by Bethany Gayman, RBT
Self-injurious behaviors are explained as maladaptive behaviors to which the individuals physically harm themselves. Self-injurious behaviors (SIB) are a more common in individuals with Autism Spectrum Disorder (ASD) than those with a different neurodevelopmental disorder. At least 50% of individuals with ASD will develop SIB at some stage in their life. SIB’s look like biting, scratching, pinching, skin picking, punching, or head banging. There are also less common behaviors like eye gouging, pica, hair or teeth pulling, and even dislocating their own joints.
Researchers have found a few possible explanations as to why SIB are occurring. Self-injurious behaviors are highly-correlated with individuals with low expressive communication skills. This is also displayed in research that have a high prevalence of challenging behavior in individuals with ASD who have limited spoken language. Some research has shown a correlation between self-injurious behaviors and severity of ASD deficits. Some behaviors are displayed to gain attention or escape a demand. In some situations, SIB will occur as an automatic reinforcement. This means the individual is being reinforced by the act of the SIB as a sensory stimulation.
There are a few effective ways to reduce self-injurious behaviors. A way to reduce sensory stimulation created by the SIB can be to find a similar stimulation to replace the behavior with. For example, if the individual is biting themselves, a vibrating toy may be able to give the same sensation. Or using “chewlery” which is a hard silicone piece that individuals can chew on.
There are reinforcement-based strategies like differential reinforcement. This can be done by reinforcing any other behavior beside the SIB. There is differential reinforcement of incompatible behaviors which can be done by putting something in the individual’s hands to prevent them from hitting themselves or giving them something to chew on to prevent them from biting themselves. Differential reinforcement of an alternative behavior can be done by reinforcing a specific, more appropriate behavior. There is also functional communication which is done by teaching the individual a more effective way of communicating. This can be teaching an individual to use pictures of what it is they want, to verbally say what they want, or to use sign language. This is different for each individual and their skill set.
Extinction based strategies may also be used when an individual is trying to avoid or escape a demand. This can be done by breaking down the task into smaller steps and by keeping the demand on before getting reinforcement. Sensory extinction can be difficult to put on extinction as the individual is getting reinforced by engaging in the self-injurious behaviors. Like previously stated, it can be beneficial to find an object that gives the same sensation as the SIB. If the individual bites themselves, they can be given something to chew on. If the individual scratches themselves, they can be given a piece of sandpaper or Velcro to scratch in place of themselves. Antecedent based strategies that are used by the environment can be altered in a way to decrease the SIB and increase appropriate behaviors. The individual’s schedule can be rearranged to avoid what is causing the individual to engage in SIB. This can be accomplished by making a visual schedule or how the demand is being delivered.
Reducing self-injurious behavior is not a quick fix and takes time to find a solution that works for each individual. The reduction of SIB can take weeks or months depending on the severity of the behavior and the strategy being used. Using a variety of strategies or just one may work for one person but not the other.
References
Alakhzami, M., & Chitiyo, M. (2021). Using Functional Communication Training to Reduce Self-Injurious Behavior for Individuals with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 52(8). https://doi.org/10.1007/s10803-021-05246-8
Maass, A. (2017). Autism and Self Injurious Behavior | Autistic Aggression | Fathering Autism Vlog #19. Www.youtube.com. https://www.youtube.com/watch?v=L-HpjHzq-KM
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, 7, 125. https://doi.org/10.2147/prbm.s44635
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