Self-injury sometimes goes hand in hand with autism. Up to 50 percent of adults and children diagnosed with autism spectrum disorder will display self-injuring behaviors. Knowing the signs of this behavior is important for any family so appropriate treatment can be sought out.
Defining Self-Injury and Autism
Self-injurious behavior (SIB) is the process of purposefully inflicting harm to oneself. These behaviors are not things like a fall or a scraped knee from an accident, but rather self-harming behaviors that the individual engages in. They may be considered self-mutilation and self-destructive behaviors.
Some individuals may injury themselves through means that lead to retinal detachment, broken bones, bleeding, blindness or sometimes death. Medical professionals believe that those with more severe cognitive impairments are more likely to engage in more serious forms of self-injury.
Types of Injurious Behavior
The most common types of SIB in children and adults with autism spectrum disorder include hand biting, head banging and scratching. There are many other forms of self-injury, ranging from severe and life-threatening injuries to lesser injuries. Some of the most common self-injuries engaged in by children and adults with autism include:
- Head rubbing, repeatedly and intensely
- Nail picking
- Head banging, which is the most common amongst those with autism spectrum disorder
- Arm sucking
- Finger sucking
- Ingesting air
- 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
- Pica (eating non-edible substances)
Why Self-Injury Occurs
There are various theories about SIB and why it occurs. Researchers suggest that multiple factors impact the self-injuring behavior that those with autism spectrum disorder engage in.
- Serotonin levels: Research suggests that a serotonin specific transporter gene and overall serotonin levels may impact the incidence of SIB.
- Stop 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 putting a stop to the education. In essence, the SIB stops the demands placed on the child by the caregiver.
- Pain expression: In a study of children with autism spectrum disorder, researchers found that those who self-injured and those who did not do so had significant differences in terms of how they expressed pain. Those who self-injured consistently showed enhanced expressions of pain.
- Biological: Recent studies have lead doctors to believe that in some cases, biological conditions may cause people to injure themselves. For example, the release of endorphins may lead to feelings of pleasure during the self-harming episodes. Opiate blockers have been used to successfully treat those who self-injure and reduce or completely eliminate their self-injuring behaviors.
Unfortunately, there is no clear answer. Other findings suggest that sensory overload, hyperactivity, sleep issues and mood issues tend to correlate with self-injuring behaviors. Children and adults with autism who self-harm are thought to have highly complex reasons that are not fully understood.
Finding Treatment for SIB in Autistic Individuals
In many situations, a combination of various treatment methods has proven to be very helpful. Natural therapies are available for those who self-injure. In some cases, medications can help reduce aggressive self-injury in those with autism.
Applied behavior analysis (ABA) is a common treatment option. It aids in reducing the injurious behavior while helping to increase communication. This is accomplished through one-on-one interaction and instruction with the child and counselor. It can be done for up to 40 hours per week. The goal is to reduce any activities or behaviors considered undesirable while reinforcing the positive behaviors.