Self Injurious Behaviour (SIB) in ASD

Self-Injurious Behaviour in ASD

Rose Akinsehinwa                               November 2016

Self-Injurious Behavior (SIB) is one of the behavioral issues associated with Autism Spectrum Disorder and some of the most common forms are head-banging, hand biting, self-hitting with fists, excessive skin picking or scratching done in a rhythmic and repetitive way. It could be subtle in some individuals but severe in some. No matter how subtle it might be, if not handled properly will increase in degree. SIB can be very devastating for the individual and for parents and care givers. Some reasons why individuals with ASD engage in SIB could include:

  • Seeking Attention: A child may choose to engage in out self-injury when they desire attention from their caregiver. For example, self-injury will typically occur after he or she requests something and does not get it, or the child occasionally gets what he or she wants during or soon after engaging in self-injury. Giving attention in this case will encourage the practice. The solution is for the parent/caregiver to ignore the behavior with very little or no contact and with neither approving nor disapproving looks. Caution must be taken that the child is not putting themselves or others in danger, in which case, they must be restrained appropriately.
  • Communication: Limited or no language at all could be a source of frustration and anxiety for a child especially when they are unable to understand what they are told or to express how they feel. Frustration and anxiety associated with ineffective communication can lead to self-injurious behavior. In this case, the child must be taught appropriate communication either through verbal or sign language, pictures or technology. All instructions to this child must be very clear and precise to avoid misunderstanding.
  • Biochemical imbalances: Some children have some imbalances in their body system which result in too high or too low sensitivity to external stimuli. Those individuals with very low sensitivity might use self-injury like scratching to self-stimulate. Sensory brushes can be used to brush the skin intermittently to give tactile feedback. Sometimes, self-stimulation can occur in individuals who don’t have sensitivity issues but still have biochemical imbalances. Nutritional supplements can aid with these imbalances in the body. See a pediatrician to determine and give the right supplement to help with this.
  • Pain: Like gastrointestinal discomfort, headaches or pain from ear infections have been identified as causes for self-injury like head banging. The child, in a bid to reduce or dampen the pain located in another area of the body will engage in self-injury. With proper observation and appropriate medication, the source of primary pain should be relieved or totally eliminated to restore normalcy.
  • Escape: Either from work, a place or a situation can be another factor. Like with attention seeking, ignore behavior and be consistent. Insist that work must go on. In cases of social discomfort, prepare the child properly with a social story before visiting a place.

General Anxiety, which can be triggered by any of the above underlying issues is the immediate cause of Self-Injury and must be avoided as much as possible.  Parents/caregiver must take time to keenly observe and know what triggers self-injurious behavior in their child and deal with it appropriately.

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