Assessment & Research

Stereotyped behaviors predicting self-injurious behavior in individuals with intellectual disabilities.

Barnard-Brak et al. (2015) · Research in developmental disabilities 2015
★ The Verdict

Body rocking or yelling in clients with ID is your cue to hunt for future self-biting, head hitting, pinching, or hair pulling.

✓ Read this if BCBAs working with children or adults who have intellectual disability and show repetitive movements.
✗ Skip if Clinicians serving only typically developing clients or those without stereotypy.

01Research in Context

01

What this study did

The team looked at records for 1,871 people with intellectual disability.

They asked: do repetitive movements like body rocking or yelling tell us who will later show self-injury?

A computer model checked if each stereotypy came before five kinds of self-hitting, biting, pinching, or hair pulling.

02

What they found

Body rocking and yelling each flagged future self-injury in almost seven out of ten cases.

The model linked these two stereotypies to all five SIB topographies.

No other repetitive acts gave a clear warning signal.

03

How this fits with other research

Matson et al. (2008) already showed that people with severe ID plus SIB carry more aggression and destruction.

Lucy et al. now zoom in and name the exact stereotypies that come first.

Boswell et al. (2023) push the timeline even earlier: stereotypy at 12 months predicts SIB by age three in autism-risk infants.

Together the three studies draw one long arc: stereotypy is an early red flag across ages and diagnoses.

04

Why it matters

If your client rocks hard or yells often, start a full SIB screen right away. Track head, hand, mouth, and hair sites. Add protective gear or functional analysis before the first bite or hit shows up. Early action can spare pain, scarring, and hospital trips.

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Open the file of every client who rocks or yells and run a brief SIB risk checklist today.

02At a glance

Intervention
not applicable
Design
other
Sample size
1871
Population
intellectual disability
Finding
not reported

03Original abstract

We examined the relation between stereotyped behavior and self-injurious behavior (SIB) for 1871 individuals with intellectual disabilities who had a score of >0 on the Behavior Problem Inventory (BPI-01; Rojahn et al., 2001). We report three main findings: First, structural equation modeling techniques (SEM) revealed that the BPI-01stereotyped behavior subscale scores predicted BPI-01 SIB subscale scores. Second, when stereotyped behavior was modeled as a predictor of SIB, mixture-modeling techniques revealed two groups of individuals: one in which stereotyped behavior was a strong, statistically significant predictor of SIB (69% of the sample), and another one in which stereotyped behavior was not a predictor of SIB (31%). Finally, two specific stereotyped behavior topographies (i.e., body rocking and yelling) were identified that significantly predicted five different SIB topographies (i.e., self-biting, head hitting, body hitting, self-pinching, and hair pulling). Results are discussed in terms of future research needed to identify bio-behavioral variables correlated with cases of SIB that can, and cannot, be predicted by the presence of stereotyped behavior.

Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2014.08.017