Stimming vs. Tics: What are the Differences?

Have you ever noticed your child engage in repetitive behavior? Do they seem voluntary or involuntary? These repetitive behaviors could be stimming or tics. Both feature repetitive movements, often performed by children with autism.

But how do you know whether it’s stimming or a tic? It’s important to understand the difference, as stimming and tics have different causes and require different forms of management. Let’s take a look at the major differences between them.

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Understanding stimming

Stimming behaviors are repetitive movements of either body parts or objects. They’re also called stereotypy. Many children with autism spectrum disorder engage in self-stimulating behavior when they become overwhelmed, usually by their environment.

Stims are often connected to the senses and may be a sign of sensory overload. Stimming behaviors are often deliberate, and the person can usually stop the action without discomfort.

Some common stimming behaviors include head banging, hair pulling, echolalia, pencil tapping, cracking knuckles, and many other repetitive behaviors. My younger son, Joey, tends to engage in head-banging when he is overwhelmed.

He often bites down on a chewy and starts banging, requiring me to slide a pillow or something soft under his head to protect him. Once he has worked through what is overwhelming him, he will stop and act like nothing happened.

Understanding tics

A tic, on the other hand, is a sudden, repetitive movement that is difficult to control. There are two major types of tics: simple tics and complex tics.

Simple tics tend to involve a single muscle group, while complex tics involve multiple muscle groups. Tics can also be further broken down into verbal or motor tics. Verbal tics deal with sounds, while motor tics involve movement.

Simple motor tics include small behaviors like excessive blinking, nose wrinkling, or lip biting, while complex motor tics involve kicking and jumping. Similarly, simple vocal tics can be sniffing or grunting, while complex vocal tics include repeating words and phrases.

While my son, Joey, is more known for his stims, he developed a tic once that led to a scary moment. He began freezing and shaking his head every so often when he was just shy of two years old.

We wound up spending a weekend in the hospital as numerous doctors believed his actions were that of a seizure until they were able to rule out any seizure activity following an EEG. 

Eventually, he was diagnosed with a complex motor tic. He made that movement for a few years before stopping, and we haven’t seen it since he was about six.

Stimming vs. tics differences

While stimming and tics are both repetitive, they both have major differences. Stimming is usually controlled by the subconscious and can be stopped, while tics are involuntary. 

Stimming is often a form of autism soothing that assists with emotional regulation and gaining control over one’s environment. While both are usually involuntary, stims are often easier to suppress without physical discomfort.

Stimming is usually more common in people with autism or attention deficit hyperactivity disorder (ADHD), while tics can be independent or connected to Tourette syndrome.

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This doesn’t mean autistic people can’t experience both. It also doesn’t mean children with autism who experience tics have both autism and Tourette syndrome. However, it does mean both are possible.

Stims tend to be more consistent than tics. They tend to follow a pattern and have many possible triggers. Stims may occur frequently, while tics can happen in large or small amounts and tend to be inconsistent.

Stims vs. tics: common overlaps

While stims and tics are different, they can have overlaps often associated with ADHD. While tics are not directly linked to autism or ADHD, a tic disorder can be co-occurring with ADHD.

Stimming and tics can then overlap, and a stim can develop into motor and vocal tics as the person begins to fidget more often. This can make tics more common when paired with other conditions like obsessive-compulsive disorder, learning disabilities, or depression.

How are compulsions different from stims and tics?

Beyond stims and tics, there’s another repetitive movement that autistic children may pick up called compulsions. Unlike tics (involuntary) and stims (subconscious), compulsions tend to be a ritualistic response to an obsession or intrusion.

While all three are coping behaviors, compulsions need to be performed according to specific rules set by the person performing them.

Much like a baseball player who adjusts his batting gloves between each pitch, a compulsion is easier to control than a stim or tic while still feeling necessary to the performer.

Understanding and support

If your child is engaging in repetitive behaviors, it may be due to stimming or a tic disorder. While there are similarities between these actions, it’s important for parents and caregivers to know the differences. Stimming appears to be used more for soothing, while tic disorders are completely and commonly involuntary and much harder to suppress.

Once parents and caregivers understand whether it’s a stim or a tic, it can be easier to manage the situation. It’s much harder to treat tics, and they aren’t directly linked to autism the way stimming can be. Still, a child will need help managing either.

If you are having trouble recognizing whether your child’s unexpected movement is a stim or tic, you can seek professional help for guidance. Working together, parents and caregivers can address these behaviors in a way that ensures children remain safe and happy.

FAQs

Q: Is stimming the same as tics?

A: Stimming and tics are completely different. Stimming is usually a repetitive, soothing behavior that can be stopped and started at will. Tics are involuntary movements often connected to Tourette’s syndrome.

Q: How do I know if it’s a stim or a tic?

A: For parents trying to decipher if their children with autism are experiencing a stim or a tic, a stim tends to have a purpose like soothing. Meanwhile, tics tend to be random and can happen at any time without warning or control.

Q: Can you stim and not be autistic?

A: While stimming is commonly seen in children with autism, it is not an autistic-exclusive trait. Neurotypical people have been known to stim, including biting fingernails, tapping their fingers, or twirling their hair.

Sources

Charlton, R. A., Entecott, T., Belova, E., & Nwaordu, G. (2021). “It feels like holding back something you need to say”: Autistic and Non-Autistic Adults accounts of sensory experiences and stimming. Research in Autism Spectrum Disorders, 89, 101864 https://www.sciencedirect.com/science/article/pii/S1750946721001392

Ganos, C., Martino, D., Espay, A. J., Lang, A. E., Bhatia, K. P., & Edwards, M. J. (2019). Tics and functional tic-like movements: Can we tell them apart?. Neurology, 93(17), 750-758. https://www.neurology.org/doi/abs/10.1212/wnl.0000000000008372

Martino, D., & Hedderly, T. (2019). Tics and stereotypies: a comparative clinical review. Parkinsonism & related disorders, 59, 117-124 https://www.sciencedirect.com/science/article/pii/S1353802019300367

Termine, C., Grossi, E., Anelli, V. et al. Possible tics diagnosed as stereotypies in patients with severe autism spectrum disorder: a video-based evaluation. Neurol Sci 42, 1559–1561 (2021) https://doi.org/10.1007/s10072-020-04995-1