Stereotypies and Self-Stimulatory Behaviors as Means of Self-Regulation in Autism

Abstract

Repetitive motor behaviors, particularly stereotypies and self-stimulatory behaviors (stims), play a role in emotion- and self-regulation in autism. Less is known whether the self-regulatory function is also found in mental conditions that co-occur with autism, for example ADHD, OCD, and social phobia. In a series of online surveys, we presented stereotypy-internal state combinations. The final survey was completed by 4990 participants who indicated whether the 22 presented stereotypies were expressions of internal states for them. Participants could state (a) no diagnosis, (b) self-diagnosis, or (c) formal diagnosis of ADHD, ASD, OCD, or Social phobia. Stereotypies were done for various reasons, and various stereotypies were done for the same reason. The highest prevalence was among autistic persons, followed by persons with social phobia, OCD, and least among persons with ADHD. Co-occurrence of social phobia or OCD increased the prevalence by 1.5 stereotypy. Regarding validity, the assessed stereotypies were performed for self-regulation in autistic persons, but there was no difference in validity for persons with or without ADHD, OCD, or social phobia. Performing the stereotypy for the specific emotion was more common across all four mental conditions. Stereotypies were performed to cope with positive, negative, low, and high arousing states. There was no universal mapping of stereotypy to specific internal states. Stereotypies provide a means of self-regulation, particularly for autistic persons with co-occurring OCD or social phobia. Knowledge about the variety of human means of self-regulation can reduce the stigma of stereotypies.