In many cases, self-injury begins as a means of communication. Often a child is trying to convey a feeling or idea they may not be able to express in words. Biting, headbanging or other self-injury behaviors may be attempts to express pain, fear, displeasure, or anxiety. Self-injury can also be a form of sensory stimulation. An individual with autism may self-injure as a way to increase or decrease their level of arousal. An increased understanding of the incidence and risk factors associated with SIB in autism is needed to develop treatment options.
Self-injurious behavior is an important public health problem in individuals with autism spectrum disorder (ASD). SIB is a debilitating behavior that occurs in a significant proportion of children, teens, and adults with ASD. Atypical sensory processing and the need for sameness were contributors to SIB in this study. Research has also found significant associations between SIB and behavioral (aggression, hyperactivity, anxiety) developmental (adaptive behaviors, nonverbal IQ), and somatic (sleep and GI problems ) factors. Current and previous research findings support the need for a comprehensive and multidisciplinary approach for assessing and managing SIB in ASD. It is critical that interventions that target the risk factors associated SIB be identified and implemented in clinical practice. Providing empirically supported behavioral interventions to autistic individuals with self-aggressive behavior will not only impact directly on the problem behavior, but will their enhance social, educational, and adaptive functioning as well. Further research is clearly needed to better understand additional contributing factors that may influence these complex behaviors in children with ASD. For example, temperament, ability to self-regulate emotions, and medication usage might contribute to increased self injury.
Wilkinson, L. A. (2017). Best practice in special education. In L. A. Wilkinson, A best practice guide to assessment and intervention for autism spectrum disorder in schools (pp. 157-200). London and Philadelphia: Jessica Kingsley Publishers.
Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist, chartered psychologist, and certified cognitive-behavioral therapist. He is author of the award-winning books, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools and Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT. He is also editor of a best-selling text in the APA School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools. His latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition).