my husband and i adopted my bio nephew when he was 2 years old. he was born addicted to meth and is adhd and bi polar. unmedicated. he is now 13. i have noticed he likes to choke himself, even in public places, it seems that when he is excited or nervous his hands go right to his neck. he does it subconsiously... not intentional. he and i have made up a code word that i say when he is doing it in public so that he knows he needs to stop what he is doing... we did this so not to embarrase him in front of people.
i have noticed a few other things... there have been times when he is in his bedroom and i open the door and he is masterbating. so, the code with that is, if the door is closed i knock before entering as to not cause embarrasement for him or myself. i understand at this age he is going to masterbate... he knows that this is to be done behind a closed door.