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Start, Stop, Scale, Stim…

…some neuroscience of autism, simplified!

*Please note: I am not a researcher, but a clinician (physical therapist) who holds a strong interest in neuroscience research that can give insight into the effective provision of support strategies for autistic people*

I had posted the following as a comment in a discussion on the Facebook group “Autistic Researchers Researching Autism“, and someone requested to be able to share the info in the comment. I’ve copied the comment, along with a bit of expansion and some links to references, below:

“I’ll throw in my perspective as a clinician who has training in supporting people with “movement disorders” (conditions occurring because of differences in the brain regions that start/stop/scale/coordinate brain functions).

In addition to the line of research others have mentioned that indicates general brain connectivity differences, there is a more specific line of research into connectivity differences between two particular areas, the basal ganglia and cerebellum, and the rest of the brain.

The basal ganglia help to start/stop/scale brain functions. This is oversimplifying it, but it’s kind of like a light switch with a dimmer function.

Differences in basal ganglia connectivity will result in some brain functions tending to turn on more or less easily. Special interests/hyperfocus, involuntary movements, intrusive thoughts, sensory sensitivity etc are examples of brain function that turn on more easily than average. Inertia, low sensory registration, slower transitioning between activities are examples relating to some brain functions turning on less easily than average.

The cerebellum helps coordinate brain functions. Think rhythm, timing, smoothness, etc.

Differences in cerebellar connectivity will result in some brain functions tending to have differences in the timing/rhythm of how they occur. Differences in coordinating movement and integrating multiple types of sensory input simultaneously can relate to cerebellar connectivity differences.

I think one could make an argument that all autistic traits boil down to differences in the timing, rhythm, and intensity of how brain functions relating to movement, sensory function, and executive functioning occur.”

If we think of autism through this lens, we can consider how for any given autistic person’s individual pattern of basal ganglia and cerebellar connectivity, there will be certain activities (stims) that help to facilitate the starting, stopping, scaling, or coordination of certain brain functions.

I think this idea meshes nicely with Nick Walker’s definition of stimming in Neuroqueer Heresies:

To stim is to engage in any action that falls outside the boundaries of the social performance of normativity, and that provides some form of sensory stimulation in order to facilitate, intentionally or otherwise, some particular sensorimotor process, or access to some particular state or capacity of consciousness or sensorimotor experience.

As physical therapists, when we support individuals with movement disorders like Parkinson’s disease, we use all sorts of sensory cues (stims!) to help our clients start, stop, scale, and coordinate their movement.

What if we as clinicians supporting autistic people were more widely taught to help individuals explore which stims help to start/stop/scale/coordinate which brain functions given their personal, individual patterns of brain connectivity?

Thinking of autistic support strategies through this lens could be useful for clinicians when supporting autistic folks with communication challenges, motor control challenges, and executive functioning and mental health/cognitive conditions (burnout, shutdown, inertia, intrusive thoughts, OCD, anxiety, etc). There are many clinicians already doing so, but we need more high-quality research in this area guided by collaborations between autistic individuals, clinicians, neurologists, and neuroscientists to help healthcare professionals better understand how to support autistic clients.

Some links to review papers on: