Predictors of Self-Injurious Behavior and Self-Restraint in Autism Spectrum Disorder: Towards a Hypothesis of Impaired Behavioral Control
- 1.1k Downloads
Self-injury is common in autism spectrum disorder (ASD); however few studies have investigated correlates of self-injury or the putative associations with self-restraint. Questionnaire data on self-injury, self-restraint, health conditions, overactivity/impulsivity and repetitive/restricted behavior were collected on 208 children and 216 adults with ASD (mean age = 24.10, range 6–61). Self-injury and self-restraint were frequent and significantly associated in both children (45.7% and 40.9%, p < 0.001) and adults (49.1, and 42.6%, p < 0.001). Severe self-injury was predicted by lower ability, health conditions and overactivity/impulsivity in children (p < 0.001) and repetitive/restricted behavior and overactivity/impulsivity in adults (p < 0.001). These data provide preliminary support for a developmental model of self-injury and self-restraint in which painful health conditions and compromised behavioral control influence the presence and trajectory of self-injury in ASD.
KeywordsAutism spectrum disorder Self-injury Self-restraint Prevalence Impulsivity Pain
This study was funded by Research Autism and Cerebra.
CR contributed to the design of the study, collected and analysed the data and drafted the manuscript. LD contributed to the design of the study and revised the manuscript. CO contributed to the design of the study and revised the manuscript. All authors read and approved the final manuscript.
Compliance with Ethical Standards
Conflict of interest
Dr. Caroline Richards declares that she has no conflict of interest. Dr. Louise Davies declares that she has no conflict of interest. Professor Chris Oliver declares that he has no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- Cooper, S. A., Smiley, E., Allan, L. M., Jackson, A., Finlayson, J., Mantry, D., et al. (2009). Adults with intellectual disabilities: Prevalence, incidence and remission of self-injurious behavior, and related factors. Journal of Intellectual Disability Research, 53(3), 200–216.CrossRefPubMedGoogle Scholar
- Courtemanche, A. B., Black, W. R., & Reese, R. M. (2016). The relationship between pain, self-injury, and other problem behaviors in young children with autism and other developmental disabilities. American Journal on Intellectual and Developmental Disabilities, 121(3), 194–203.CrossRefPubMedGoogle Scholar
- Duerden, E. G., Oatley, H. K., Mak-Fan, K. M., McGrath, P. A., Taylor, M. J., Szatmari, P., & Roberts, S. W. (2012). Risk factors associated with self-injurious behaviors in children and adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(11), 2460–2470.CrossRefPubMedGoogle Scholar
- Forman, D., Hall, S., & Oliver, C. (2002). Descriptive analysis of self-injurious behavior and self-restraint. Journal of Applied Research in Intellectual Disabilities, 15, 1–7.Google Scholar
- Melzack, R. & Wall, P. D. (1965). Pain Mechanisms - A New Theory. Science, 150, 971-&.Google Scholar
- Petty, J. (2006). Self-injurious behaviour in children with severe intellectual disabilities. Unpublished Ph.D. thesis.Google Scholar
- Rojahn, J., Mulick, J. A., McCoy, D., & Schroeder, S. R. (1978). Setting events, adaptive clothing, and the modification of head banging and self-restraint in two profoundly retarded adults. Behavioral Analysis and Modification, 2, 185–196.Google Scholar
- Shattuck, P. T., Seltzer, M. M., Greenberg, J. S., Orsmond, G. I., Bolt, D., Kring, S., et al. (2007). Change in autism symptoms and maladaptive behaviors in adolescents and adults with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 37, 1735–1747.CrossRefPubMedGoogle Scholar
- Turner, M. (1997). Towards an executive dysfunction account of repetitive behavior in autism. In J. Russell (Ed.), Autism as an executive disorder (pp. 57–100). Oxford: Oxford University Press.Google Scholar