Stereotypies – repetitive movements or sounds

Stereotypies are repetitive movements or sounds. They are often called ‘stereotyped movements and sounds’ or ‘stimming’. They are different to individual tics, and last longer. Some children may engage in the same movement or sound for seconds, minutes or even hours.

Common movement stereotypies include rocking, nodding, hand flapping, and spinning. Common sound stereotypies include humming, ‘ahh’ noises, screeching, or repeating words or phrases.

Stereotypies don’t serve a direct purpose, however there is some evidence that they may be self-soothing, help regulate emotions, provide sensory feedback, or just feel good.

Most of the time, stereotypies are not anything to worry about unless they are getting in the way of everyday life. Only rarely, are stereotypies unpleasant or cause children to injure themselves.

Stereotyped movements and sounds are very common – they occur in up to 60% of children. Some groups of children are more likely to develop stereotypies, including children with autism and those with an intellectual disability. They are also more common in boys than girls.

Common everyday triggers include heightened emotions, such as excitement or anxiety, being engrossed in activities, boredom or tiredness. Stereotypies may be seen whilst playing video games, watching television, at mealtimes, and during car journeys. Some children engage in stereotyped movements whilst just using their imagination!

It can be hard to tell the difference between stereotypies and tics. The common features are listed below, although it’s important to every child is different.

Stereotypies:

• Usually start before three years old.
• No ‘urge’, unlike with tics.
• Rhythmic, patterned, repeated movements or sounds.
• A child might engage in the same stereotyped movement or sound over many years.
• A child can usually be distracted away from engaging in stereotypies.
• Usually, experienced as pleasurable or self-soothing.

Neurodevelopmental tics:

• Usually start in early primary school age children.
• There is often an ‘urge’ to tic, such as a feeling of pressure or an itch in that area of the body.
• Sudden or rapid movements or sounds that are not repeated continuously.
• Certain tics will come and go over time – we call this ‘waxing and waning’.
• Children can’t be distracted away from a tic.
• Tics are not usually enjoyable.

As children grow older, stereotypies often reduce and children might prefer to carry them out privately. For most children, stereotypies are enjoyable and harmless, and specific treatment is not needed.

These are some simple strategies to help manage stereotypies:

• Talk openly about stereotypies and offer reassurance. Encourage your child to let a trusted adult know if they begin to cause difficulties.
• Give stereotypies a name to help your child understand that stereotypies are just something they experience,rather than who they are.
• Notice when stereotypies happen more often, such as when bored, when tasks feel difficult or learning something new. This could help identify when extra support might be needed at home and school.
• Support your child to develop an alternative movement or sound that is similar but less noticeable. This can be helpful in shared settings such as school classrooms.
• Encourage short practice sessions to help them practice reducing or pausing stereotypies in specific situations. Start with short sessions – for example, a few minutes – and increase gradually overtime. Using rewards and praise can help your child stay engaged with practicing this strategy.
• Support your children to use private spaces, such as at break time or in the bathroom, to perform stereotypies when needed. This can help children manage stereotypies in public or shared settings while still allowing them to engage in stereotypies when needed.
• Exercise can help – it doesn’t need to be a sport or class, but can include running, climbing or doing other activities they enjoy.
• Some children find having access to music or certain sounds useful, particularly for reducing sound stereotypies. This could include listening to music, singing quietly, or having background sound available.
• Distraction can also help. Spending time doing activities such as drawing, colouring, playing indoors or outdoors may help reduce the amount of time spent engaging in stereotypies.

Unlike with tics, there is no medication that directly treats stereotypies. Instead, management is based on understanding stereotyped behaviour and working to reduce unwanted or harmful stereotyped movements or sounds.

If stereotypies are troublesome, interfere with daily life, or cause injury, additional support may be needed. Evidence-based therapies such as Habit Reversal Therapy (HRT), functional behavioural analysis and positive behavioural support, may help. If you’d like more information or to be referred for HRT, please speak to your child’s GP or paediatrician.

Written by: Tic Service and Children’s Epilepsy Surgery Service (CESS)

Reference number: 0226CWT0046

Last reviewed: February 2026

Next review due: February 2030