Risk Factors Associated with Self-Injurious Behaviors in Children and Adolescents with Autism Spectrum Disorders.
While self-injurious behaviors (SIB) can cause significant morbidity for children with autism spectrum disorders (ASD), little is known about its associated risk factors. We assessed 7 factors that may influence self-injury in a large cohort of children with ASD: (a) atypical sensory processing; (b) impaired cognitive ability; (c) abnormal functional communication; (d) abnormal social functioning; (e) age; (f) the need for sameness; (g) rituals and compulsions. Half (52.3%, n = 126) of the children (n = 241, aged 2-19 years) demonstrated SIB. Abnormal sensory processing was the strongest single predictor of self-injury followed by sameness, impaired cognitive ability and social functioning. Since atypical sensory processing and sameness have a greater relative impact on SIB, treatment approaches that focus on these factors may be beneficial in reducing self-harm in children with ASD.
The list of possible factors is helpful but, like everything in autism, the devil is in the details. It is one thing to say that "atypical sensory processing" is a major contributor to SIBs but it is quite another to find the specific sensory problem and to find a way to mitigate it.
We went through a rough couple of years where one of the twins would develop SIBs every fall that lasted until spring. There are few things more disheartening that having to physically restrain your child to prevent them from hurting themselves.
Fortunately, we managed to find a way to mitigate her SIBs after only three years of trying and she seems to be better able to regulate herself as she has gotten older. But those were very long years and my heart goes out to families that have to deal with SIBs on a daily basis.
Duerden EG, Oatley HK, Mak-Fan KM, McGrath PA, Taylor MJ, Szatmari P, Roberts SW. Risk Factors Associated with Self-Injurious Behaviors in Children and Adolescents with Autism Spectrum Disorders. J Autism Dev Disord. 2012 Mar 16. [Epub ahead of print] PubMed PMID: 22422338. DOI: 10.1007/s10803-012-1497-9