatization but an act of self-expression.
Does vocal stimming go away with age?
Not necessarily. While certain types of stimming may diminish over time or with the implementation of supportive strategies, for many neurodivergent individuals, it remains a lifelong characteristic. Importantly, its presence doesn't always signify a problem; stimming can serve essential functions for self-regulation.
What does vocal stimming sound like?
The sounds involved in vocal stimming go from simple humming, clicking, or repeated phrases to sophisticated vocalizations, animal noises, or even singing.
Should I intervene with stimming?
The intervention should be directed to the roots of needs, not just the noise. When stimming is not annoying or harmful, it plays a vital role in self-regulation, communication, or sensory processing. Seek professional help to understand the 'why' and think about other ways to deal with stimming, especially if it causes significant problems.
Vocal stimming is a common autistic and ADHD behavior.
These vocalizations may play a variety of roles, such as regulating sensory reactions, facilitating self-soothing behavior to aid application of focus.
Vocal stimming has diverse functions that are beyond the mere noise in the case of individuals with autism and/or ADHD.
Vocal stimming should not be considered only as a disruptive behavior in children. It often fulfills vital functions for neurodivergent children such as coping with sensory overload or helping to focus on a task in ADHD.
- Research in Autism Spectrum Disorders. Vocal stereotypy and autism spectrum disorder: a systematic review of interventions.
- Research in Autism Spectrum Disorders. “It feels like holding back something you need to say”: autistic and non-autistic adults accounts of sensory experiences and stimming.
- Autism. 'People should be allowed to do what they like’: Autistic adults’ views and experiences of stimming.
- Frontiers in Psychiatry. ASD and ADHD comorbidity: what are we talking about?