Piano Guidance
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Can ADHD sing?

Verbal stims that may be common with ADHD are often symptoms of hyperactivity and impulsivity, as presented by the National Institute of Mental Health (NIMH) : blurting. humming. singing or repetitively quoting from a movie or video.

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Stims include humming, tapping, or nail biting unconsciously. If your ADHD stimming soothes you, great! If it distracts or embarrasses you, there are ways to manage it. Share on Pinterest AndreyPopov/Getty Images Self-stimulation or “stimming” refers to self-soothing, mostly unconscious repetitive sounds or movements. Almost everyone stims: think hair twirling or nail-biting. For folks with conditions such as autism or attention deficit hyperactivity disorder (ADHD), stimming may be harder to control, however. Stimming behavior can look very much like tics. Tics are also repetitive movements, but unlike stims, they are involuntary, anticipated, and not particularly pleasurable. Tics are features of Tourette syndrome (TS) and other Tic disorders (TD). While ADHD stimming differs from autism spectrum disorder (ASD) stimming and tics, ADHD, ASD, and TD symptoms overlap. If you have ADHD, you may also have another coexisting condition that causes stimming or tics. If your stimming does not put you at risk or cause you embarrassment, you may choose not to worry about it. But if your stims worsen your distractedness or seem to be intensifying, having a medical professional test for coexisting conditions may ensure you get the most effective treatment. What is vocal stimming? Vocal stimming involves making sounds with your mouth or breath. Examples of vocal stimming include: verbal noises

humming

shrieking

repeating words or phrases, including from books, movies, or echoing someone else Auditory stimming is related to vocal stimming. Some common auditory stims involve: tapping tables

tapping ears

motor stimming, including pacing, rocking, and spinning in circles

humming

biting nails

biting inside of cheeks

foot-tapping

pacing

knuckle cracking

spinning

jumping

Why do folks with ADHD stim? ADHD stims may look like disinterest or even defiance. Still, they often result from unconscious efforts to cope with brain differences that make daily functions challenging. These include: executive functioning challenges

self-regulatory challenges

impulsivity Causes A 2017 causal analysis found that hyperactivity, impulsivity, and inattention associated with ADHD influence repetitive behaviors or stimming in various ways: Restlessness. Restlessness may lead to a decreased ability to control motor behaviors. While most folks blurt, hum, or fidget from time to time, people with ADHD have a harder time stopping once they start. Sensory processing differences. If you live with ADHD, one feature of your experience may be hypersensitivity. This means that your mind can’t always discern which sound or sensation of many is important. If you find yourself chewing your pen or singing while working, you may be unconsciously offering yourself the sensory input needed to stay present and grounded in your body and the task. Impulsivity. Impulsivity with ADHD can make it hard to delay gratification. Most people stim because it feels good immediately. Once the habit of stimming starts, it reinforces itself. Triggers Triggers for ADHD stimming involve situations or tasks that tax executive functioning skills or worsen challenged impulse control, hyperactivity, and self-regulation. Some examples include: boredom

overwhelm when coping with prioritizing tasks

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distractions

poor sleep can worsen executive functioning skills

lack of exercise or mandatory sitting for long periods

fear, stress, or excitement

ADHD stimming and related or coexisting disorders Autism spectrum disorder Often, ADHD stimming looks similar to the repetitive verbal stims and stereotyped movements performed by people with autism spectrum disorder (ASD). ASD is a spectrum of conditions that affect speech and nonverbal communication. Some vocal stims associated with ASD include shrieking, humming, and echoing words or phrases from books or movies. ADHD ASD stims cope with feelings stims communicate feelings differences in brain regions responsible for repetitive speech patterns differences in brain regions responsible for repetitive speech patterns last longer than ADHD stims A 2017 analysis of the relationship between ADHD and ASD found that up to 65% of children with ADHD have clinical symptoms of ASD. Treatment options for both conditions may also overlap. One observation the analysis explores — though more research is needed — is that the condition overlap may support the theory ADHD is a mild subset of ASD. Tourette syndrome and tic disorders Tourette syndrome (TS) is a severe tic disorder that develops at a young age. While tics are repetitive movements that look like stims, the experience of tics is different. ADHD TS stims are unconscious but can be stopped and started tics feel uncontrollable stims can be soothing or focusing tics are unpleasant relief is felt from doing the stim relief is felt when they’re over differences in the brain’s dopamine transmitters and receptors may be a factor differences in the brain’s dopamine transmitters and receptors may be a factor Tics usually onset with a precursor feeling, generalized or local to one body part. While ADHD does not cause tics, one systematic review finds: the brain differences may increase the chances of developing both conditions 7% of children with ADHD also have TS Even if you have a mild tic disorder with ADHD, you may be directed to treat ADHD symptoms first. Reviewers suggest that the symptoms of TD may be helped by treatments for ADHD. How to manage stims Stims with ADHD are not harmful and can be helpful to self-regulate. But if stims are causing more disruption than self-soothing, there are options. Often the recommended prescription, behavior, and treatments for ADHD can reduce stims, even when co-occurring disorders are present. Medication Effective medications for ADHD can help with stimming behaviors. Stimulants commonly prescribed are: amphetamine/dextroamphetamine

methylphenidate

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dexamphetamine If you or your doctor are worried about side effects, you might try nonstimulant medications: guanfacine

atomoxetine

clonidine Executive functioning help Having a coach assist you with executive functioning challenges may relieve stress and remove triggers for stimming. A trained professional can help you develop skills in: time management

prioritizing activities

organizing space Behavioral therapy If you’re concerned about how your stims appear or if they’re distracting, you may wish to ask about “habit reversal training.” You can learn to substitute: gum chewing for hair chewing

toy squeezing for blurting out responses

stretching for jumping up at inopportune times Lifestyle changes You may be able to reduce stress and stimming behaviors by managing other triggers. Changes to consider include: more sleep

planned exercise breaks

planned rewards for work accomplished Self-advocacy Living with a mental health condition may often mean self-advocating for your wellness at work, with family, or in social settings. On the job or at school, this might look like: Proactively inform your boss or co-workers, teachers, or classmates you collaborate closely with that your brain uses vocal stims to focus, and it doesn’t mean you’re not listening.

Ask whether they find it distracting, and would lowering your volume or putting your hands beneath the table be a fair accommodation?

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