Self Injurious Behaviour and Autism

Key Features

It is important to explain what we mean by the term self injurious behaviour (SIB) and how this differs from the similar but different term “self harm”.

This is difficult because different people seem to use the same terms to mean different things and there is an overlap between the practices found in self injury and in self harm. For example

• Murphy and Wilson (1985) defined self injurious behaviour as “Any behaviour, initiated by the individual, which directly results in physical harm to that individual. Physical harm (includes) bruising, lacerations, bleeding, bone fractures and breakages, and other tissue damage.” *
• The Self injury Support website, accessed on 1 February 2016, stated that “Self-injury can be many things that people do to themselves in a deliberate and often hidden way like cutting, burning, overdosing, scratching, biting, hair pulling and breaking bones.”
• The NHS Choices website accessed on 1 February 2016, stated that “Self-harm is when somebody intentionally damages or injures their body. It's usually a way of coping with or expressing overwhelming emotional distress.”

In practice, self harm is more likely to be intentional and is more likely to involve practices such as cutting or overdosing.  Self injury, on the other hand, is less likely to be intentional and is more likely to involve practices such as head banging or biting oneself. Self injurious behaviour is also more likely to occur in people on the autism spectrum who also have a learning disability.

Of course, some people on the autism spectrum may self harm, some may self injure and some may do both.  However we will be concentrating on self injurious behaviour.

There are some specific types of self injurious behaviours which are commonly found in people on the autism spectrum. These include:

• head banging
• hand or arm biting
• hair, teeth and fingernail pulling
• eye gouging or poking
• face or head slapping or punching
• skin picking, scratching or pinching
• forceful head shaking
• dislocation of joints
• pica (persistent eating of non-nutritive substances)

* It is worth noting that some researchers (such as Oliver & Richards, 2015) have suggested that some forms of SIB (such as head banging) may not result in obvious physical damage but may result in physical changes to brain anatomy.

Updated

02 Nov 2017