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Hand Flapping in Toddlers
Home Occupational Therapy Hand Flapping in Toddlers
Hand flapping may be one of the most well-known and talked about “stims” when it comes to children so parents who see their child flap their hands may grow concerned.
The truth is that hand flapping is a fairly common behavior in toddlers. It can be seen to especially occur when they get excited, anxious or even upset. In typically developing children it is a result of having a large overflow of emotion that has to be expressed and when they don’t know what to do with all that emotion it can come out as a body movement such as hand flapping. Most toddlers will outgrow this by their 2nd or 3rd birthday as they become better at controlling unexpected emotions.
When Hand Flapping is a Stim
There are times that hand flapping may be used as a “stim”, or self-stimulatory activity, by children though and this is when bigger conversations about hand flapping in your toddler usually occur. First it is really important to understand that everyone, including you, has stims that they use. Stims are repetitive movements that you perform that can be used for multiple reasons. They can help you deal with anxiety or frustration by calming you and making you feel more regulated and in control in the moment. Stims can help you stimulate yourself when you are bored or have been sitting too long. They can even give you something to focus on when you are feeling overwhelmed or when there is a lot of input that you are trying to process in your environment. Consider if you have ever done any of the following on this list for any of those reasons:
  • Biting your nails
  • Twirling your hair
  • Tapping your foot
  • Drumming your pencil on a surface
  • Doodling on your paper
I’m sure that if you haven’t done one of those things the list above they probably still helped you think of a stim you do engage in when you are stressed or bored. It is essential to remember that everyone stims and we should expect to see our children stimming at times also.
Children engage in a wide variety of stims that adults do not other than hand flapping and you may remember doing some of these when you were a child. These include but are not limited to:
  • Rocking in place
  • Biting their shirt, another object or themselves
  • Spinning in circles
  • Staring at stationary moving objects such as ceiling fans when rotating
  • Pulling their own hair or repetitively pulling/holding the hair of others
  • Staring at bright lights
  • Banging their heads
  • Hanging upside down off the couch
The main difference between children and adults stimming is that children do not always recognize when their stims are being done at a time or in a way considered socially inappropriate by others around them.
When Hand Flapping is a Stim
This naturally leads to the question of when to be concerned about your child engaging in a stim. At times parents can grow concerned about social stigmas which exist around a child stimming. It is important to recognize this for what it is (the feeling of the need to conform to society’s expectations combined with the feeling of being protective of your child) and refocus on the benefits of letting your child stim. As mentioned above, stims can help calm a person when they really need it or even help them focus when sitting through a long talk. Stims are something that everyone has and they help us regulate our bodies and feelings and self-soothe so we can be successful in our environment.
At the same time, there are times when your child having a particular stim can present a concern for the family. The reasons that a stim becomes concerning from a health care professionals point of view will be if:
  • It gets in the way of the young child playing or engaging with their environment for an extended period of time on a regular basis.
  • The stim begins to cause them to become excluded and interferes with the child making any friends.
  • The stim interferes with learning to the extent that the child is incapable of focusing long enough to engage in a learning activity such as in the school environment.
  • The child engaging in the stim results in self-harm to the child. In a typically developing child stims usually will not present themselves to the point that one of the above occurs. However, there are medical conditions, such as autism, where stims can reach these levels and where intervention is recommended.
It is critical to recognize that your child having a stim which is used a lot does not mean that they have autism. If you are concerned that your child may have autism then you should consider if they exhibit any other signs of autism such as:
  • Deficits in social communication or interaction with others such as a lack of eye contact or delayed communication skills
  • Deficits in developing, maintaining or understanding relationships such as not wanting to engage with their peers in play
  • Having restricted, repetitive patterns of behavior, interests or activities
These are signs, among others, are part of the diagnostic criteria for a diagnosis of autism laid out in the DSM-5 which is the handbook used by health care professionals to describe what signs and symptoms are required to gain a diagnosis of different mental health conditions. If you have concerns that your child may be exhibiting signs of having autism then seeking the advice of a medical professional will be important for your family. A child exhibiting stims without any of these other signs does not mean that they have autism though.
How to Handle a Concerning Stim
If your child has a stim which is at the point where it is concerning to you and your family, the most important thing to know is that you should not punish your child when they engage in the stim. We again want to remember that for your child the stim is a source of comfort and self-soothing and we want them to engage in behaviors which contribute to their sense of well-being. Also, if you simply encourage the child not to engage in the stim they will seek to replace it and experience shows that at times the new stim can be worse than the old stim.

If you truly feel a stim is harmful or occurs too often consider taking the following steps:

Step 1. First rule out a medical condition that could be contributing to your child stimming. For example, if they are banging their head a great deal suddenly then it could be a sign that they have an ear infection that requires attention.

Step 2. Provide opportunities for exercise for your child. Exercise provides proprioceptive input for your child which helps regulate their system and keeps them on an even keel throughout the day. In this way it is a proactive way to help your child not feel the need to engage in stims as they will already feel in better control of themselves

Step 3. Consider why your child is engaging in the stim in the first place. If you see them coming home from school wound up and overstimulated then consider other outlets for them to use to help deal with that anxiety such as building them a calm, safe place or encouraging an after-school nap. Perhaps their teacher is reporting that they are stimming during class when they are required to sit for long periods of time. For this type of circumstance, you could ask if your child could sit on a therapy ball, you could teach them small movements they can do in their chair or have them ask to get a movement break. There are many ways we can help our children learn to deal with anxiety, frustration or the need to move and the more tools they have to use, the better they will be able to cope with their day.

Step 4. Consider alternative tools which can be provided to your child. If your child likes to bite their nails you could consider giving them a fidget spinner or a stress ball to squeeze to try to get input into their hands instead. If they like to bite their arm or shirt, there is something called chewelry (a mix of the words chew & jewelry) which can be bought to provide a safe alternative for your child to get the oral motor input they are desiring.

Lastly, if you are worried about the stimming behaviors that your child is engaging in then consider reaching out to a pediatric occupational therapist. They can help you determine why your child is engaging in the behavior and if it is something to be concerned about. The occupational therapist will help you work to ensure your child has alternatives to keep him or her safe and give you guidance on how to help your child have multiple tools to know how to self-soothe. In this way you will know that your child has the skills to move forward and be successful!