Brief Report: Further Examination of Self-Injurious Behaviors in Children and Adolescents with Autism Spectrum Disorders.

Dempsey et al. (2016) looked at how well common tests predict self-injury in kids and teens with autism.

They ran regular cognitive and behavior scores against how often the children hit or bit themselves.

Those usual scores explained only 13 % of the difference in self-injury rates.

In plain words, most of why a child hurts himself is still missing from our checklists.

Flowers et al. (2020) studied only teens and added irritability and daily-living skills. They found those two factors matter, but still left a lot unexplained.

Lance et al. (2014) checked if losing early skills (regression) raises self-injury and saw no link. Like Jack, they show single variables give weak answers.

Kaiser et al. (2022) warn that many autism tools were built for verbal youth with average IQ. Jack’s low 13 % may partly reflect using tools that do not fit all clients.

Stop relying on IQ, language, or age alone to judge self-injury risk. Add direct measures: sleep, pain, sensory triggers, and recent life changes. If scores look “mild,” still watch the child—most risk lies outside the numbers we usually collect.