Comprendiendo el comportamiento estereotipado en niños con autismo

Título: Comprendiendo el comportamiento estereotipado en niños con autismo

Perfil: Día Mundial del Autismo: se exploran comportamientos estereotipados en niños autistas, enfatizando apoyo y aceptación social.

Palabra clave: ['Salud mental', 'Desarrollo infantil.']

Why does he always turn in circles?

Five-year-old Yu was spinning around in the same spot, one turn, two turns, three turns... His mother gently called his name, but he did not respond. When his mother tried to catch him, he immediately screamed and moved away, continuing his spinning.

To others, this may seem like a "strange behavior" that is hard to understand. But in Xiaoyu's world, the regular sensation of spinning is the only way to organize chaotic sensory input.

Stereotyped behavior refers to repetitive, fixed patterns of behavior or actions that usually show high regularity and little variation. Such behavior is common in some neurodevelopmental disorders, such as autism spectrum disorder (ASD), but can also appear in other mental states or illnesses. Stereotyped behavior often provides individuals with a sense of security and predictability, enabling them to cope with the uncertainties of the external environment.

The Yiyang Central Hospital reports that stereotyped behaviors are one of the core characteristics of autism spectrum disorder, manifesting as repetitive and fixed behavior patterns that seem to lack an evident function. Among the most common are:

Body movements: shaking the body, clapping, spinning, walking on tiptoes.

Object use: repeatedly organizing toys, opening and closing doors, spinning wheels.

Language repetition: constantly repeating the same phrase or advertisement slogan.

Routine rituals: following a fixed route, eating specific foods, rejecting any changes.

Many people misinterpret these actions as 'disobedience' or 'intentionally causing problems.' But the reality is far from that.

Second, stereotyped behavior is not a 'problem,' but a 'coping strategy.'

Neuroscience research shows that individuals with autism often face 'sensory overload' when processing information; common environmental stimuli (light, sound, touch) can feel as overwhelming as a tidal wave.

Repetitive behaviors are precisely their way of regulating this pressure.

Self-regulation: Repeating actions can stimulate the release of endorphins, creating a calming effect that helps individuals regain tranquility amidst chaos.

Creating predictability: When the external world is filled with unpredictable changes, stereotyped behavior provides a fully controllable 'safe island.'

Expressing demand: Some children communicate 'I am too anxious' or 'I need a break' through repetitive behaviors.

Satisfying sensory needs: Certain repetitive movements can provide pleasurable sensory feedback, compensating for deficiencies in other sensory input.

When is intervention necessary?

Not all stereotyped behaviors need to be changed. The criterion for judgment is: do they affect quality of life or safety?

No need for intervention: gentle movements, organizing toys, talking to themselves; as long as they do not harm themselves or others, this can be considered their 'comfort zone'.

Needs guidance: self-injurious behavior (head banging, biting hands), interference with learning or socialization, complete inability to accept any changes.

The goal of intervention is not to 'eliminate' stereotyped behaviors, but to provide alternatives that help meet the same needs in a more adaptive way.

Fourth, what can we do for them?

Do not judge or forcefully interrupt. Coercively interrupting a rigid behavior without providing an alternative only increases anxiety and may even lead to more intense reactions.

Understand the function behind a behavior. Observe the context in which the behavior occurs: is the environment too noisy? Is the task too difficult? Is it excessive excitement or extreme fatigue? Identifying the cause is fundamental to providing support from the root.

Provide alternative options. If the child needs sensory stimulation, they may benefit from compression balls, weighted blankets, or swings; if the child needs predictability, visual schedules can help them 'see' what will happen next.

Allow space for 'permission.' In situations where it does not affect others, let them adjust in their own way. It is not about 'overindulging,' but about respect.

Fifth, breaking misunderstandings starts with understanding.

When we see someone repeatedly clapping, swaying, or spinning, we should not rush to look at them strangely. It is not a 'problem' that needs to be fixed but someone trying to relate to this world.

April 2 is World Autism Awareness Day. We do not need to label everyone with the romantic term 'star children.' What we really need to do is see people as they are, including those behaviors that, although they may seem strange, have their own meaning.

Understanding is the first step towards acceptance. And accepting does not require you to do something special, you just need to be willing to look a little deeper and then say:

"Don't worry, you can exist your way."

Let us embrace each of these special children, as well as the families behind them.

References:

1: "Diagnóstico y Estadístico de los Trastornos Mentales (5ª edición)" (DSM-5)

Haohuirui, Dong Xianwen, Li Enyao, et al. Study on the correlation between repetitive and stereotyped behaviors of autism spectrum disorder and sensory control [J]. China Journal of Child Care, 2022, 30(04): 366-370.

Author: Zhan Wen, Pediatric Department, Yiyang Central Hospital.

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(Editor: YT)