Mom perplexed by toddler stimming

我们两岁的孩子在摇动东西时开始来回奔跑 - 左手绳子，电线，铅笔，衣架等。他这样做了几个小时，并开始在公开场合进行。我如何找到这种行为的替代品和/或限制他花费的时间？如果我拿走他的颤抖，他很合适。但这变得极端，人们开始注意到。

Today’s “Got Questions?” answer is by psychologist Stephanie Weber, of the Kelly O’Leary Center for Autism Spectrum Disorders at Cincinnati Children’s Hospital Medical Center. The center and hospital are part ofAutism Speaks Autism Treatment Network。

Editor’s note: The following information is not meant to diagnose or treat and should not take the place of personal consultation, as appropriate, with a qualified healthcare professional and/or behavioral therapist.

Thank you for your question. I hear similar concerns from many families whose children come to our autism center for behavioral therapy. It’s great that you’re being proactive in recognizing that these repetitive behaviors can become barriers to your son interacting with people who don’t understand them.

Safety first

在我们了解您的儿子为什么要做这些事情以及如何与他一起工作之前，首先让我们确保他安全。因此，请看一下他喜欢摇晃的电线，铅笔，衣架或其他物体，并考虑是否会伤害您的儿子，例如，他跌倒还是摇晃。如果是这样，最好将它们（以及其他危险物体）远离他的覆盖范围和视线。

了解自我舒适的行为

许多患有自闭症的儿童和成年人发现它舒缓了摇滚，踩在脚趾上，在眼前拍打物品并拍打手。这些只是与自闭症相关的重复行为的一些例子，这些行为可以自刺激或自我平息。

是否有某些情况触发您儿子的行为？如果是这样，可能是他正在利用这种行为使自己平静下来。如果您可以避免或限制触发情况，这将有所帮助。

无论如何，从您对儿子来回摇动几个小时的方式的描述来看，我认为这对他来说真的很好。此外，您的儿子可能无法掌握如何玩其他孩子的方式。

许多家庭感到困惑，说：“我们有很多玩具！我不明白为什么我的孩子只想轻弹和摇动东西！”我解释说，尽管有各种各样的玩具，但许多患有自闭症的孩子不知道如何以我们期望的方式与他们一起玩。

The types of play we consider “natural” can seem confusing or frustrating to many children who have autism. As a result, they entertain themselves with activities just like the ones you describe in your question.

学习如何玩

我的第一个建议是帮助您的孩子学习如何玩一个简单的玩具。您可能需要使用温柔的手动提示向他展示如何。

Hand-over-hand prompting is just like it sounds: You put one or both of your hands over his to guide his motions to complete a task. You can do this with many kinds of toys such as ring stackers, shape sorters, simple puzzles, activities that involve matching picture, putting pennies in a piggy bank … and the list goes on!

在教孩子新的游戏方式时，请确保提供口头赞美。例如，“出色的工作。你把橙色的戒指放在钉子上！”除了提供积极的强化外，这还可以帮助您的儿子建立语言，并为您提供有关您对他的期望的具体信息。

重定向和加固

Many children who have autism aren’t easily redirected away from the activities they love. It sounds like that may be the case with your 2-year-old. Often a reward can help motivate a change. For example, does your son have a favorite video? You can explain that he’ll get to watch a short clip from the video after the two of you finish stacking the blocks together. Or perhaps he’ll be motivated by a few mini M&Ms or a hug and tickle. You know your son and what motivates him.

与视觉支持交流

一些自闭症儿童对视觉的反应比口语方向更好。孩之宝创建了许多视觉支持，社会叙事和“操作方法”指南，以帮助患有自闭症儿童学习以有意义的方式玩耍。检查一下Autism Project website想要查询更多的信息。

自闭症会新利luck娱乐在线说视觉支持工具套件是另一个很好的资源。

Learn more about visual supports and下载自闭症会说ATN/AI新利luck娱乐在线R-P Visual Supports工具套件。

鼓励功能行为

Through the strategies described above, your aim is to help your son replace some of his “nonfunctional” behaviors with functional ones. By nonfunctional, we mean that the behavior isn’t helping your son communicate or connect with others or to accomplish a task – such as playing in a way that can build important skills.

At the same time, it’s important to remember that it doesnotwork to take away a child’s favorite activities without giving him or her something else that feels good. That’s why the verbal encouragement and rewards can be so important as your son learns to enjoy playing in a more functional manner.

自我舒缓的地方和时间

It’s also important to build times into the day when it’s okay for your child to engage in the self-stimulatory behaviors that feel good to him. I suggest that you clearly explain to him何时何地these behaviors are okay and when and where they arenot合适的。

考虑绘制有关孩子何时，何时和多长时间参与自刺激行为的简短列表。例如，一些家庭发现它可以让孩子每天在某些时间进行行为几分钟，但仅在家中进行行为。一些家庭鼓励他们的孩子只在自己的卧室里进行行为。这是一个额外的教训，即这些行为不适合社交环境。

You can plan for those times when the repetitive behaviors are不行by having a favorite toy or other distraction ready to help redirect your child.

继续使用这些视觉支持

有了两个年龄的孩子，使用图片与新规则一起进行非常重要。视觉支持可以帮助您传达您的期望。

Along these lines, a visual daily schedule can help you make clear when different behaviors are appropriate. On the calendar, you can draw a picture to illustrate “Free Time” or “Sammy’s choice of activity” at the appropriate time or times during the day. Then teach your son – through lots of reminders and practice – that this is the time he can engage in his self-soothing behaviors.

大多数两岁的孩子只是学习如何一次专注于一次活动5至10分钟。因此，计时器可以是另一个好工具，让您的孩子知道一项活动结束并开始下一个活动。这包括使用计时器向您的孩子展示他可以从事自我舒适行为多长时间。当计时器熄灭时，是时候做一些新的事情了。

这可能有助于给您的孩子一个特殊的盒子，他可以将他喜欢摇晃的绳子或其他物体收起。然后他知道这是安全的，并且等待下一个预定的时间。

Another great way to use visual supports to direct your son’s activities is with a “First/Then Board.” The “first” picture shows the child what activities he or she needs to complete before moving on to a desired activity. For example, the “first” picture might show your child playing with the ring stacker. In the “then” box, you can put a picture of your son running back and forth with his string! Photos can be particularly helpful for young children who don’t yet understand that cartoon drawings symbolize real people and objects.

一旦您的孩子对您在家中引入的新活动（例如玩玩具）感到更加满意，我建议您介绍您儿子可以在公共场合与家人一起做的愉快活动。例如，在公园长凳上或等待医生的约会时一起读书。首先在家中练习这些新活动，然后在社区中尝试。

Thank you again for your question!

读者：对我们的行为和医学专家有疑问吗？将它们发送到gotquestions@autismspeaks.org。