Playing with hair is a common behavior that, on its own, is not a sign of autism. Many individuals, both children and adults, engage in this action for various reasons. This article explores common explanations for hair manipulation, differentiates typical repetitive behaviors from those associated with autism, outlines broader indicators of autism, and provides guidance on when professional assessment might be beneficial. Understanding the context and accompanying behaviors is key to interpreting such actions.
Common Reasons for Playing with Hair
Many people play with their hair as a form of self-soothing, a way to regulate emotions and find a sense of calm. This behavior can be a response to feelings of restlessness, nervousness, or anxiety, acting like a physical outlet for internal tension. It provides a tactile sensation that can be comforting and help individuals settle themselves.
Hair twirling or touching can also be a habit, a mindless action performed out of boredom or to occupy the hands. The sensory input from touching hair can be a form of sensory exploration. For some, it might even be an unconscious way to flirt or draw attention.
Playing with hair can also be a tic, an involuntary, repetitive movement. While benign, it can escalate for some into compulsive hair pulling, known as trichotillomania, a body-focused repetitive behavior (BFRB). This condition involves an overwhelming urge to pull out one’s own hair and is often linked to stress and anxiety, where the pulling provides a temporary calming sensation.
Understanding Repetitive Behaviors in Autism
For an autism diagnosis, repetitive behaviors are categorized as “restricted and repetitive patterns of behavior, interests, or activities” (RRBs). While playing with hair can be a repetitive action, for it to indicate autism, these behaviors are characterized by their intensity, frequency, and the significant interference they cause with daily functioning. They are a core diagnostic criterion for Autism Spectrum Disorder (ASD), as outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
RRBs in autism often manifest as stereotyped or repetitive motor movements, such as hand flapping, rocking, or spinning. They can also include an insistence on sameness, inflexible adherence to routines, or ritualized patterns of behavior, where deviations cause extreme distress. Highly restricted, fixated interests of unusual intensity or focus are another form of RRBs. These behaviors may also involve unusual reactions to sensory input, such as over- or under-sensitivity to sights, sounds, or textures.
Unlike typical fidgeting or self-soothing habits, RRBs in autism are pervasive and can significantly impact a person’s ability to engage in social interactions, learn, or function in various settings. While hair twirling can be a form of self-stimulation (stimming), many neurotypical individuals also stim. If hair twirling is part of an autistic person’s stimming, it aligns with broader patterns of intense, repetitive behaviors that are difficult to interrupt and serve a self-regulatory purpose, sometimes linked to sensory needs.
Key Indicators of Autism
An autism diagnosis is not based on a single behavior like playing with hair, but on a combination of persistent challenges across two main areas. The first core area involves persistent deficits in social communication and social interaction across multiple contexts. This includes difficulties with social-emotional reciprocity, such as abnormal social approach, failure of normal back-and-forth conversation, or reduced sharing of interests and emotions.
Individuals with autism may also show deficits in nonverbal communicative behaviors. This can manifest as poorly integrated verbal and nonverbal communication, abnormalities in eye contact and body language, or difficulties understanding and using gestures. Challenges in developing, maintaining, and understanding relationships are common, ranging from difficulties adjusting behavior to suit various social contexts to an absence of interest in peers.
The second core area for diagnosis involves restricted, repetitive patterns of behavior, interests, or activities. These signs appear in early childhood, by ages two or three, and cause clinically significant impairment in social, occupational, or other important areas of functioning. A diagnosis requires meeting criteria in both these broad areas, not just one isolated behavior, and the severity of these symptoms is also considered.
When to Seek Professional Guidance
Concerns about a child’s development, including repetitive behaviors, warrant professional guidance. Consider the pattern of behaviors, their intensity, frequency, and how they impact a child’s overall development, social interactions, and daily life. If playing with hair is accompanied by significant delays or differences in social communication skills, or if it is part of a broader pattern of rigid and repetitive behaviors that interfere with functioning, an evaluation is advisable.
A healthcare professional can provide an initial assessment and, if necessary, refer to specialists for evaluation. Early intervention is important, and a professional diagnosis can help families access appropriate support and resources. When consulting a professional, prepare a list of specific behaviors and concerns observed, including when they occur and their impact.