Self-Injury 2
The purpose of this research assignment was to examine self-injurious behavior in
children with autism. Previously it was thought that autism affected 1 in 100 children, then it was
1 in 68. But more recently the CDC has estimated that 1 in 36 children are diagnosed with
autism. For this research paper I have found two peer reviewed journal articles which examine
self-injuries in children with autism. I can speak from experience on this topic. My son used to
hit his head off our floor and then laugh. Thankfully it did not last that long, and he stopped
doing it.
The first article I chose focused on how prevalent self-injury is in children with autism.
According to this study, individuals with autism also exhibit behaviors that challenge the
following:
1.) Destruction
2.) Aggression
3.) Self-Injurious
As I mentioned above, self-injury is extremely common in individuals with autism. Steenfeldt-
Kristensen et al. (2020) examined data from 14,379 participants in thirty-seven different research
papers and after pooling a prevalence estimate they came up with an estimate of self-injury in
roughly 42% of individuals with autism.
The following are some of the more familiar self-injurious behaviors of an individual with
autism:
1.) Hand-hitting
2.) Self-cutting
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3.) Hair pulling
4.) Self-scratching
Comorbidities of autism can be extremely challenging for the individual with autism as well
as the family and caregivers of the child or adult who has been diagnosed on the spectrum. It is a
known fact that those with autism are at a greater risk of certain types of comorbidities.
Steenfeldt-Kristensen et al. (2020) composed the following list of medical and psychiatric
conditions that individuals with autism are at greater risk of having to deal with:
1.) Sleep disorders
2.) Mental health problems
3.) Intellectual disabilities
All the above have a significant impact on the quality of life for an individual with autism.
Overall, the study by Steenfeldt-Kristensen et al. (2020) found in 14 different studies the
following twenty-one topographies of self-injurious behavior:
1.) Hand hitting
2.) Object hitting
3.) Skin picking
4.) Self-scratching
5.) Self-pinching
6.) Object/finger in cavities
7.) Self-biting
8.) Hair pulling
9.) Nail pulling/eating
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10.) Teeth grinding
11.) Head banging
12.) Hitting self against objects
13.) Self-cutting
14.) Keeping sores open
15.) Throwing self to floor
16.) Induced Vomiting
17.) Burning
18.) Ingesting dangerous substances
19.) Rubbing skin against surfaces
20.) Carving
21.) Unspecified
This study by Steenfeldt-Kristensen et al. (2020) was the first meta-analysis to synthesize
prevalence rates of self-injurious behavior in autism. Their study did also find that there was:
1.) No significant association between the mean age and proportion of those with an
intellectual disability and prevalence of a self-injury.
2.) Gender had an effect on prevalence rates with male participants exhibiting a decrease in
prevalence of self-injurious behavior.
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The second article I examined focused on functional communication training as a means of
reducing self-injury behavior for individuals with autism. Alakhzami & Chitiyo (2021) believes
that self-injurious behavior or SIB is often a result of deficits in communication skills.
Functional communication training or FCT is an evidence-based practice intervention for
problem behaviors. Alakhzami & Chitiyo (2021) define functional communication training as:
1.) A communication strategy that decreases different types of problem behaviors.
2.) Based on theory that problem behavior may be a representation of a person’s inability to
communicate needs and wants in more socially acceptable ways.
This study consisted of three children which were based on four criteria.
1.) Autism diagnosis based on Childhood Autism Rating Scale
2.) Limited functional communication skills
3.) Between 4 to 14 years old
4.) Self-injurious behavior which is used as a means of an escape. Must be determined by a
functional behavior assessment and functional analysis.
The topographies of self-injurious behavior that was examined for this study included head
banging and head hitting. Alakhzami & Chitiyo (2021) specifically examined three specific
questions to answer:
1.) To what extent does functional communication training and most to least prompting
reduce self-injury behavior for children with autism spectrum disorder?
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2.) To what extent do children with autism spectrum disorder maintain their use of socially
appropriate requests to communicate needs or request desired items over time after the
intervention has ceased?
3.) To what extent is resurgence of self-injurious behavior observed during maintenance?
The study found that for question one, all three participants exhibited a decreasing trend in
self-injurious behavior by implementing functional communication training. Maintenance was
active for 7, 10, and 14 days for all three of the participants. Question two found that 2 out of the
3 participants exhibited a maintained near zero level of self-injurious behavior. To examine
question three, the participants had to wait until one week after the maintenance phase had ended
and there were no active intervention procedures occurring. Of the three participants, all three of
them exhibited an overall trend of an increase in self-injurious behavior.
Alakhzami & Chitiyo (2021) found four specific results:
1.) Functional communication training when combined with most to least prompting
procedures had decreased self-injurious behavior for all three of the participants.
2.) Functional communication responses replaced self-injurious behavior.
As I had initially mentioned, the CDC now estimates that 1 in 36 children are diagnosed as
having autism spectrum disorder. Steenfeldt-Kristensen et al. (2020) also stated that an estimated
42% of individuals with ASD suffer with self-injurious behavior with the most common self-
injurious behavior being hand-hitting. Alakhzami & Chitiyo (2021) found that there was a
significant reduction in self-injurious behavior which was maintained for up to two weeks after
an intervention had been removed. Unfortunately, self-injurious behavior returned upon the
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implementation of extension. Self-injurious behavior continues at a high rate among individuals
with autism.
“Or do you not know that your body is a temple of the Holy Spirit within you, whom you have
from God? You are not your own, for you were bought with a price. So glorify God in your
body.” (ESV Study Bible, 2008, 1 Corinthians 6:19-20 ).
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References
Alakhzami,JM., & Chitiyo,JM. (2021). Using functional communication training to reduce self-
injurious behavior for individuals with autism spectrum disorder.JJournal of Autism and
Developmental Disorders,J52(8), 3586-3597.Jhttps://doi.org/10.1007/s10803-021-05246-
8
ESV Study Bible. (2008). Crossway Books.
Steenfeldt-Kristensen,JC., Jones,JC.JA., & Richards,JC. (2020). The prevalence of self-injurious
behaviour in autism: A meta-analytic study.JJournal of Autism and Developmental
Disorders,J50(11), 3857-3873.Jhttps://doi.org/10.1007/s10803-020-04443-1
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