Self-injurious behaviour in individuals with autism spectrum disorder and intellectual disability.
Half of kids with autism hurt themselves, and the risk spikes when low speech, high activity, and negative mood meet.
01Research in Context
What this study did
Early et al. (2012) asked 1,246 parents about self-injury in their children. All kids had autism, Down syndrome, or fragile X. Parents filled out a survey about hitting, biting, and head-banging.
The team also asked about impulsivity, mood, and speech level. They wanted to see which traits travel together.
What they found
Half of the children with autism hurt themselves. Most did it every day. Within the autism group, self-injury clustered with three things: low speech, high activity, and negative mood.
Kids with Down syndrome or fragile X had lower rates. Autism plus low ability created the highest risk.
How this fits with other research
Chou et al. (2007) first mapped two behavior waves in autism: early sleep and eating issues, then later self-injury and tantrums. The 2012 survey shows the second wave hits a large share of kids.
Boudreau et al. (2015) looked at 250 clinic patients whose self-injury stayed severe after many drugs. They found a large share fit this drug-refractory group. Together the papers say: half of autism cases show self-injury, and one in five of those are tough to treat with medicine alone.
Austin et al. (2015) studied adults with autism plus ID. They saw the same triple load: self-injury, impulse problems, and mood issues. The pattern holds across the lifespan.
Why it matters
If you serve kids with autism, expect self-injury in every other case. Screen for low speech, hyperactivity, and irritable mood—these flags predict daily hitting or head-banging. Start behavior plans early; drugs alone often fail the severe cases.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Run a quick checklist: speech under 50 words, pacing or flapping, and frowns or cries—if all three show, add a functional assessment for self-injury today.
02At a glance
03Original abstract
BACKGROUND: Autism spectrum disorder (ASD) has been identified as a risk marker for self-injurious behaviour. In this study we aimed to describe the prevalence, topography and correlates of self-injury in individuals with ASD in contrast to individuals with Fragile X and Down syndromes and examine person characteristics associated with self-injury across and within these groups. METHOD: Carers of individuals with ASD (n = 149; mean age = 9.98, SD = 4.86), Fragile X syndrome (n = 123; mean age = 15.32, SD = 8.74) and Down syndrome (n = 49; mean age = 15.84, SD = 12.59) completed questionnaires relating to the presence and topography of self-injury. Information was also gathered regarding demographic characteristics, affect, autistic behaviour, hyperactivity, impulsivity and repetitive behaviour. RESULTS: Self-injurious behaviour was displayed by 50% of the ASD sample: a significantly higher prevalence than in the Down syndrome group (18.4%) but broadly similar to the prevalence in Fragile X syndrome (54.5%). Self-injury was associated with significantly higher levels of autistic behaviour within the Down and Fragile X syndrome groups. Within the ASD group, the presence of self-injury was associated with significantly higher levels of impulsivity and hyperactivity, negative affect and significantly lower levels of ability and speech. CONCLUSIONS: Self-injurious behaviour is prevalent in individuals with ASD and the presence of ASD phenomenology increases the risk of self-injury in individuals with known genetic disorders but without a diagnosis of idiopathic autism. Person characteristics associated with self-injury in ASD indicate a role for impaired behavioural inhibition, low levels of ability and negative affect in the development of self-injurious behaviour.
Journal of intellectual disability research : JIDR, 2012 · doi:10.1111/j.1365-2788.2012.01537.x