Self Injury and Autism
From LoveToKnow Autism
In some people, self injury and autism go hand in hand. Families with children who are severely autistic are more likely to experience self injurious behavior, commonly called SIB for short. Knowing the signs of this behavior is important for any family. It is estimated that between 10 to 15 percent of individuals with autism will display some form of self injury.
Defining Self Injury and Autism
Self injurious behavior is the process of injuring one's self. It is not a fall or a scraped knee from an accident, but rather behaviors that the individual causes. The most common types of self injury in autistic children include hand biting, hitting their head and banging their head against tables, walls or something else.
In some children, self injury can escalate. It can be severe. Some individuals may injury themselves through means that lead to retinal detachment, broken bones, bleeding, blindness or sometimes death. Doctors believe that those with more severe cognitive impairments are most likely to engage in more serious forms of self injury. Those who have mental retardation are more likely to have self injurious behavior.
Types of Injurious Behavior
There are many forms of self injury. They range from sever and life threatening injuries to lesser injuries. They may be considered self mutilation, masochistic behavior or self destructive behavior. The following are some of the most common self injuries performed by autistic children and adults.
- Head rubbing, repeatedly and intensely
- Nail picking
- Head banging, sometimes coming into contact with a hard surface
- Arm sucking, finger sucking
- Ingesting air
- Pinching
- Scratching
- Poking openings in the body, especially the eyes, nostrils and ears
- Sucking on things, putting things into the mouth
- Ingestion of feces or touching feces
- Pulling hair
- Slapping of the thigh or other area of the body
- Taking in too much fluid
There may be other ways that those with autism injury themselves. Virtually any behavior that is repeated often or intermittently could be considered self injury.
Why Self Injury Occurs
Doctors are not fully able to understand why some people with autism self injure and others do not. They do believe that some aspects can lead to it.
- Attention: For some children, hitting themselves gets the attention of caregivers. This may warrant more attention from the caregiver than is normally received so the child continues to self injure.
- Stops Demands: If a child is being taught, either in instructional or in academic activities, and he or she does not want to continue, self injury may be a way of stopping the education. It stops the demands placed on the child by the caregiver.
- Biological: Recent studies have lead doctors to believe that in some cases, biological conditions may cause people to injury themselves. The release of chemicals into the brain that are pleasurable may occur when an individual self injures themselves. Some research suggests that children may continue to self injury because it makes them feel good.
Unfortunately, there is no clear answer. Most children and adults with autism are thought to have a highly complex reason for self injury that is not fully understood. Most often, doctors believe it is a combination of these and other things that lead to self injury.
It is important to note that most people with autism do not want to hurt themselves. For example, there is a complete difference from self injury with autistic people and suicidal thoughts. Many times, there is no obvious reason for the self injury.
Finding Treatment for Self Injury in Autistic Individuals
Natural autism therapies are available for those who self injure. The most common treatment option is applied behavior analysis or ABA. It aids in reducing the injurious behavior and in helping to increase communication and appropriate behaviors. This is accomplished through one on one interaction and instruction with the child and teacher. It is done for up to 40 hours per week. The goal is to reduce any activities or behaviors considered undesirable while reinforcing the positive behaviors.
In addition, there are some medications including risperidone that has been able to help reduce aggressive and self injury in those with autism. In many situations of self injury and autism, a combination of ABA and medication is the best route for the individual..
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Comments
Hi Kim,
Yes, definitely. Painful underlying medical problems--falling under the biological component--can lead to self-injury. I worked with a little girl who pulled clumps of hair out of her head because she was in so much pain from a urinary tract infection.
It is extremely important to look at possible medical conditions. Thanks for adding this information and your story. It is one of the most difficult things to deal with when you love a child so much.
You forgot one of the MOST important reasons an autistic child may self abuse: underlying, undetected medical problems causing pervasive pain and frustration. This pain lowers the self injurious threshold. Many times, if you treat the medical issue, the SIB is radically reduced. I know, I have a child with severe autism who has been beating himself for over a decade. This is a very complex case. For example, he will smash his fists into his head if he has a cold. Likewise, if he hears a loud noise. Has a headache (which he can't tell us since he can't communicate....) Moreover, it could be as simple as you don't make his food quick enough or he's hot, cold, tired or has a wet diaper. Sometimes,there is no rhyme or reason to any of it and you just try to protect him and make him feel comfortable. It's the most undiscussed topic in autism. You rarely hear anyone show this side of autism. If people came into our home with a camera and spent a week, they'd be changed forever. Imagine someone beating your child. Just the thought triggers intense emotions. Anger. Rage. Fear. Confusion. Now imagine the perpetrator is your child’s hands. And he can’t help it. To live this is crazy. Complex. To witness this, shapes the mind, alters attitudes and colors the world around you.1991-2009, I am lying in bed, the chaos of years thundering like a drum in my head and as dawn breaks and my face feels frozen and something like lighting stirs and settles in my skin, thuds echo through the house like bakers pounding dough. No matter how many times I hear it, I jump up, crash down the hallway, run downstairs, stumble into the bedroom and flick on the light. Doctors say they don’t know what happened. All I know is I had a normal pregnancy and delivery, and then, on March 17th, 1989, gave birth to a healthy baby boy. I named him James. Called him Jamey. Five months later, after his second immunizations, he was wailing, arching his back and didn’t want to be touched. From there, he lay supine in his crib, staring at his Butterfly Mobile. Analyzing why an autistic, self-injurious child hits himself is key to treatment and recovery, say experts. But my son belts himself for a dizzying amount of reasons. when he hits himself things move so fast and everything goes so wrong, there is nothing to do but grab fists and survive the moment. It is a constant, unexpected rush to beat him to the punch. The strange thing is; however, I wouldn't trade him for another child. He is who he is for reasons only GOD alone knows. Is it hard? Yes! It's crazy hard. But it has made me stronger than anything could ever make me. If you survive living with a child with this kind of crazy behavior, you will survive anything. You can handle just about anything. Nothing really matters after you've repeatedly witnessed this madness and can say, okay, it is what it is, let's keep going. Let's find a better way. Tomorrow is a new day. Never give up.
-- Contributed by: kim oakley
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