What’s The Difference Between Routines, Perseveration and Stimming?
One of the defining aspects of autism is a tendency towards repetitive behaviors such as stimming, perseveration and routines. But despite being grouped together these all have quite different causes and functions, so I thought it might be helpful to take a closer look at exactly what these behaviors are all about.
Perseveration means to respond in the same way repetitively, but it’s about more than just doing the same thing over and over. There’s an added component, which is continuing to do that thing past the point where it’s reasonable to stop (because the conditions have changed or the behavior no longer serves a purpose) or being unable to stop. And that’s the key idea about perseveration, the ‘being stuck’ part.
At its core, perseveration has to do with a thinking skill called cognitive flexibility – that’s the one we use to cope with change by adjusting the way we think. People who have difficulty shifting attention, thinking about different things at once or finding multiple ways to solve a problem are said to be cognitively inflexible, or rigid thinkers. That lack of flexibility makes it hard to adapt to new information or change thinking styles to fit the situation, so thoughts and responses can become ingrained and hard to budge.
Another process involved with perseveration is being able to interrupt or stop impulsive responses, like the urge to look at your phone when you hear a text message beep. Sometimes we need to control that habit or impulsive reaction in a new situation (e.g. not reading text messages at a dinner party), and that kind of control can be difficult for some people. Without it they continue to respond in the same way even when the context or environment around them changes.
You can think of perseveration as being a little like a train traveling along fixed tracks. Once you’re on the track it’s difficult to switch to a different one (no matter how much you might want to), it requires an interchange of some kind. Sometimes the track loops around and around, and other times it runs in a straight line far off into the distance, but in either case it makes it really hard to get to any other destination.
There are lots of different ways that thoughts and actions can perseverate, such as:
- Continuing to talk on a topic after the conversation has moved on
- Anxiety about an event which has passed or no longer a threat
- Asking the same question over and over despite receiving an answer
- Not being able to move on from feeling angry
- Constantly talking about something that happened weeks ago
- Trying the same solution to a problem even though it’s clearly not working
- Giving the same answer to a set of questions
- Looking for a toy in the place where it used to be hidden
- Texting a new friend over and over even when they don’t reply
- Repeatedly going over previous conversations in your mind
- Calling the new teacher by the old teacher’s name
- Walking around with a towel in your hand long after your shower is over
So the key idea about perseveration is that it involves processes like attention, flexible thinking and impulse control, which are not always voluntary or conscious.
Stimming is short for ‘self stimulation’ and in its most basic form it means an action that stimulates the sensory system. However that simple definition really doesn’t come close to describing all the many things that stimming can be – there are lots of different ways that people stim, and even more reasons why they might do it.
Stimming can be a way to calm down an overexcited body or stimulate an understimulated one. It can provide rhythm, comfort and release, or a way to cope with pain or emotions so they don’t become overloading. It can be a way to concentrate, to focus on one source of input when there’s a lot of information flooding in. And although it usually involves a repetitive action, it doesn’t always have to.
Examples of stimming are many and varied, but include things like rubbing surfaces, hopping, jumping, spinning, doodling, staring at flickering lights, vocalizing, sniffing objects, flapping hands and bouncing knees. Using our train example, stimming would be opening the window of the train to feel the breeze buffeting you about the face, or enjoying the calm that comes from the steady rumbling and clickety-clack-clickety-clack of the rails.
So stimming is one word which can mean a lot of different things. The main thing to remember is that it’s about actions which provide additional and predictable sensory input.
Having a preference for routine is about finding comfort in things that are done in the same way or at the same time or in the same order – things that are consistent, predictable and reliable.
The ability to cope with change relies heavily on executive functions like planning, sequencing and being able to shift attention, so people who have difficulty in these areas often find change very unsettling. Change and transitions also come with a lot of extra sensory input, which can quickly become overloading. So routines become a way to cope with all this discomfort by creating predictable input, which acts as signposts amidst the chaos.
Using our train example, routines are about wanting to get the same train at the same time every day because you know where it will go and what you’ll see along the way. It’s comforting because there are no surprises so you can just relax and enjoy the ride.
So Is Repetitive Behavior A Problem?
It’s important to note that none of these behaviors are in themselves dysfunctional – there are times when thinking and acting repetitively can be a very useful way to learn, process or cope with the world around us. But sometimes these behaviors do become unproductive, interfere with other functioning or affect the ability to adjust to new situations, and that can indeed be a big problem.
So just remember that repetitive behavior is in itself neither good nor bad – it’s the outcome of that behavior for a particular person in a particular situation that determines whether or not it’s dysfunctional. And even though all three of these behaviors have repetition in common they come from quite different places and serve different functions, so understanding these differences is a really important first step towards figuring out what you can do to help.
For more information:
What Is Stimming? – There’s a great list of over 100 examples of stimming, which I highly recommend checking out.
About the Author
Bec Oakley is a special needs advocate, writer, blogger, and a parent of two boys with autism in Australia. Autism is part of what makes her and her kids who they are, so she’s passionate about helping people understand what it’s all about. Check out her excellent blog, Snagglebox.com.