The relationship of self-injurious behavior and other maladaptive behaviors among individuals with severe and profound intellectual disability.

The team asked a simple question. Does severe self-injury travel alone?

They looked at adults with severe or profound intellectual disability. Half had long-term self-injury. Half did not.

Staff filled out the Aberrant Behavior Checklist. The study counted how many other problem behaviors showed up in each group.

Self-injury rarely comes solo. The group that hurt themselves also showed far more aggression, destruction, and repetitive movements.

The irritability sub-scale of the ABC caught this pattern. It put three out of four people into the right group.

Tureck et al. (2013) zoomed in on adults with both severe ID and autism. They found even higher rates of self-injury when the person could speak. Together the papers tell you: check for ASD and verbal skill when you see self-injury.

Barnard-Brak et al. (2015) flipped the timeline. They showed that body-rocking and yelling today often foretell tomorrow’s self-biting or head-hitting. The 2008 paper shows the full picture once the behaviors are already present.

Boswell et al. (2023) seems to disagree. In baby siblings of children with autism, early self-injury predicted later self-injury. That looks opposite to the 2008 finding that self-injury brings extra problems. The gap is age. Babies have only simple behavior. Adults with profound ID have years of learning other topographies.

When you see severe self-injury, plan for a crowd. Screen for aggression, property destruction, and stereotypy right away. Use the ABC irritability sub-scale as a quick flag. Build treatment plans that reduce multiple behaviors at once, not just the injury.