An unwelcome habit

Self-injurious behavior in autism

Self-injurious behaviors (SIB), such as skin picking, head banging, hair pulling, scratching, are frequently seen among individuals with autism. Up to half of autistic people harm themselves, and SIB can be persistent. In a research study, self-injurious behavior persisted in over 44% of such cases during a 10-year period.

The common predictors of SIB are impulsivity and over-activity. Other predictors are stereotyped behavior, problems in social communication and reduced self-control. SIBs may provide a physical outlet for emotional pain. They are observed more often in women with autism as in men with the condition.

Uncontrolled SIB can lead to adverse consequences on educational, work, health and social outcomes. Caregivers and clinicians should be sensitive and observant to their occurrence. SIBs call for help as early as possible, even during the childhood years once they are detected. Interestingly, SIB can be subject to self-restraint indicating that the underlying difficulty in impulse control can be addressed by behavioral modification approaches.

References:

Laverty C et al, Molecular Autism, 2020 Jan 20: 11:8. Persistence and predictors of self-injurious behavior in autism: a ten-year prospective cohort study.-

Maddox BB et al, Autism, May 21 (4) 412-422. 2017. Untended wounds: Non-suicidal self-injury in adults with autism spectrum disorder.