Predictors of self-injurious behaviour exhibited by individuals with autism spectrum disorder.
Impulsivity and stereotypy—not low IQ—drive self-injury in autism, so screen these plus sleep and start treatment fast.
01Research in Context
What this study did
The team looked at what predicts self-injury in people with autism. They used a one-time survey and math model. The model tested if low IQ, impulsivity, or stereotypy best explained how bad the self-injury was.
What they found
Impulsivity and stereotypy predicted worse self-injury. Low IQ did not. The take-home: watch for kids who act fast without thinking or repeat the same body movements. These traits flag higher self-injury risk.
How this fits with other research
Faso et al. (2016) extends this idea. They followed toddlers for one year and showed early stereotypy leads to later self-injury. The link is now cause-and-effect, not just a snapshot.
Hatzell et al. (2026) adds sleep problems to the list. In 8,000 autistic youth, bad sleep doubled the odds of self-injury. So today you screen for impulsivity, stereotypy, AND sleep.
van der Miesen et al. (2024) closes the loop. Their 2024 meta-analysis says any good SIB plan works—clinic or home, staff or parent. Knowing the predictors helps you pick WHO to treat, not just HOW.
Why it matters
You now have a quick risk checklist: impulsivity, stereotypy, sleep. Score these at intake. If any flag high, move the client up the SIB intervention list. Start parent training early—van der Miesen et al. (2024) shows home delivery works just as well.
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02At a glance
03Original abstract
BACKGROUND: Presence of an autism spectrum disorder is a risk factor for development of self-injurious behaviour (SIB) exhibited by individuals with developmental disorders. The most salient SIB risk factors historically studied within developmental disorders are level of intellectual disability, communication deficits and presence of specific genetic disorders. Recent SIB research has expanded the search for risk factors to include less commonly studied variables for people with developmental disorders: negative affect, hyperactivity and impulsivity. METHOD: A heterogeneous sample of 617 individuals with autism spectrum disorder diagnoses was derived from the National Database of Autism Research. Latent constructs were estimated from items of the community version of the Aberrant Behaviour Checklist. Structural equation modelling was used to assess whether impulsivity, hyperactivity, negative affect, severity of stereotypy, intellectual functioning or severity of autism symptoms predicted severity of SIB. RESULTS: Impulsivity (β = 0.46), followed by intellectual functioning (β = -0.39), and stereotypy (β = 0.23) were the variables most highly predictive of increased SIB; impulsivity and stereotypy remained significant predictors of SIB after severity of autism symptoms and intelligence quotient (IQ) were controlled for. CONCLUSIONS: High levels of impulsivity and stereotypy were significant predictors of SIB in a large and diverse sample of people with confirmed autism diagnoses. Future research is needed on the effects of reducing impulsivity and stereotypy on the outcomes of treatment, early intervention and attempts to prevent the development of SIB.
Journal of intellectual disability research : JIDR, 2013 · doi:10.1111/j.1365-2788.2012.01628.x