Factors Associated with Self-Injurious Behaviors in Children with Autism Spectrum Disorder: Findings from Two Large National Samples
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In this study, we explored potential associations among self-injurious behaviors (SIB) and a diverse group of protective and risk factors in children with autism spectrum disorder from two databases: Autism and Developmental Disabilities Monitoring (ADDM) Network and the Autism Speaks-Autism Treatment Network (AS-ATN). The presence of SIB was determined from children’s records in ADDM and a parent questionnaire in AS-ATN. We used multiple imputation to account for missing data and a non-linear mixed model with site as a random effect to test for associations. Despite differences between the two databases, similar associations were found; SIB were associated with developmental, behavioral, and somatic factors. Implications of these findings are discussed in relation to possible etiology, future longitudinal studies, and clinical practice.
KeywordsAutism spectrum disorder Autism Self-injurious behaviors Challenging behaviors Maladaptive behaviors Children
We acknowledge CDC ADDM project personnel, ADDM projects coordinators, clinician reviewers, abstractors, data managers, and ADDM investigators at each site who contributed to the ADDM surveillance project and data collection. We acknowledge AS-ATN project coordinators and all families who provided data into the AS-ATN registry. This Network activity was supported by Autism Speaks and cooperative agreement UA3 MC11054 through the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Research Program to the Massachusetts General Hospital. This work was conducted through the Autism Speaks-Autism Treatment Network.
Dr. Gnakub N. Soke conceptualized and drafted the original proposal of the study, carried out the analyses, drafted the original manuscript, revised the manuscript, and approved the submission of the final manuscript; Drs. Steven A. Rosenberg, Richard F. Hamman supervised the initial manuscript, reviewed and revised the manuscript and approved the submission of the final manuscript; Drs. Cordelia Robinson and Ann Reynolds supervised the initial manuscript, contributed to data acquisition, reviewed and revised the manuscript and approved the submission of the final manuscript; Drs. Tasha Fingerlin and Carolyn DiGuiseppi supervised the initial manuscript, supervised the analyses, reviewed and revised the manuscript and approved the submission of the final manuscript; Drs. Maureen S. Durkin and Lisa Wiggins played prominent roles in reviewing and revising the manuscript and approved the submission of the final version; Drs. Laura Carpenter, Ellen Giarelli, and Li-Ching Lee reviewed and revised the manuscript and approved the submission of the final version provided feed-back on.
Compliance with Ethical Standards
All procedures performed in studies involving human participants were in accordance with ethical standards of the institutional and /or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study is a secondary data analysis of unidentified data previously collected in a surveillance system. Therefore, formal consent is not required.
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