Preventing Self-injury in Kids and Teens with Autism

2/18/2019 By Sydney LaFleur, BCBA

If your child or teen engages in self-injurious behavior (SIB), you know how upsetting it is for both you and your child. If SIB is something your child is struggling with, it’s important to understand why the behavior is happening, do what you can to prevent it in the moment, and work with a professional to create a plan to prevent future SIB.

SIB occurs when a person physically harms themselves. This harmful action may be head-banging (often on walls or floors), hand or arm biting, eye gouging, skin picking, thrashing, face or head slapping, hair pulling, or any other behavior that can cause harm either immediately or when repeated over time. If your child exhibits these behaviors, you’re not alone. Research shows that about 50% of individuals with Autism Spectrum Disorder engage in SIB at least once during their life.

SIB can occur for lots of different reasons. It may help your child satisfy a sensory need, cope with excitement or anxiety, or even communicate a need. A child might bite their arm to express that they want to be left alone. Eye gouging might be a way to say “Give me that toy back!” It’s also possible that SIB happens for more than one reason. Every person is unique, and so is their behavior.

SIB can be dangerous, and sometimes even life-threatening. It’s best to work with a Board Certified Behavior Analyst (BCBA) who has experience working with self-injury. They will find a safe way to identify why the SIB is occurring and can help you with a plan to prevent it from happening in the future. This can include teaching critical communication skills to give your child another way of expressing their feelings or needs. Using Applied Behavior Analysis, a BCBA may use antecedent strategies, extinction, and other consequence-based methods to treat SIB. If you’re interested in Applied Behavior Analysis for your child, fill out the form below and we will contact you for more information.

In the meantime, there are a few things that can be done at home to provide better support to a person who engages in SIB.

1. Try to appear calm when the behavior is happening.

Reacting negatively could upset your child more, which could make the behavior increase in intensity. Even if it seems to help immediately, scolding or trying to make them feel guilty will not decrease the behavior long-term.

2. Use redirection to try to stop the behavior

If there is a way to safely redirect your child to another task or activity, that can be a valuable distraction. However, it is important that you do not redirect them to their favorite fun activity. This could teach them that if they pull their hair, they get screen time or a snack.

3. Try to change the environment to prevent the SIB from happening.

If you have noticed that your child always engages in a SIB in a certain environment, work to avoid that environment or reduce what distresses them. For example, if thrash when exposed to loud music, you can try to avoid concerts and public music venues or use headphones to help reduce sensitivity to loud noises. Keep in mind, this approach is not always possible and you don’t want to limit your child from fun, meaningful experiences. If the environment can’t be changed to prevent a behavior, a BCBA may be able to work with your family to teach other ways of mitigating SIB that allow access to all environments!

4. Introduce protective equipment to prevent injury.

If you don’t currently have a way to prevent SIB, the most responsible option can be using protective equipment. Arm pads can be used to prevent arm biting, gloves can prevent hand biting and knee pads are great for protecting the knees if your child bites or drops to the floor. Protective equipment should be durable, easy to clean and should serve to injury without restraining your child. Protective equipment may not always be an appropriate long-term solution, but it can decrease the risk of harm until a safe treatment can be implemented.

Please note, using something like a mechanical restraint incorrectly can cause physical and emotional harm and should never be done without the supervision of a professional.

5. Seek functional communication training.

SIB is often used to communicate a want or a need because the person has no other way of communicating effectively. Learning to use sign language, a picture exchange system, or an augmented and alternative communication (AAC) device to communicate may help eliminate the need to use SIB.

6. Build a support network.

When you’re the only person you know that has a child who engages in self-injury, it is easy to feel alone. You may want to seek out community resources for families with children with autism or even a licensed professional counselor who may be able to provide support and coping mechanisms for you or your family. This is sadly a less talked about reality for individuals with ASD, but resources are out there that can be helpful.

Self-injury can be difficult and distressing, but these tips will help you keep your child safe until a treatment plan is in place.

Applied Behavior Analysis (ABA) therapy is proven to reduce self-injurious behavior in children and teens with autism.

References: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990505/

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