Understanding and Addressing Self-Injurious Behaviors in Autistic People

It’s estimated that about 42% of autistic folks interact in self-injurious behaviors. Self-injurious habits (SIB) is when an individual bodily harms themselves by head banging on flooring, partitions or different surfaces, hand or arm biting, hair pulling, eye gouging, face or head slapping, pores and skin choosing, scratching, rubbing or pinching, or forceful head shaking.

One other time period it’s possible you’ll hear is self-harm. The National Health Service within the UK describes self-harm as “when any person deliberately damages or injures their physique. Self-harm is most frequently described as a solution to categorical or deal with emotional misery.”

The distinction between self-harm and self-injurious habits is self-harm is deliberately inflicting bodily ache or hurt to oneself, usually as an try and handle tough feelings or misery. It doesn’t essentially imply that somebody desires to finish their life. It will also be known as non-suicidal self-harm (NSSI). Self-injurious habits is the results of an try to manage or categorical speedy bodily ache or discomfort, or talk a specific want.

Autistica UK lists the next causes for self-harm which differ from SIB:

to manage despair or numbness
to precise or deal with emotional misery
to really feel a way of management
to punish themselves
to alleviate insufferable pressure
to cry for assist (this isn’t the identical as consideration looking for)
to distract from intrusive ideas

What are a few of the causes of self-injurious behaviors (SIBs)?

Some causes of SIBs could also be:

Medical – For some autistic people, SIB could also be a solution to mediate ache. By creating ache in a managed approach by an SIB, an individual might masks one other supply of ache equivalent to an ear an infection, toothache, headache or constipation. When my daughter was 2 years previous, she pulled all of her hair out round her ear. I found later that she had an ear an infection. Engaged on interoceptive awareness might assist a person to grasp the place their ache is and be capable to level to the place their ache both on themselves or on a body check chart.
Sensory Variations– People might interact in SIB to extend their arousal level or to counteract sensory overwhelm/overload. Rest strategies, calming actions or train might assist regulate an individual.
Communication Difficulties – When below stress, it could be tough to speak desires and desires. If the person struggles with useful communication, frustration and a rise in nervousness can happen which can set off SIBs. SIB stands out as the approach an individual is making an attempt to speak. For instance, hand biting may assist deal with nervousness or pleasure. Pores and skin choosing might relieve boredom. Head banging on a tough floor could also be a approach of telling you they’re pissed off.
Repetitive Habits – Some types of self-injury could be a part of a repetitive habits, an obsession, or a routine.
Avoidance or Escape from Non-Most popular Actions or Undesirable Stimuli – Some people might be taught that they will keep away from or escape from undesired actions or stimuli in the event that they interact in SIB.
Needing Consideration – SIB could also be a solution to get assist or consideration from different folks; nevertheless, this doesn’t often clarify why SIBs happen within the first place. There’s often another excuse (equivalent to compensating for communication difficulties).
Developmental Levels – A person may nonetheless do some issues that most individuals cease doing as younger youngsters, equivalent to hand mouthing – placing their fingers or hand into their mouth – inflicting damage. My son used to do that when he was on the pc to the purpose of constructing himself vomit.

What can we do when self-injurious behaviors happen?

The National Autistic Society suggests the next issues you are able to do when SIBs occur:

Reply Rapidly– Reply shortly and constantly when an individual self-injures, it doesn’t matter what the reason being. It’s by no means acceptable to disregard extreme self-injurious habits.
Use Low Key Responses – Restrict verbal feedback, facial expressions and different shows of emotion. Attempt to communicate calmly and clearly, in a impartial and regular tone of voice. We speak about this in Low Arousal Method coaching. It’s a part of de-escalation.
Cut back Calls for – Cease speaking and cut back calls for on the person. You may come again to issues later when the particular person feels calm.
Take away Bodily and Sensory Discomforts – Work out what’s inflicting the person’s discomfort. It could be noise, smells, shiny lights, or different folks’s proximity.
Redirect – Attempt to redirect the particular person on what they should do relatively than partaking within the SIB. Strive one other exercise that may’t be carried out similtaneously the self-injurious habits. For my son, that could be coloring in a coloring ebook.

How can we stop self-injurious behaviors?

Seek the advice of a well being skilled for assist with any self-injurious habits which is tough to handle or locations the particular person liable to hurt.

Rule out medical or dental issues. Go to a GP or a dentist. Deliver your observational notes on when the SIB happens, when it began, how lengthy it lasts, and the state of affairs when it happens.
Determine our the operate of the SIB – There’s all the time a motive for an SIB. Preserve a journal and file what is going on earlier than, throughout and after the habits. Make notes in regards to the setting, together with who was there, any change within the setting and the way you assume the particular person was feeling.
Have a structured setting and routine. Structure and routine assist predictability which lessens nervousness. Creating predictability and decreasing nervousness can go a great distance in the direction of creating an setting that helps probably the most communication attainable.
Create a sensory weight loss program and use sensory instruments. A sensory diet is an individualized plan of bodily actions and lodging to assist an individual meet their sensory wants. This plan offers the sensory enter wanted to remain centered and arranged all through the day. It prevents sensory and emotional overload by assembly the nervous system’s sensory wants. Sensory instruments equivalent to noise cancelling headphones cut back auditory enter. For a kid who chews, a chewy pendant could also be simply the factor.
Use communication instruments. A physique verify chart, photos or symbols for signs might assist an individual talk their discomfort.

Addressing self-injurious behaviors in autistic people requires a multi-faceted method. After we perceive the basis causes of SIBs, assist communication, and foster wholesome methods of coping, we create an setting that helps well being and well-being, enhancing the quality of life autistic people.