Self-Stimulatory Behaviors
Presenters:
Brittain Coleman, MA, BCBA
Behavior Analyst
Tracy Palm, MS, BCBA
Executive Director
Transformations Autism Treatment Center
What is a Self-stimulatory
behavior?
• Stereotypy or self-stimulatory behavior refers to
repetitive body movements or repetitive
movement of objects
• Often observed in the following forms:
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Visual
Auditory
Tactile
Vestibular
Taste
Smell
What do they look like?
• Visual:
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Staring at lights or ceiling fans
Repetitive blinking
Moving fingers in front of the eyes
Hand-flapping
Gazing at nothing in particular
Tracking eyes
Peering out of the corners of eyes
Lining up objects
Turning on and off light switches
What do they look like?
• Auditory:
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Vocalizing in the form of humming
Grunting, or high-pitched shrieking
Tapping ears or objects
Covering and uncovering ears
Snapping fingers
Making vocal sounds
Repeating vocal sequences
Repeating portions of videos, books or songs at inappropriate times
What do they look like?
• Tactile:
– Scratching or rubbing the skin with one’s hands or with another object
– Opening and closing fists
– Tapping surfaces with fingers
• Vestibular:
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Rocking front to back
Rocking side-to-side
Spinning
Jumping
Pacing
• Taste:
– Placing body parts or objects in one’s mouth
– Licking objects
• Smell:
– Sniffing or smelling people or objects
What do they look like?
• In extreme instances, self-stimulatory behaviors
may take on the form of self-injurious behavior:
– Head banging
– Eye poking
– Hand biting
• Not all self-injurious behaviors are considered
self-stimulating
Why do people engage in selfstimulatory behaviors?
• THE REAL ANSWER?...
No one really knows for sure
Hypotheses:
• Hypotheses:
– To calm themselves down
– To receive some sort of sensory input they need
– It releases opiate-like substances in the brain called beta-endorphins,
which can produce either a euphoric or anesthetic effect
– Provides an extra dose of internal stimulation for children with ASD
who feel under-stimulated
– Provides a feeling of tranquility for children who feel overstimulated
– Children who are hyposensitive, or under-responsive to stimuli, may
demonstrate the opposite effects: self-stimulatory behaviors may
actually increase arousal
So what have we done for selfstimulatory behaviors?
• Beginner Program:
– This intervention will help an individual learn to do
alternative behaviors and decrease their self stimulatory
behaviors.
– This intervention will allow the therapist/parent/caregiver
etc. to assist the individual in decreasing their self
stimulatory behavior
– This intervention uses positive reinforcement to teach an
individual how to discriminate between an appropriate vs
inappropriate time to engage in self-stimulatory
behaviors
When is the individual ready to do
this type of program?
• Does the child respond to multiple reinforcers?
• Does the child use a token system successfully?
• Does the child respond to delayed reinforcement?
• What is the functioning level of the individual?
Materials Needed
• Timer
• Reinforcers
• Token System
Steps to the intervention
• Determine a baseline
– How often is the person currently doing the behavior?
• Pick your target time
– This time should be slightly below the baseline time
•
Determine your master criterion
– Typically 3-5 successful sessions
– If the individual has more than 5 unsuccessful sessions
then back the time down to the last previously successful
time frame
• Increase the time in small increments in the
beginning to create opportunities for success
Steps to the Intervention cont.
• Make the deal
– Make sure to explain to the child what is expected and
what the reward will be
– Use a token system once the child is able to work for
longer periods of time without primary reinforcers
• Set the timer
• Reward/Try Again
• Increase the criterion as needed
What else do I need to teach?
• Replacement behaviors
– Determine the function for the behavior then you can
determine an appropriate replacement behavior
– Sensory/automatic
• Weighted or textured clothes, etc.
– Positive Reinforcement/ Attention
• Asking for assistance, attention
– Positive Reinforcement/ Access to Items or Activities
• Manding for items/activities
– Negative Reinforcement
• Asking for a break
• Asking for people to go away
• Asking for something to stop
What does the data show?
Self Stimulatory Behaviors
Frequency of Unsuccessful Intervals
180
160
140
120
100
80
Self Stimulatory Behaviors
60
40
20
0
Probe Seesions
11 year old boy, diagnosed with ASD
So what have I done for selfstimulatory behaviors?
• Expanded Program:
– An intervention that aims to help an individual learn how
to control their own self stimulatory behaviors
– An intervention that allows the therapist/parent/caregiver
etc. to some control over the individual’s self-stimulatory
behavior
– An intervention that in a sense teaches an individual
how to discriminate between an inappropriate time to
engage in self-stimulatory behaviors
Participants
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2 participants
Both have an Autism diagnosis
Both males
Age:
– Client #1: 6 yrs old
– Client #2: 11 yrs old
• Skill level:
– Client #1: High functioning, able to understand some basic
rules, some more complex language skills
– Client #2: Low functioning, unable to understand basic rules,
limited language skills
Topographies
• Topographies:
– Client #1: Vocal Stereotypy
– Client #2: Hand-flapping, feet tapping,
repetitive head movements
– Often individuals who engage in frequent selfstimulatory behaviors engage in behaviors that are
observed in a variety of topographies, therefore it is
important to discuss and determine which or all of
the behaviors are going to be targeted
What was involved?
• This intervention is comprised of several different
components:
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Basic Stimulus Discrimination
Systematic Phases
Token Economy
Response Cost
Reinforcement
Self Management
Time Management Technology
Stimulus Discrimination
• I utilized a basic red card and a basic green card
to teach discrimination
• Red card signifies the time the individual was not
allowed to engage in self-stimulatory behavior(s)
• Green card signifies the time the individual was
allowed to freely engage in the targeted selfstimulatory behavior(s)
No Silly Noises
Yay! Silly Noises
OR
Quiet Body
OR
Yay! Break Time
Red Card Means: No Silly Noises
1. 08:00 Did I have a quiet voice?
Yes: Token No: Reset Timer & Tokens
2. 06:00 Did I have a quiet voice?
Yes: Token No: Reset Timer & Tokens
3. 04:00 Did I have a quiet voice?
Yes: Token No: Reset Timer & Tokens
4. 02:00 Did I have a quiet voice?
Yes: Token No: Reset Timer & Tokens
5. 00:00 Did I have a quite voice?
Yes: Token No: Reset Timer & Tokens
Systematic Phases
• This intervention was designed to be implemented
very carefully taking careful consideration of each
step as progression (or lack there of) is made
Systematic Phases
Phase:
Red Card Time
10 seconds
Token Time
Interval
2 seconds
Green Card
Time
10 min
1
2
20 seconds
4 seconds
9 min 30 sec
3
30 seconds
6 seconds
9 min
6
1 minute
12 seconds
7 min 30 sec
7
1 min 30 sec
18 seconds
7 min
8
2 min
24 seconds
6 min 30 sec
17
8 min
1 min 36 sec
2 min
18
9 min
1 min 48 sec
2 min
19
10 min
2 minutes
2 min
= break in the phases
RCC= Red Card Condition
Criteria for
Phase Change:
3 RCC without
VS
3 RCC without
VS
3 RCC without
VS
4 RCC without
VS
4 RCC without
VS
4 RCC without
VS
5 RCC without
VS
5 RCC without
VS
5 RCC without
VS
VS= Vocal Stereotypy
Token Economy
• It is essential that the individual be able to
understand and navigate a token economy
• If the individual has not yet been taught a token
economy this needs to be the first step taken
– Even if an individual does have a learning history with a
token economy it is recommended to go back through
the steps of pairing the tokens with reinforcers
systematically
• For the two clients that have used this method a
token economy with five tokens was used
– The number of tokens is not crucial
Response Cost
• It was found that some degree of response cost
was necessary for success
• In the beginning taking away one token for a
single incidence of self-stimulatory behavior was
tried
• However after assessment and consideration
specifically for the two clients for which this
intervention, it was determined removal of all of
the tokens was the best approach
Reinforcement
• Preference assessments prior to starting are
necessary for success
• Reinforcers are used as added incentive to
continue to not engage in self-stimulatory
behaviors, especially in the beginning phases
• The ultimate reinforcer used is the ability to freely
engage in the self-stimulatory behavior
Self-Management
• This component is to aid in the success of the
individual being able to utilize this intervention
across a variety of settings
• If the individual is able to maintain and manage it
all by him/herself it increases the quality and
quantity of learning that is possible
• Throughout all of the phases of the intervention is
it recommended to require the individual place
their own tokens on the token board
• Once the individual satisfies the criteria for the
final phase you should then move to the
maintenance phase
Maintenance Phase
• The maintenance phase consists of the following:
– Prompting the individual to:
• Monitor the time
• “Asking” or determining themselves whether or not they
engaged in the behavior
– If yes
» Delivering their own tokens
– If no
» Not delivering a token
» At this point elongating the time should be aversive
enough
– Systematically fading those prompts until the individual
can independently maintain it all
Time Management Technology
Used
• Timer
– A timer was used to indicate the end of the red and
green card condition
– The time was also used to monitor the increasing time to
know when to deliver the tokens
HOWEVER:
If the resources are available:
• A Motivaider is believed to be the better
technology of choice for the following reasons:
– Constant monitoring of time is not necessary
– More discretion
Refresher on Participants
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2 participants
Both have an Autism diagnosis
Both males
Topographies:
– Client #1: Vocal Stereotypy
– Client #2: Hand-flapping, feet tapping, repetitive head
movements
• Age:
– Client #1: 6 yrs old
– Client #2: 11 yrs old
• Skill level:
– Client #1: High functioning, able to understand some basic
rules, some more complex language skills
– Client #2: Low functioning, unable to understand basic rules,
limited language skills
Results
Vocal Sterotypy
Frequency of Yes' and No's in each phase
14
12
10
8
Yes
6
No
4
2
0
1
2
3
4
5
6
7
8
9
10 11
Phase
12
13
14
15
16
17
18
19
• Yes means the individual successfully did not engage in
vocal stereotypy during that time frame
• No means the individual did engage in vocal stereotypy
during that time frame
Results: Client #2
Physical Self-Stimulatory Behaviors
Frequency of Yes' and No's in each phase
60
50
40
30
Yes
No
20
10
0
1
2
3
4
5
6
7
8
Phase
9
10
11
12
13
14
15
• During the sessions that have increased frequency of “no’s” the
data also showed an increase in problematic behaviors
• It was also noted that on during phases/sessions 3, 11, and 15 the
clients mother reported the client not sleeping the night before
Questions?
Contact Information:
• Tracy Palm: Executive Directory
– tracypalmaba@aol.com
• Brittain Coleman: Behavior Analyst
– BrittainColeman@gmail.com
Transformations Autism Treatment Center
(901)-231-2931