Are Fidget Toys Helpful For Kids With Autism?

Open the school bag of any elementary school student, and you'll likely find some form of fidget spinner, fidget cube, or silicone popper. These small toys have become increasingly popular in recent years, especially among young children.

They come in a wide variety of designs and may be characterized by how they stimulate different senses. The most common ones offer tactile, visual, or auditory stimulation.¹

• Tactile fidget toys: Designed to be played with using the hands. Examples are stress balls, squishy toys, and fidget spinners.

• Visual toys: Designed to provide a visual stimulus. Examples are kaleidoscopes and other patterned objects.

• Auditory toys: Make sounds when they're played with. Examples are clickers and rattles.

These toys might look like just another version of the latest plaything hitting the kids' consumer market, but various mental and allied health professionals suggest that fidget toys may have important therapeutic uses.

Fidget toys may be especially helpful for managing some symptoms associated with conditions such as:

• Anxiety

• Attention-deficit hyperactivity disorder (ADHD)

• Autism spectrum disorder (ASD)

In the context of ASD, it's theorized that fidget toys may provide much-needed sensory input, helping these children to better regulate their emotions and behaviors.

All of this might sound reasonable, but is there any scientific evidence supporting the use of fidget toys in therapeutic settings?

Keep reading to discover whether fidget toys work to help manage symptoms of ASD.

What's the purpose of fidgeting?

To find out whether fidget toys have any relevance in therapeutic settings, we need to understand why people fidget in the first place.

At some point in your life, you've probably been tapping your foot, jiggling your leg, or mindlessly clicking your pen. These behaviors often seem purposeless, and a 2013 self-report study validated this idea by suggesting that they are usually symptoms of distraction.

The researchers measured spontaneous and deliberate mind wandering (daydreaming) and fidgeting behavior through self-report measures. While there may be an element of bias in these findings, as the data is based on self-reports, the analysis demonstrated that spontaneous mind wandering predicted fidgeting behavior.²

However, newer research suggests that fidgeting may have a deeper purpose.

Instead of being a symptom of inattentiveness, it could be an unconscious way of coping with anxiety, boredom, or lapses in concentration.

Concentration

One theory is that fidgeting provides low-level stimulation that helps to keep the brain active without overwhelming it. In other words, fidgeting can help to strike the perfect balance between boredom and sensory overload.³

Additionally, fidgeting may help to release excess energy, which can otherwise be a distraction. For example, a 2009 study found that doodling may benefit memory and focus.

The participants listened to a boring phone message while either doodling or not doodling. They were then given a surprise memory test, and the results showed that those who had doodled during the phone message recalled 29% more information than those who did not doodle. The researchers concluded that doodling helps to keep people's minds from wandering during boring tasks.⁴

Stress relief

Other experts suggest that we may fidget to cope with stress.

In a 2018 study on the effect of displacement behavior on stress in men, participants were placed in a stressful situation where they did some mental sums in front of strangers.⁵ The researchers found that the participants with more pre-test anxiety showed more displacement behaviors (for example, scratching or lip touching, which can also be considered fidgeting) during the math test.

Interestingly, the men who exhibited more fidgeting behaviors during the test reported less overall stress.

Fidgeting may help with healthy energy expenditure

Some studies suggest that another benefit of fidgeting might come from weight management.

A 2019 study involving 40 preschool children looked at how posture changes from fidgeting over 150 minutes could affect their overall energy expenditure.⁶ ⁷

During the observation period, all children followed a set timetable (e.g., TV, art, playing with toys). Fidgeting behavior (changes in posture) was noted throughout the activities. Energy expenditure was also measured by calculating the amount of oxygen inhaled and carbon dioxide exhaled in the experiment room.

The researchers found the group that fidgeted the most used an average of six more calories per hour compared to those that fidgeted the least.

Similar results were also found in a 2016 study conducted with adults.

In this experiment, the participants who sat on non-office chairs or used foot devices that promoted fidgeting expended 20%–30% more energy than those who sat on regular office chairs.⁸

Autism and fidgeting

The studies we've looked at so far explain why people in the general population might fidget.

But does it also apply to people with ASD?

It turns out that the purpose of the subconscious, undirected movements might be slightly different regarding ASD.

Fidgeting as sensory processing in autism

Autism spectrum disorder (ASD) is a developmental disorder that affects a person's ability to communicate and interact with others.

Although ASD can present in a variety of ways, there are three main symptom clusters: 

• Impaired social interactions

• Impaired communication

• Repetitive behaviors (such as body rocking or spinning, hand flapping, or insistence on sameness)

These repetitive behaviors are often called self-stimulatory behavior (also called "stimming") which may be seen as a type of fidgeting.

Experts suggest that the root cause of such behaviors is an issue with "sensory processing."

What is sensory processing?

Sensory processing is organizing and making sense of the information we receive through our senses. This includes external stimuli, like sights and sounds, or even from our bodies.⁹

Our brains constantly process this information to plan our next move and keep us safe. For most people, this process happens automatically, and they are unaware of it.

Sensory processing issues arise when people are oversensitive or undersensitive to sensory inputs.¹⁰

For example, a person with ASD who is oversensitive to sensory stimulation might be unable to tolerate the sound of a vacuum cleaner or the feel of certain fabrics. Others might have a strong aversion to particular foods or smells.

In some cases, these sensitivities can be so extreme that they cause feelings of anxiety.

On the other hand, those with hyposensitivity to certain sensory inputs won't be as responsive as other people to stimuli such as sound, touch, or smell. As a result, they may seek out sensations to feel more connected to the world around them. For example, they may chew on hard objects or spin in circles.

The impact of sensory processing issues can be quite severe. It can lead to:

• Anxiety

• Difficulties with self-care

• Problems integrating with the school environment

When impaired sensory processing affects a person's ability to function, this condition is called Sensory Processing Disorder (SPD).

It's estimated that 65%–90% of people diagnosed with ASD also have sensory processing issues. But, it's important to know that not all people with SPD have ASD.¹¹

Do fidget toys help with autism? Experts are divided

The idea of using fidget toys to cope with sensory issues is appealing because they neatly fit within the sensory processing theoretical framework.

Many fidget toys move, have textures, or make sounds, which can produce low-level stimulation that might benefit a child with ASD.

They also tend to be portable and aren’t conspicuous, making them more socially acceptable than repetitive behaviors often associated with autism (e.g., hand flapping).

However, once we start analyzing their effectiveness from a scientific point of view, things get complicated — as the concept of SPD is controversial.

The controversy surrounding SPD

Occupational therapists (OTs) first conceptualized SPD in the 1980s.

However, it's not currently recognized as a diagnosis by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which serves as the authoritative guide used by mental health professionals to diagnose mental health disorders.

Why hasn't it officially been included?

Even though most of the medical community would agree that people can experience sensory issues, there are not enough scientific studies to make this determination.¹² ¹³ ¹¹

The following controversies and ongoing questions are associated with SPD:

• Whether it's a symptom of other disorders rather than a fully-fledged disorder. Some experts believe it's simply a cluster of symptoms that can be better explained by other conditions, such as autism or ADHD.

• How much of the sensory process can be used to explain such behaviors (e.g., If a child keeps hugging others excessively. Is this a need for bodily sensory pressure or simply a lack of understanding of social cues?)

• The long-term effectiveness of sensory treatments.

However, things are slowly changing, with more research being conducted to investigate the effectiveness of therapies intended to treat sensory processing disorders.

The main therapeutic interventions conducted by OTs include:

• Sensory integration therapy (SIT): Clinic-based and may include activities like bouncing or swinging, which help to regulate children’s sensory processing.¹⁴

• Sensory-based interventions: Happens within the context of the person's daily life. This might include adapting the environment to support sensory integration — for example, with items such as weighted vests or fidget toys.

Can sensory toys help ASD sensory issues? Further studies are required

To date, no studies have examined whether sensory toys such as fidget spinners can help with ASD-related sensory sensitivities.

However, one group of researchers investigated how they could help with attentional issues (which can be related to underlying sensory problems).

The study found that fidget toys were not effective in helping children with ASD to improve their attention in academic settings.¹⁵

When we look at SIT more broadly, there is evidence demonstrating its effectiveness.

A 2011 study found that SIT effectively reduced autistic mannerisms like repetitive behaviors. However, the study drew criticism because of the small sample size of just 37 children.¹⁶ A more recent meta-analysis that reviewed three studies found more promising results. Two of the three studies were randomized controlled trials.

Furthermore, of these two studies, one found that the Ayres sensory integration intervention (a technique developed by Jean Ayres) was effective at reducing autism mannerisms.¹⁷ These results are promising and justify continued research into the effectiveness of SIT.

How to choose suitable sensory toys

What should parents make of the debate surrounding fidget toys and other sensory items to manage sensory processing issues?

Pediatric neuropsychologist, Michael Rosenthal, Ph.D., who is also the son of an occupational therapist, explains that because of the current lack of research, we should be looking at each child's sensory needs and allow that to lead intervention strategies.

“I’ve known many OTs who are really creative and ‘get’ kids very well,” he says in an interview with the Child Mind Institute. “The thing we don’t really understand is how and if this approach works for every kid who has sensory issues and where the science is in creating a specific sensory diet for a specific kid.”¹³

Many parents of children diagnosed with ASD are proceeding with sensory-based interventions, despite the lack of scientific evidence, as they see the benefits.

A 2021 survey of 399 families found that 74.8% of parents with ASD-diagnosed children find that sensory-based interventions are either important or very important.¹⁸

If you're keen on trying sensory-based interventions, be aware that many fidget products are marketed as “therapeutic” — even when there is little to no scientific evidence to back it up.

It's always best to receive information and guidance from an OT when choosing sensory interventions for your child, as they are the most equipped at tailoring therapy to suit an individual's sensory needs or preferences.

Some children may prefer soft and squishy objects, while others may prefer hard or textured objects.

It's also important to consider the size, shape, and weight of the object. Some children may prefer smaller objects that are more portable, while others may prefer larger objects that they can wrap their arms around.¹⁹

The lowdown

From a scientific perspective, the jury is still out on how effective sensory objects manage sensory symptoms associated with ASD.

However, this doesn't mean it hasn't been useful for people with ASD.

Many parents choose to try some form of sensory intervention because they've heard it's worked for others.

It's also a relatively harmless type of intervention. If a spinning toy can help prevent a meltdown at a restaurant, most parents wouldn't hesitate to try it.

But remember, commercial fidget toys weren't designed for therapeutic purposes.

That's why it's always best to speak to your child's healthcare provider before buying any sensory toys.

They will be able to direct you to the right professional (usually an occupational therapist) who can make an assessment of your child's sensory needs and provide the appropriate sensory integration recommendations.

Sources:

1. The 10 best fidget and stim toys to improve focus in children with autism | Harkla

2. Wandering in both mind and body: individual differences in mind wandering and inattention predict fidgeting. (2013)

3. The surprising science of fidgeting | The Conversation

4. What does doodling do? (2009)

5. Displacement behaviour regulates the experience of stress in men (2012)

6. Energy expenditure associated with posture transitions in preschool children (2019)

7. Why fidgeting could be good for your child’s health | The Conversation

8. Chair-based fidgeting and energy expenditure (2016)

9. Sensory processing | Kid Sense Child Development

10. Implications of sensory processing and attentional differences associated with autism in academic settings: An integrative review (2021)

11. Sensory processing (2017)

12. Is sensory processing disorder for real? | Scientific American

13. The debate over sensory processing | Child Mind Institute

14. Sensory integration therapy | Raising Children Network (Australia)

15. Increasing engagement and academic performance of children with autism spectrum- disorder and attention difficulties: Do fidget spinners help? (2019)

16. Effectiveness of sensory integration interventions in children with autism spectrum disorders: A pilot study (2013)

17. A systematic review of ayres sensory integration intervention for children with autism (2019)

18. Brief report: Parent perspectives on sensory-based interventions for children with autism spectrum disorder (2021)

19. Everything you need to know about fidget toys for ADHD & anxiety | Adapt & Learn

Dawn Teh is a health writer and former psychologist who enjoys exploring topics about the mind, body, and understanding what helps humans thrive.