A local TVI posed this question... any assistance on her behalf would be appreciated. Many thanks, Sheila I have a three year old preschool student who stims by moving his head side to side when he is not fully engaged or reminded to work, look, play, etc. The student has been diagnosed with bilateral congenital retinal detachments and hydrocephalus for which he has a shunt. He is blind in his left eye and has some functional vision in his right. (i.e. shapes, colors, etc.) He is a non-verbal student who recently began to walk on his own. He receives OT, PT, and Speech. I see him approx. 2.5 hours a week. We are currently working on simple tasks and concepts like: in/out, up/down, push/ pull, light/heavy, cause and effect toys, textures, shapes, identifying common objects, etc. He does not initiate much and often presents with limp wrists and arms requiring me to use HOH assistance, wrist and/or elbow prompts to encourage him to complete a task. He will place his hands on a ball, but when asked to roll it to me, he will just keep his hands on the ball. He must constantly be reminded to put his hands up on the table during lessons. He stims during my lessons but will focus at times. Here's my question... His preschool teacher is concerned that he will choke during lunch time when he is stimming. The OT has ordered a weighted vest for the student. Based on suggestions from a colleague, I suggested we find a replacement behavior (i.e. tap his leg to possibly replace the head movement) for the side to side head movements. Has anyone experienced something similar? If so, what did you do to replace/lessen, and/or stop the stimming? Any other suggestions?