Self Injurious Behaviour and Autism

Current Research

Current Research Studies and Reviews

We have identified 30 research papers (reviews and other significant studies) of self injury in people on the autism spectrum published in peer-reviewed journals

Some of the papers looked at studies which included only people on the autism spectrum, for example, Weiss J. A. (2002). Others looked at studies which included people with a range of conditions including autism, for example, Oliver and Richards (2015).

Some of the papers looked only at individuals from a specific age range -such as children, for example Richman (2008); adolescents, for example Rattaz et al. (2015); or adults, for example Cooper et al. (2009). Other papers looked at individuals from across the age range, for example Richards et al. (2012).

Many of the papers looked at interventions designed to prevent or reduce self injury, for example, Minshawi N. F. et al. (2015). Other reviews looked at related issues, such as the assessment and prevalence of self injury, for example Duerden et al. (2012); or likely risk factors, for example Richman et al. (2013).

Many of the papers (for example, Minshawi et al, 2014) recommended undertaking a functional assessment of the self injurious behaviours before undertaking any intervention.

Some of the papers reported some benefits from specific types or groups of intervention.For example

• Mahatmya. et al. (2008) reported that some behavioural approaches and some medications could be effective as treatments for self injurious behaviours
• Minshawi (2014)  reported that some behavioural interventions (including antecedent-based intervention strategies, reinforcement-based intervention strategies, extinction-based intervention strategies, and punishment-based intervention strategies) could be effective as treatments for self injurious behaviours
• King (2000) reported that some medications (including anticonvulsants, antidepressants, antipsychotics mood stabilisers, and opioid antagonists) could be beneficial as a treatment for self injurious behaviours
• Cox and Schopler (1993) reported that the TEACCH approach could be effective as a treatment for self injurious behaviours

Some of the papers reported that there was currently mixed or insufficient evidence to support the use of some interventions. For example, Mahatyma et al (2008) reported that the medication naltrexone may reduce self injurious behaviours in some individuals on the autism spectrum but make them worse in others.

Status of Current Research Studies

There are limitations in most of the research reviews and studies we have identified to date and in most of the studies included in those reviews.

Some of the papers looked only at individuals from a specific age range such as children, for example Richman (2008); adolescents, for example Rattaz et al. (2015); or adults, for example Cooper et al. (2009).

Some of the papers were limited to people on the autism spectrum with additional conditions. For example, Richards et al. (2012) looked only at people on the autism spectrum with learning disabilities.

One paper, Lang et al. (2010), reported only on interventions for a specific form of self injurious behaviour - skin picking.

Some of the papers were limited to specific types of intervention.For example

• Matson and LoVullo (2008) looked only at behavioural interventions
• Rana et al. (2013) looked only at medications; Roy et al. (2015) looked only at a specific group of medications - opioid antagonists; Symons et al. (2004) looked only at a specific type of opioid antagonist - naltrexone
• Cox and Schopler (1993) looked only at the TEACCH approach.

There appeared to be very few / no reviews which looked at other types of intervention, such as social care, standard health care, assistive and adaptive technology, augmentative and alternative communication, motor-sensory interventions, diets and supplements.

Some of the reviews included very small numbers of studies and/or participants on the autism spectrum. For example, Rana et al. (2013) included only five studies with a combined total of only 50 participants. Only one of these studies included any participants (17) who were on the autism spectrum and injuring themselves.

We were unable to identify any reviews which looked at how people on the autism spectrum (or their parents/cares) felt about the interventions being used to prevent or reduce self injurious behaviour.

Updated

02 Nov 2017