Identification of early self-injurious behaviour in young children with intellectual disability.
Teacher concern, not test scores, forecasts which preschoolers with autism or ID will escalate self-injury.
01Research in Context
What this study did
Teachers picked preschoolers they worried might start self-injury.
Each child had autism or intellectual disability.
The team watched these kids and a control group for months.
They tracked which ones later showed real self-harm.
What they found
Teacher worry alone predicted who got worse.
IQ scores and autism severity did not.
Many at-risk kids never hurt themselves.
Still, teacher flags caught every future case.
How this fits with other research
Granieri et al. (2020) later showed kids with any delay hit themselves more often than typical peers.
Duerden et al. (2012) surveyed 241 children and found sensory issues topped the risk list.
Lemcke et al. (2013) seems to clash: parent reports at 6–18 months failed to predict autism.
The gap is the source: teachers see daily social pressure, parents see infancy milestones.
Why it matters
If a teacher says "I think this child will start hitting herself," act now.
Do not wait for test scores or an autism label.
Start safety planning, brief functional screening, and caregiver coaching the same week.
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Ask each classroom teacher to list any child they worry may begin self-harm and schedule a brief observation within five days.
02At a glance
03Original abstract
Very little is known about the early stages of self-injurious behaviour (SIB) in young children with developmental disabilities, even though there has been a great deal of research into the prevalence, assessment and treatment of well-established SIB in older individuals. In the present initial study, teachers in special schools for children under II years of age with severe intellectual disability and/or autism were asked to identify children who were beginning to show early self-injury (the index group). These children were then matched to classroom controls (of the same ability level and mobility), and teachers were interviewed about the children's behaviours and skills. The index children showed significantly more potential SIB than the control group children, but there was overlap between the groups in terms of percentage duration of potential SIB, suggesting that teachers do not find it easy to identify children with 'early' SIB. The index children's skills and problem behaviours, their sensory impairments and degree of autism did not differ significantly from those of the control group. When all the children showing any potential SIB were pooled together, it transpired that developmental age and degree of mobility were significantly correlated with percentage duration of SIB, suggesting that these characteristics may be important risk markers. The index children were also observed at 3-month intervals at school over the following 18 months and self-injury clearly escalated for some of the index children, while it did not do so for others. Using regression analysis, increases in SIB were shown to be associated only with the degree of concern expressed about the child's behaviour at time I by the teacher, no other variables predicting increases in SIB.
Journal of intellectual disability research : JIDR, 1999 · doi:10.1046/j.1365-2788.1999.00183.x