This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
Thumb Sucking With Asperger’s Syndrome
By Pam Marshalla
Q: I have a 9-year-old male client with Asperger’s who sucks him thumb. I read your book How to Stop Thumbsucking and have had success with other children, but not this one. Advice?
I have never faced this but I think this all boils down to what makes sense for him. It seems that the only things that get through to these clients are the things they can plug into their own logic. If you can figure out what makes ideas get through to him, and if you could steer conversation toward that, then I think you could work out a plan.
For example, if he is rule-bound, perhaps you could teach him a rule: “No children above the age of X suck fingers or thumbs.” Then it would be logical for him to stop because he is beyond that age. Perhaps the rule should be embedded into a series of general 5-10 rules about appropriate behavior in the classroom, at home, etc.
I worked with one very rigid four-year-old who was like this. When he went to his 3-year dental checkup he overheard his dentist say that thumb sucking was not bad. So for the next year the boy insisted that he should be left alone to suck his thumb. But then the dentist reversed this opinion at the boy’s four-year checkup. The doc mentioned that the boy had to stop because it was beginning to ruin his occlusion and the boy quit the next day.
You never know what will cause a child to comprehend and accept a new idea, especially when they have Autism or Asperger’s Syndrome 🙂
When my daughter was starting to suck her thumb more than previous at age 4, I explained about how it could ruin her teeth and it wouldn’t look very good. She didn’t believe me. I googled “Thumb Sucking Teeth” on google images, showed her what could happen, and she stopped that day. Its been over a year and a half. The images are pretty sightly. A friend of mine was skeptical, but did the same with her 5 year old son after trying many different things and he stopped immediately too, that’s been almost a year. I’d check with parents first though.
Janie-
This is such an excellent idea !!!
Pam
My daughter is 10, I’ve shown her images, I’ve helped her with replacement behavior, tried chewing gum, candy, straw, ice…you name it, I’ve tried it. She doesn’t do it all the time, only when anxious. Tried breathing, blowing up a balloon, sensory toys (slime, squishy toys, etc). Nothing seems to work. Most of her baby teeth are gone and her mouth does not look distorted (I’m glad that it isn’t, however, I thought if she had crooked teeth, she would stop). I’m truly hoping by middle school or high school she will kick the habit
Please show her this message. My mother told me i needed to stop, but the stress at home was too much. My mother would end up telling me to go “suck my thumb and calm down” …when i turned 18 i went to an ortho oral surgeon…she said she would have to break my jaw and sew ir shut to realign it. Rip out 2 teeth in order to push my row of teeth back. Then after months of my mouth wired shut. I can make an ATTEMPT at braces with baby screws put in my gums. She said i may be too far gone. At age 18. She said that years further my front teeth will push into each other. I have open bite, cross bite malocclussion. I never got the surgery. I still have lock jaw/ pain. Too many cavities due to bacteria etc. Also PLEASE remove your child’s wisdom teeth before they push through. It will make bite worse and burrow holes into other teeth….I teeth….I wish i would have quit but i was shamed and screamed at constantly. I’m in late 20s now and being treated for adhd etc
this isn’t true but i like the enthusiasm to scare this persons kid into stopping
My grandmother told me it made my breathe stink I didn’t do it ever again
Please do not scare your children into this. That only creates a psychological burden between what they are doing and the fear of doing it. They are looking for something to self sooth. I suggest a healthy behavior replacement. Instead of sucking their thumb perhaps encourage them to lay under a weighted blanket or use their hands by playing with a fidget toy.
I was diagnosed with autism, aspergers syndrome a few years ago. I started sucking my thumb again when I was 4, I wet myself, my mother smacked me, I have difficulty controlling bodily functions, speech, movement etc. I am now 64, 65 next year, but have held down jobs, had some academic success, and, at present, am looking after myself with the help of family and friends. It just shows there is light at the end of the tunnel, a pot of gold under the rainbow, but it’s hard, but never give up!
My daughters partner is 30 years old he has aspergers he is always sucking his thumb we go out shopping or anywhere he does it in public people always stare at him and us I’m embarrassed by this not so much as when we are at home but when out and about in public
Yea you’re a bad person and really need to grow up.
Well I still do it, particularly under stress, I enjoy it when no one is looking and sometimes I will do it in public, but, it is still a rare thing to see, allegedly not socially acceptable, but on the occasions I have explained it to a member of the public they were tolerant. I never met anyone who said, no please don’t, it is not so bad as smoking.
I have been reading a lot of comments on different platforms about ‘stimming’ and ASD children. My 4 year old son sucks 4 fingers every day and rubs his ear. What I’ve noticed is parents saying this form of behaviour isn’t “socially acceptable” and concentrating on whether or not a child will look aesthetically acceptable to society if they continue sucking their fingers/thumbs. ARE YOU LOT SERIOUS???!!!
Children with ASD were hidden away for years and people in society fought for this to be unacceptable. Now it seems that children with ASD have to be taught not to be the very thing people fought for? The tables have now turned to parents discriminating their own children? Really? Are you that embarrassed about having an ASD child that you have to change them? This is shocking.
Grow up and take a leaf out of your ASD child’s book. Let them be who they are!!
Thank you.
I am just learning about how controversial some autism therapies are, and how the autistic community has rallied against oppressive therapies. My little girl is in the process of being diagnosed, and it is SO important for me to hear the voice of reason (and empathy.)
It is a form of self regulatory stimming. However, other ways of self regulation can be taught that is not bad for their oral health. It is proven that thumb sucking is bad for one’s teeth. So as an educator, I teach children other ways to self regulate.
THANK YOU! I’m 38 and still suck my thumb. I know to do it at home only but the things adults did to get me to stop still hurt if I think about them. One adult In My life would even rip my thumb out and my teeth would cut my thumb. I’m literally not hurting anyone, I’m not soothing with drugs, alcohol, caffeine etc. and my mouth and teeth are perfectly fine. I think if people truly understood how hurtful it is they’d reconsider.
When I was 4 or 5, my family use to do horrible things trying to make me stop thumb sucking. Once, my aunt said she would call a doctor who would cut my thumb off, if I didn’t stop. She actually picked up the phone e pretended she was dialing and I was so horrified and scared at the idea of having my thumb cut that I screamed and beg her please, promising I would never suck my thumb again, crying desperately.
So, I started to do it hidden from everyone.
It was such an ilogical thing they did to me, because I never really stop, only for periods, and stop to avoid their company, so I could do it without been harm.
Today I am 39, have been diagnosed as autistic only a few months ago and it was a relief to understand myself, because I was so closed off to other people approaching, thinking I was doing something bad and they would not love me if I just were myself.
If I could make an advice, it is, please, always be loving and kind with your kids, especially over tings they cannot control.
For the records, sometimes I still suck my thumb, when I need to calm myself down, but is really rare nowadays.
Sorry if my English is not good enough, it is not my native language…
There is clearly a careful balance to be had here, between traumatising your child and preventing dental problems that may arise later (or earlier) in life. I agree wholeheartedly that we spend too much time trying to fit ASC children into the narrow boxes that society has agreed we can all exist in, and challenging all behaviour outside of “normal” expectations. I think that it is the responsibility of the neurotypical to gain a better understanding and appreciation of behaviours and mannerisms that do not fit into their “normal” box, rather than the responsibility of the neurodiverse to behave more like everyone else. There are a lot of stimming behaviours that appear odd when not fully understood, and thumb-sucking is no different. I sucked my thumb up until the age of 28, and I honestly haven’t really managed to fully give it up. I have spent my life hiding this source of comfort because it is not socially acceptable, along with a lot of the rest of my personality, and it is absolutely exhausting. How much easier would it have been throughout my entire childhood if it wasn’t something I was being constantly berated for? Called childish for. Smacked for. Mocked for. Had my fingers/thumbs dipped in foul-tasting salves for.
But. I have tried very hard to stop, because I am 31 years old and my teeth are, for want of a better word, buggered. I was told at 14 that I would need to have jaw re-alignment surgery to fix what was already an impressive overbite alongside the damage I had caused by thumb-sucking. It would be a package of operations that would take me through the rest of my school life, with my face in plaster and my jaw wired shut pretty much throughout my GCSEs. I was obviously horrified, and this kind of dental work seemed so insurmountable at that time in my life that I declined to have it. I became afraid of the dentist because they would judge me. So I stopped going. My teeth were already a source of embarrassment so I stopped caring about them at all. Then, at age 28, I woke up with a front tooth so wobbly that it scared the hell out of me, and finally I understood that I needed to stop sucking my thumb immediately. It has taken the threat of me actually pushing my teeth out of my own head for me to quit, and even then it wasn’t just a case of choosing to stop. I literally have to keep my hands trapped under a pillow to stop myself sucking my thumb at night. It’s not ideal.
So yes, allow your child to stim. Help them understand why they do it, to not be embarrassed by it, to find ways to stim without self-harming or creating damaging habits. But when it comes to thumb-sucking, work hard to nip it in the bud. As far as advice goes for how to do that, I have no idea. Nothing other than the threat of actually losing teeth worked for me, and all the adults around me tried everything they could when I was young. What I do remember, though, is never ever feeling supported to manage it, so maybe just being there, being understanding and working on it as a team with your kid, rather than against them, is a good place to start.
I’m 46 and I still can’t stop. Fortunately I never got an over bite, just an odd cross bite that I have to make sure I where my retainer to keep in line. I still have nightmares from the yelling and abuse to get me to stop. The unending bullying and the complete rejection of always having to pretend to be someone else in public.
Thank you! I’m glad I’m not alone. I therapist recently suggested I get tested for autism. I’m early 40s and I still suck my fingers. That and many other autistic traits were slapped, beaten, and in other abusive ways punished. Hot sauce on my hands. Covering it with mittens. Getting the most hostile member of the family to intimidate me. Constant bullying from my own damn family. I learned to mask and mask HARD at a very, very young age. Itś not healthy, causes much distress. I was suicidal at least three times in my life. It would of been REALLY NICE to know I was autistic or had neurodivergent tendancies rather than be shamed and punshished for them! All I can say is that it brings the most soothing feeling. I’m able to regulate through it. After this evaluation I hope I can learn some more effective ways of self-soothing that work for me. I have no plans on stopping any time soon. It is something I do at home, and having an ND husband really helped shed shame.
Thank you for sharing your experience. I hope your experience is a powerful reminder for neurotypicals to listen to Autistics and not to try to stop stimming behaviors that are not harmful. NTs can learn from Autistics about the negative impact of stopping stimming and how it can have life long impacts that are invisible.
Hi Lily, thank you for sharing your experience. My daughter has sucked her fingers all her life. She stopped once for about 6 months then started again because ‘it felt nice’. We have tried everything, it seems the more we try the more anxious she gets and the more she sucks. She is now 14 and bring assessed for possible autism / ADHD. We just want her to be happy with herself , but today the dentist told her she would need surgery to fix her overbite. No chance of her agreeing to that! I suspect one of the reasons she has not tried to stop sucking is because she was told she would need to stop to get braces – which she does NOT want, cannot contemplate having something in her mouth. I worry about her dental health as she has stopped brushing her teeth regularly because of the taste of the toothpaste (and yes I’ve tried strawberry flavour). I could share your story, but suspect she would block it from her mind as another attack. It’s so hard.
My son sucked his thumb frequently and held a small piece of his baby blanket he called a “ligon”. He would brush hit on his nose and mouth with and appeared to be smelling it with his while sucking the thumb of the same hand. He eventually stopped doing this when he was 3 or 4 years old. Does this seem like “high-functioning” autistic behavior?
My son sucked his thumb frequently and held a small piece of his baby blanket he called a “ligon”. He would brush it on his nose and mouth and appeared to be smelling it while while sucking the thumb of the same hand. He eventually stopped doing this when he was 3 or 4 years old. Does this seem like “high-functioning” autistic behavior?
I don’t think I’m autistic… but as a child I sucked my finger and rubbed a satin fringed blanket on my lips. As I did this, I smelled the blanket as well – loved it! So soothing…. I highly recommend it! Even the memory of doing it is so soothing. I eventually only did it at night – at bedtime and my parents still wanted me to stop. One day, when I was 8 years old, we were on a camping trip and I was putting up the tent. I sledgehammered my sucking finger! It was a total accident. We wrapped it up in so many bandages. I couldn’t suck that. I’ve had a scar there ever since and that’s the story of how I stopped sucking my finger.
Thumb sucking is regulating for Autistic people. If an Autistic child naturally stops thumb sucking on his/her/their own that is fine, however, if they are trained to stop due to dentition the overall impact on their sensory regulation needs to be considered. What other way will that child regulate? Sucking can be deeply regulating for Autistics and taking that away can be harmful to their regulation whether it is visible or not. Consider replacing sucking on a finger in public to just at home or sucking on a lollipop.
My 19-year-old smart, confident, capable daughter still sucks her thumb. We thought it was cute when the ultrasound photo had her thumb in her mouth, but we’ve tried everything. She does have ADHD and anxiety. She’d kicked the habit for months, but reverted when she had a concussion playing ice hockey when she was 16. She hasn’t been able to stop since. I just wish it didn’t affect her teeth. She needs braces but won’t be able to get them unless she stops.
Yesterday I was told to help my 10yo boy to stop sucking his thumbs. On one hand he had a very visible chapping (dry rough skin that was cracking and almost bleeding) and his thumb is flat. He has a very bad overtime and his teeth are crossing. To help with the chapping we put Vaseline and gauze and coban over it to help it heal. Well the dentist told us to do that nightly either way to try and stop him.. we tried last night and ended up having a very anxious and upset child. He had tears in his eyes, would not go to sleep, and clearly was having a rough time with it. All I asked of him was to try. He did. It looked like it was physically and mentally hurting him. I removed the one that was not hurt and he physically calmed down. We have tried other remedies and had the same effect. I refuse to put my child through something that will damage him more emotionally. He has gone from sucking all day everyday to just at night.
Just let people be. It’s no one else’s concern whether someone sucks their thumb, or not. It’ doesn’t necessarily affect your teeth, and so what if it does? The benefit received outweighs this. It is a natural thing to do, some never do it, others stop themselves, some hide it. It’s only an issue if others make it one, Let the person doing it decide for themselves. They will figure out if they can handle public scrutiny or not. Or if their teeth matter that much to them. Other people can’t help themselves but comment and this is human nature with many issues. It doesn’t hurt anyway else, so just let people be, is all I say.
My almost five year old daughter sucks her thumb while simultaneously rubbing her eyelid with a finger on the same hand. She rubs to the point of sores on her eyelid. It makes her upset and she wants to stop. She says she can’t get comfortable or sleep without doing it. I’m at a loss and want desperately to help her. If anyone here has any advice, it would be much appreciated.
Just a little comment for the mothers on the thread, I had always sucked my thumb. I had a dentist tell me I would look like bugs bunny when I was about 5, if I didn’t stop. I am now 30 I still suck my thumb and my teeth are perfectly fine, didn’t budge. Please, if you suspect your child has autism or a version of it, leave them be. It is a self soothing method and let’s all be honest, if that’s what’s going to help them through this world is it really that bad ?!
I just recently received an autism Dx and I’ve been going down a rabbit hole to deconstruct my behabior and past. Please don’t bully your kid into stopping sucking their fingers/thumbs. It is such a relief to me reading that I’m not alone in the behavior. I’m still trying to stop at 24, but painting my nails, having doctors terrorize me, encouraging my peers to mock me, getting my relitives in on it never helped. (my teeth aren’t messed up by the way) Other self regulating behaviors have helped, but it hasn’t gone away I just got better at hiding it. I also realize now how messed up my mom was at mocking an older woman in public for sucking her thumb. Please for the love of everything holy learn to love your kid as they are not as you want them to be.
I am 31 and still suck my thumb. I have four kids and I cannot stop. I haven’t been diagnosed clinically with autism but my husband has it and he swears I have it. My teeth are perfectly fine, all my friends know and don’t even care and I don’t really do it around my kids but they have seen it and never really seem bothered either. If it’s not hurting anyone why must the child stop something that regulates their emotions. To me it beats therapy and anything you could think of. Much healthier than cigarettes too. Just teach them good hygiene and to always wash their hands and be prudent on that!