An investigation of self-injurious behaviors in adults with severe intellectual disabilities.
Among adults with severe ID, co-occurring ASD and verbal ability each predict higher SIB rates—screen these factors during intake.
01Research in Context
What this study did
Tureck et al. (2013) looked at self-injury in adults with severe intellectual disability. They asked two questions: Does having autism on top of ID matter? Does being able to speak matter?
The team used records from a large residential center. They compared adults with ID only, ID plus autism, verbal and nonverbal clients.
What they found
Adults who had both severe ID and autism showed more self-injury than those with ID alone. The same was true for adults who could use words.
In short: autism plus ID equals higher risk, and verbal ability adds extra risk.
How this fits with other research
Matson et al. (2008) already showed that adults with severe ID and self-injury usually have other problem behaviors too. Kim’s team adds autism and verbal status to that risk picture.
Boswell et al. (2023) moved the lens backward, finding that early stereotypy in baby siblings predicts later self-injury. Kim moves the lens forward, showing the risk stays high into adulthood for those with ASD.
Barnard-Brak et al. (2015) found that body rocking and yelling forecast specific self-injury topographies. Kim’s work says also check for ASD and verbal ability when you see those signs.
Why it matters
When an adult with severe ID comes onto your caseload, screen for autism and note if they use words. If either is present, plan for more frequent and severe self-injury. Build stronger environmental safeguards, increase functional assessment hours, and involve medical and speech teams early.
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02At a glance
03Original abstract
Self-injurious behavior (SIB) is commonly observed among individuals with intellectual disability (ID) living in state-run supports and services centers. Specific examples of SIB include poking oneself in the eye; harming oneself by hitting, scratching, or pinching; and pica (i.e., swallowing objects causing bodily harm). Previous research has focused on SIB in individuals with ID more generally without focusing on specific levels of ID or taking into account other important personal variables. This study examined 45 adults with severe ID living in two large state-run facilities in the Southeastern United States who were separated into groups for comparison (ASD and non ASD; verbal and nonverbal). Data was collected on the presence of SIB using the Autism Spectrum Disorder-Problem Behavior Adult Version (ASD-PBA). A two-way analysis of variance (ANOVA) was conducted to determine if there were significant differences between groups on rates of SIB. Individuals with ID and ASD exhibited significantly higher rates of SIB than individuals with only ID, F (1,43)=50.84, p<0.05. Furthermore, verbal individuals had significantly higher rates of SIB than nonverbal individuals, F (1,43)=57.612, p<0.05. There was a significant interaction between the effects of ASD diagnosis and verbal ability on rates of SIB, F (1,43)=50.84, p<0.05. The implications of these findings in the context of other research on ID, ASD, SIB, and verbal abilities are discussed.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.05.022