Assessment & Research

Self-Injurious Behavior in People with Intellectual Disabilities and Co-Occurring Psychopathology using the Self-Harm Scale: A Pilot Study.

van den Bogaard et al. (2018) · Journal of developmental and physical disabilities 2018
★ The Verdict

A simple incident form revealed that cutting and Mondays top the self-injury list in adults with ID.

✓ Read this if BCBAs working with adults who have ID and self-injury
✗ Skip if Clinicians who only serve children or non-verbal autism without SIB

01Research in Context

01

What this study did

McGarty et al. (2018) tested a new form called the Self-Harm Scale. Staff used it to log every act of self-injury in adults with intellectual disability.

They tracked 33 adults for 41 weeks. Eight adults showed 104 incidents.

02

What they found

Cutting was the most common method. Mondays had the most incidents.

The form caught details that old checklists missed.

03

How this fits with other research

Grindle et al. (2012) said we need both operant and sensory tools. The new form adds the sensory side.

MacFarland et al. (2025) used the ABC checklist to flag automatic SIB. The incident form gives the day-by-day numbers.

Titlestad et al. (2019) validated the French BPI-S. Both papers show we need better rulers before we treat.

04

Why it matters

You can start using the Self-Harm Scale today. One page per incident shows time, place, and method. After a week you will see patterns. Use those patterns to pick when to teach replacement skills or add sensory breaks.

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→ Action — try this Monday

Put a Self-Harm Sheet on the clipboard and log every SIB before lunch.

02At a glance

Intervention
not applicable
Design
case series
Sample size
33
Population
intellectual disability
Finding
not reported

03Original abstract

Self-injurious behavior (SIB) is one of the most detrimental behaviors for the person showing it, as well as for their environment. Nevertheless, structured clinical assessments of SIB are scarce. Staff completed a Self-Harm Scale (SHS) every time they witnessed SIB in clients with an intellectual disability (ID) and co-occurring psychopathology (N = 33). Descriptive statistics were conducted to explore the nature of the incidents of SIB and the characteristics of the people involved in the incidents. In 41 weeks, 104 SIB incidents were reported for 8 out of 33 clients (24%). Incidents were most prevalent on Mondays (23%). As far as the methods of SIB concerned, cutting was the most used method (63%). Clients who showed SIB differed significantly from clients who did not on gender, having a personality disorder and communicative abilities. This study was one of the few that used an incident-based record form to report SIB by direct observation. It is hoped that the SHS helps to gain more information about SIB, to improve individualized interventions. Further research is necessary to determine the psychometric properties and clinical utility of the scale.

Journal of developmental and physical disabilities, 2018 · doi:10.1111/j.1600-0447.2008.01155.x