Stimming and ADHD
By Jenni Jacobsen, LSW on July 27, 2021
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders among children and can affect people of any age. Symptoms include inattention, hyperactivity and impulsivity. The condition is considered chronic but manageable. When someone has ADHD, they may experience a symptom called stimming. The reasons for stimming in ADHD can vary depending on the individual and their environment.
What Is Stimming?
Stimming stands for self-stimulatory behavior. Someone with ADHD might repeat certain sounds or movements for varying reasons. Stimming is included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association as a symptom of autism. It’s also associated with ADHD. It’s also important to note that even if someone engages in self-stimulatory behavior, it doesn’t necessarily mean they have ADHD or autism. Neurotypical people can also practice self-stimulatory behaviors.
Types of Stimming
ADHD Stimming behaviors can include:
- Visual, which might involve spinning objects, flipping pages but not paying attention to what’s on them, or pacing.
- Verbal or auditory stimming behaviors can include humming, repeating sounds or noises, or compulsively clearing the throat.
- Tactile or touch stimming behaviors might include chewing the inner cheek, skin scratching, teeth grinding or chewing fingernails.
- Vestibular or balance-based stimming can include rocking, swinging or spinning.
- Mental stimming behaviors can include repeating certain phrases or words in mind.
- Taste or smell stimming includes tasting or smelling certain things repeatedly.
Other examples might include repeatedly writing the days of the week or continuously acting out a scene from a movie.
ADHD and Stimming
There are theories about why some people with ADHD will stim. One is that people with ADHD have brain development and activity differences, and stimming may result from those differences. Overly or under-stimulating environments may play a role too. There are also situations where someone engaging in stimming behaviors finds them pleasurable, or they may stim to help themselves focus.
Stimming Triggers in ADHD
ADHD stimming behaviors and their triggers can be broken down into a few categories. These are emotional, environmental and a need to focus. In ADHD, the most common stimming triggers are boredom or relieving anxiety. If they are bored or anxious, stimming can be a way to use the energy they can’t expend otherwise. Stimming can also redirect negative energy, including anxiety.
If someone is in an unfamiliar or unpleasant environment, they might be more likely to stim. Sometimes stimming is a way to show frustration or anger or to help relieve physical pain. In younger kids who have ADHD, stimming can be a way to get attention. A child might repeat loud, disruptive stimming behaviors to get people to pay attention to them. If it works, then their behavior is reinforced. Most of the time, however, stimming is automatic and involuntary.
Common ADHD Stimming Behaviors
Stimming ADHD examples can include:
- Rocking back and forth
- Stroking fabrics
- Twirling hair
- Grinding teeth
- Rubbing objects on the cheek
- Clenching the fists
- Cracking knuckles
- Repeatedly smelling something
- Lining up objects
- Staring at flashing lights
- Peering from the corner of the eyes
- Repetitive blinking
- Hand flapping
- Laughter fits
What Is Happy Stimming?
While we often associate stimming and ADHD with negative emotions, self-stimulatory behaviors can also be related to positive feelings. Happy stimming in ADHD is when someone stims to show pleasure instead of as a way to help them focus or calm down. Any type of stim can be happy stimming. Happy stimming can be a way to alleviate boredom, show creativity or feel connected to your surroundings.
How To Manage Stims
Certain strategies may help manage ADHD stimming behaviors:
- Setting aside a particular time and place for stim behaviors.
- Finding activities that don’t involve stimming, like sports or exercise.
- Distractions when the need to stim arises.
- Talking to a therapist about the behaviors.
- Using a sensory toy.
Not all stimming behaviors are going to require management. If you are experiencing the behaviors or your child is, you should talk to your health care provider. If stimming interferes with daily activity, is time-consuming, or leads to self-injury, then it’s appropriate to get professional help. For parents with children who stim, don’t use punishment as a way to control the behaviors, because it’s ineffective.
Sometimes, stimming may not interfere with daily life, and there is no need to intervene. For ADHD stimming that needs to be managed, medications may be an option. ADHD medications help with the control of behaviors and reduce impulsivity and hyperactivity. Stimulant and non-stimulant medications are available, or a doctor may recommend both.
Behavioral therapy can also help if someone is experiencing distressing, disruptive, or unwanted stimming behaviors. Cognitive-behavioral therapy can help someone learn self-awareness, accept their thoughts and improve their focus and concentration. Family-based therapies, as well as support groups, may also be useful.
If you’d like to explore your emotions, mental health goals, and thoughts from your phone, learn more about the Nobu app. Nobu is a free wellness app that supports various mental health symptoms and conditions. With a paid plan, you can also connect to a licensed mental health professional for additional support.
Edited by – Melissa Carmona
As the content manager at Advanced Recovery Systems, Melissa Carmona puts years of writing and editing experience to work helping people understand substance abuse, addiction and mental health disorders. Melissa is a Florida State University graduate… Read more.
Written by – Jenni Jacobsen, LSW
Jenni Jacobsen is a licensed social worker through the Ohio Counselor, Social Worker and Marriage and Family Therapist Board. She has seven years of experience working in the social work field, working with clients with addiction-related and mental health… Read more.
Medically Reviewed by – Dr. Angela Phillips
Angela is a licensed therapist and clinical researcher, and has worked in public, private, government, and not-for-profit organizations, across clinical and research-oriented roles. Angela’s clinical and research experience has included suicide prevention, cognitive behavioral… Read more.
- American Psychiatric Association. “What is ADHD?” June 2022. Accessed July 22, 2022.
- National Autistic Society. “Stimming-A Guide for All Audiences.” August 14, 2020. Accessed July 22, 2022.
- Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). “Stimming and Fidgeting Help Some people with ADHD to Pay Attention.” ADHD Weekly, March 17, 2022. Accessed July 22, 2022.
- Wang, Karen. “Autism and Stimming.” Child Mind Institute. Accessed July 22, 2022.
- Cleveland Clinic. “Attention Deficit Hyperactivity Disorder (ADHD): Stimulant Therapy.” February 23, 2016. Accessed July 29, 2022.
- Lambez, Bar; Harwood-Gross, Anna; Golumbic, Elana; Rassovsky, Yuri. “Non-pharmacological interventions for cognitive difficulties in ADHD: A systematic review and meta-analysis.” Journal of Psychiatric Research, January 2020. Accessed July 29, 2022.