Children with Autism spectrum disorder(ASD) demonstrate Self-Injurious Behavior (SIB) at high rates. Nothing is more difficult for the parents of autistic children to tolerate than SIB. SIB behaviors are unpleasant to observe, to think about, or to discuss, but they do exist, and must be dealt with.
Some autistic children hit their heads against walls or floors so hard that they have fractured their skulls, detached their retinas, or caused deafness. Others hit themselves with their fists or their knees so hard that they have broken noses, deformed ears, and even blinded themselves.
Some children bite themselves and others, and hit other children and their parents with such violence they have broken bones.
These behaviours can be physically dangerous for the individual who is head-banging, self-hitting, biting themselves, or pressing on their eyes; and SIB is very concerning for their caregivers who want to keep these children safe. In order to implement a behavioral treatment for SIB.
A Functional behavior Assessments (FBA) should be performed to help determine the environmental and/or internal factors that are maintaining the behaviors. This information is then used to inform behavioral interventions in order to preempt the causes or replace the unwanted behaviors with ones that are more acceptable.
Examples of commonly used behavioral interventions include removing the antecedent that had been prompting the behavior, reinforcing a more appropriate behavior via positive attention, or extinguishing the SIB by deliberately ignoring it.
SIB that is maintained by automatic reinforcement (internally reinforced because it feels good to the person with ASD) is the most difficult type of SIB to change but even this can be often be helped by using differential reinforcement and replacing the inappropriate behavior with a behavior that may provide a similar sensory experience, amongst other interventions.
The problem of SIB in ASD is common and can require immediate intervention in order to avoid injury. Fortunately there are several intervention methods that can reduce or eliminate the SIB and refocus the child’s behaviour in a more positive manner.