Symptom severity as a risk factor for self-injurious behaviours in adolescents with autism spectrum disorders.
In teens with autism, sharper autism symptoms raise self-injury risk, while stronger thinking and communication skills protect against it.
01Research in Context
What this study did
The team looked at existing data on teens with autism. They wanted to know which traits make self-injury more likely.
They checked autism severity, IQ scores, and communication skills. Then they saw who later showed self-injurious behavior.
What they found
About one in three teens with autism hurt themselves. Stronger autism symptoms raised the risk.
Better childhood thinking skills and teen communication lowered the risk.
How this fits with other research
AHand et al. (2020) and Soto et al. (2024) show the next step. They treated anxiety in non-speaking teens and saw self-injury drop. Together the papers say: check for anxiety, then treat it.
Capio et al. (2013) seems to disagree. They found milder autism, not severe, linked to anxiety in younger kids. The gap is age and outcome. Mild traits worry younger kids; severe traits drive teen self-injury.
Bitsika et al. (2020) add the middle link. Sensory avoiding, especially sound sensitivity, carries autism symptoms into anxiety. Target sensory issues and you may short-circuit the path to both anxiety and self-injury.
Why it matters
You now have a quick risk map. Teens with high autism severity and weak communication need the closest watch. Add anxiety and sensory screens to your assessment. If either shows up, start coping-skills training, sensory breaks, or referral for CBT-adapted sessions. These simple add-ons may prevent severe self-injury before it starts.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add one anxiety and one sensory question to your intake form for every teen client.
02At a glance
03Original abstract
BACKGROUND: Self-injurious behaviours (SIB) are highly prevalent in individuals with autism spectrum disorders (ASD) and have deleterious effects on the individual and their environment. The aim of this study was to examine SIB prevalence and associated features in a population of 152 adolescents with ASD and to determine risk factors for SIB. METHODS: The present study uses a subset of data of a longitudinal follow-up of 152 children with ASD. The presence of a low or high level of self-injury was assessed at adolescence through the Aberrant Behaviour Checklist completed by parents. Clinical and social variables regarding severity of autism symptoms, psychological development, adaptive behaviours, parental quality of life and total intervention time were collected during childhood (mean age = 5 years, SD = 1.6) and at adolescence (mean age = 15 years, SD = 1.3). RESULTS: About 35.8% of adolescents with ASD in our sample displayed self-injury, which was frequently associated with other challenging behaviours and was related to severity of autism symptoms, adaptive skills, intellectual functioning and language level (P < 0.001). The main risk factor for SIB at adolescence was severity of autism symptoms (P = 0.04). Cognitive development during childhood was found to be a protective factor (P = 0.03) whereas at adolescence, the main protective factor was communicative abilities (P = 0.04). CONCLUSIONS: These data showed that SIB remained highly prevalent at adolescence and yielded risk and protective factors for developing SIB at this period of life. Limitations and perspectives for future research are discussed.
Journal of intellectual disability research : JIDR, 2015 · doi:10.1111/jir.12177