What Does Self-Injurious Behaviour Look Like in Individuals with Autism Spectrum Disorder?
- HEALIS AUTISM CENTRE
- 57 minutes ago
- 4 min read
Minshawi et al. (2014) mentioned that clinically significant deficiencies in social-communication skills, such as poor eye contact, trouble holding conversations, a lack of peer relationships that are developmentally appropriate, along with restricted or repetitive behavioural patterns, are common characteristics of the autism spectrum disorder (ASD). In the search of discovering treatments plans and methods in managing the core symptoms, problem behaviours have surfaced as a point of interest for many. According to Minshawi et al. (2014), problem behaviours are defined as those that impede an individual's capacity to function and frequently carry the risk of harm or damage. Examples of these behaviors include tantrums, physical and verbal violence, property destruction, and self-injurious behaviors (SIBs).
Self-Injurious Behaviour
Self-injurious behavior (SIB) refers to self-directed behaviors that result in bodily harm to the individual without exhibiting obvious intent to harm. As suggested by Gulsrud et al. (2018), there is an emerging body of research addressing the risk markers related with the presence of SIB in people with ASD. Cognitive capacities, adaptive functioning deficiencies, and impairments in behaviour management have all been linked to SIB (for example, impulsivity and repetitive behaviours). These behaviours include but are not limited to biting, hair ripping, head-banging, and skin picking/scratching (Minshawi et a., 2014).
Why does my child have SIB?
Despite the facet of research done on SIB in ASD, there are no definitive answers on what causes SIB but the probable factors that increase the risk of displaying SIB. Soke et al. (2017), suggested that SIB may be due to an individual’s inhibitory mechanisms. For instance, ASD can be commonly characterised as having social deficits that lead to emotional dysregulation; engaging maladaptive behaviours in response to ‘protect’ them. Children who experience hyper-sensitivity or hypo-sensitivity to environmental stimuli can also engage in SIB to help manage those interactions (Soke et al., 2017).
What can i do to help my child?
Children with ASD can engage with multiple adaptive behaviours that do not pose a threat to themselves or others. It is imperative for them to learn good replacement behaviours in response to SIB as they help them regulate more effectively and build tolerance towards stimuli as they grow older.
It has been suggested that genetics, biochemistry, and environment may interact to cause SIB in certain circumstances. Hence, after assessing, the main stimulant for SIB unique to your child
can be either biological or behavioural (Mahatmya et al., 2008). Developing a treatment plan specific to those underlying functions are imperative.
Behavioural Treatment
Self-injurious behaviours that are driven by environmental factors such as demands or social interactions can be treated through an Functional Control Training (FCT). According to Mahatmya et al. (2008), offers a socially acceptable replacement for problematic behaviour in terms of communication. In FCT, problem behaviours are viewed as a communicative response. If they are reduced or eliminated without providing a replacement, the individual would be left without a way of communicating their wants and needs (Durand & Merges, 2001). An example of replacement behaviours could be substituting SIB with effective methods of communication like picture cards or simple signing (e.g. pointing/ tapping for attention) for non-verbal children. With decreased difficulty in communication, individuals can gradually adopt new methods that reduce engagement with SIB.
Biologically Mediated Treatment
For SIB maintained by automatic reinforcement, blocking or suppressing it drives treatment plans, hence pharmacological approaches are rendered. For individuals that experience hyperarousal, medication such as Clonidine are commonly used to suppress sympathetic flow to the prefrontal cortex; a part of the brain that is responsible for decision making (Sabus et al., 2019). This helps to reduce overstimulation and interactions with SIB. Another widely dispensed medication is Riluzole. According to Ghaleiha et al. (2013), Riluzole showed decreased irritability in children with ASD. Despite the significantly positive improvements with medication, it is important to take into account the side effects and the potential need to help your child navigate through the process.
Self-injurious behaviour is dangerous for both children with ASD and the people around them. Thus, finding ways to help reduce or replace SIB with healthier behaviours are crucial. As mentioned, behavioural therapies and medication are the main methods of suppressing tendencies or substituting SIB. However, further research and discussions with medical professionals are necessary steps before coming to a decision on what would be best for your child!
Written by: Tara
References
Ghaleiha, A., Mohammadi, E., Mohammadi, M.-R., Farokhnia, M., Modabbernia, A., Yekehtaz, H.,
Ashrafi, M., Hassanzadeh, E., & Akhondzadeh, S. (2013). Riluzole as an adjunctive therapy to risperidone for the treatment of irritability in children with autistic disorder: A double-blind, placebo-controlled, randomized trial. Pediatric Drugs, 15(6), 505–514. https://doi.org/10.1007/s40272-013-0036-2
Gulsrud, A., Lin, C. E., Park, M. N., Hellemann, G., & McCracken, J. (2018). Self‐injurious behaviours
in children and adults with autism spectrum disorder (ASD). Journal of Intellectual Disability Research, 62(12), 1030–1042. https://doi.org/10.1111/jir.12490
Mahatmya, D., Zobel, A., & Valdovinos, M. G. (2008). Treatment approaches for self-injurious behavior in individuals with autism: Behavioral and pharmacological methods. Journal of Early and Intensive Behavior Intervention, 5(1), 106–118. https://doi.org/10.1037/h0100413
Minshawi, N., Hurwitz, S., Fodstad, J., Biebl, S., Morris, D., & McDougle, C. (2014). The association
between self-injurious behaviors and autism spectrum disorders. Psychology Research and Behavior Management, 125. https://doi.org/10.2147/prbm.s44635
Sabus, A., Feinstein, J., Romani, P., Goldson, E., & Blackmer, A. (2019). Management of self‐injurious
behaviors in children with neurodevelopmental disorders: A pharmacotherapy overview.
Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 39(6), 645–664. https://doi.org/10.1002/phar.2238
Soke, G. N., Rosenberg, S. A., Hamman, R. F., Fingerlin, T., Rosenberg, C. R., Carpenter, L., Lee, L. C.,
Giarelli, E., Wiggins, L. D., Durkin, M. S., Reynolds, A., & DiGuiseppi, C. (2016). Factors associated with self-injurious behaviors in children with autism spectrum disorder: Findings from two large national samples. Journal of Autism and Developmental Disorders, 47(2), 285–296.
Picture Reference
Stocksnap from Mari Castro from Pixabay, [Sad Young Girl] [Photograph] Retrieved from: https://www.canva.com/