Self Injurious Behaviour and Autism

Future Research

Summary of Curent Research

• Self injury is very common in people on the autism spectrum and even more common in people on the autism spectrum with a learning disability.
• There are a number of potential risk factors associated with some people on the autism spectrum which make it more likely that they will self injure. 
• These risk factors include internal factors, such as specific genetic syndromes or painful medical conditions; interpersonal factors, such as being bullied by someone else; external factors, such as a lack of control over their living environment
• There is a considerable amount of low quality research evidence to suggest that some behavioural techniques and some medications may prevent or reduce self injurious behaviours in some people on the autism spectrum
• There is a limited amount of low quality research evidence to suggest that some medications may prevent or reduce self injurious behaviours in some people on the autism spectrum
• Determining the benefits of other interventions to treat self injury for individuals on the autism spectrum is not currently possible.  We must wait for further research of sufficiently high quality to be completed 
• There is some evidence to suggest that some interventions used to treat self injury, such as some medications, may cause significant side effects.  Because of this they should only be used with extreme care
• There are very few  tools, such as the FLACC Pain Scale, which identify pain in individuals who cannot self-report.
• There is a lack of research which involves people on the autism spectrum (including people who may be nonverbal) to review the causes, efficacy and ethical basis of interventions in this area.

Recommendations for Future Research

There is a need for further research into self injurious behaviours and people on the autism spectrum and the most effective interventions to overcome those self injurious behaviours. 

Specifically there is a need for studies which 

• involve people on the autism spectrum to review the causes, efficacy and ethical basis of interventions in this area including individuals who may be non-verbal
• identify the most effective tools to identify pain in individuals who cannot self-report
• identify the factors that may cause self injurious behaviour and specific forms of self injurious behaviours in specific groups on the autism spectrum (age, gender, diagnosis, comorbid genetic condition, IQ etc)
• identify which groups of people on the autism spectrum with self injurious behaviour might benefit most from which interventions
• identify the specific components of interventions which appear to be most successful in preventing or reducing self injurious behaviour
• examine the effects of interventions over a much longer period (longitudinal studies)
• assess collateral gains (increased rate of learning, social relationships, improved activity patterns) following interventions
• examine the interplay between different types of intervention (such as medications and behavioural interventions)
• use more rigorous and robust methods (such as large scale, randomised controlled trials)

Updated

02 Nov 2017