Navigating the challenges of self-injurious behaviors (SIBs), including head banging, can be emotionally taxing for families of children with autism spectrum disorder (ASD). These behaviors, which may include head-banging, skin picking, or self-biting, can deeply affect both the child’s quality of life and their family’s well-being. SIBs are more common among children with ASD, emphasizing the importance of understanding why these behaviors occur and how to manage them with effective strategies.
This guide explores the causes, potential interventions, and strategies for addressing SIBs in children with autism, equipping families and caregivers with information to make informed, compassionate choices.
SIBs are actions that cause physical harm to oneself, often seen in individuals with ASD. These behaviors can manifest in:
For autistic children, these actions may help cope with overwhelming emotions or sensory input. Understanding these behaviors is crucial for caregivers to develop effective interventions that improve quality of life.
Self-injurious behaviors involve actions that cause physical harm to oneself and are observed in approximately 42% of children with autism (Steenfeldt-Kristensen et al., 2020). These behaviors may appear as early as 12 months. Common types include head-banging, self-biting, pinching, and scratching. Recognizing triggers and documenting instances is crucial for understanding motivations and creating effective interventions.
The causes of SIBs are complex and often involve sensory, communicative, and behavioral factors:
Sensory Needs: Many children with ASD engage in SIBs to meet sensory needs. Self-injury can provide intense physical sensation to relieve internal discomfort or overwhelm (Wan Yunus et al., 2015).
Communication Difficulties: When children lack effective communication, SIBs may serve as a substitute. Non-verbal children may express unmet needs, distress, or frustration through SIBs (Shkedy et al., 2019).
Escape or Avoidance: Children may use SIBs to escape undesired situations, tasks, or sources of stress (Alakhzami & Chitiyo, 2022).
Understanding triggers is key to managing SIBs. Common triggers include sensory overload, frustration or anxiety, and communication difficulties. Documenting circumstances surrounding SIB episodes can reveal patterns. Functional behavioral assessments (FBAs) and behavior diaries help identify the function of SIBs, enabling more targeted interventions.
Professionals often use Functional Behavioral Assessments (FBAs) to observe the child and conduct interviews, identifying triggers and the behavior’s function. These insights help create personalized intervention strategies aligned with the child’s needs (Minshawi et al., 2015; 2014).
Interventions should be tailored to each child’s needs.
Sensory-Based Interventions: Gentle massage, weighted vests, or swings to reduce sensory overload. Incorporate coping skills to manage anxiety and replace self-injurious patterns.
Behavioral Strategies:
Medical Interventions: Medications like antipsychotics or antidepressants may help manage symptoms. Address underlying physical pain, nutritional, or medical issues contributing to SIBs.
Use augmentative and alternative communication (AAC) devices, provide visual schedules and social stories, offer sensory alternatives like weighted blankets or swings, and teach coping mechanisms such as deep breathing or counting.
Music Therapy uses music to create calming, sensory-friendly experiences. Animal-Assisted Therapy involves interacting with animals to promote emotional and physical healing. These therapies help reduce sensory overload, teach alternative coping mechanisms, and improve overall well-being.
Safe Spaces: Provide a calming area at home for the child to decompress.
Consistent Routines: Reduce potential stressors and triggers.
Positive Communication: Encourage and reinforce alternative communication skills.
Seek family counseling or support groups, connect with professionals familiar with autism, and address caregiver stress to create a resilient, compassionate environment.
Self-injurious behaviors in autistic children require a comprehensive, empathetic approach. By understanding the underlying causes and collaborating with professionals, families can effectively address these behaviors. With patience, tailored strategies, and supportive networks, children can manage SIBs and thrive (Minshawi et al., 2015; 2014; Shkedy et al., 2019).
Why does my autistic child hit his head?
To cope with discomfort or stress, sensory overload, communication difficulties, or to avoid situations.
How do I get my autistic child to stop banging his head?
Understand the underlying reasons (sensory needs, communication difficulties, or stress) and use tailored interventions, behavioral strategies, and alternative communication.
What are examples of self-injurious behavior in Autism?
Head banging, hand biting, skin picking, and excessive self-rubbing or scratching.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.) Washington, DC: Author.
Steenfeldt-Kristensen C, Jones CA, Richards C. (2020). The Prevalence of Self-injurious Behaviour in Autism: A Meta-analytic Study. Journal of Autism & Developmental Disorders, 50(11), 3857-3873. doi:10.1007/s10803-020-04443-1
Minshawi NF, Hurwitz S, Fodstad JC, Biebl S, Morriss DH, McDougle CJ. (2014). The association between self-injurious behaviors and autism spectrum disorders. Psychology Research and Behavior Management, 7, 125-136. doi:10.2147/PRBM.S44635
Shkedy G, Shkedy D, Sandoval-Norton AH, Cerniglia L. (2019). Treating self-injurious behaviors in autism spectrum disorder. Cogent Psychology, 6(1), 1-14. doi:10.1080/23311908.2019.1682766
Wan Yunus F, Liu K, Bissett M, Penkala S. (2015). Sensory-Based Intervention for Children with Behavioral Problems: A Systematic Review. Journal of Autism & Developmental Disorders, 45(11), 3565-3579. doi:10.1007/s10803-015-2503-9
Alakhzami M, Chitiyo M. (2022). Using Functional Communication Training to Reduce Self‑Injurious Behavior for Individuals with Autism Spectrum Disorder. Journal of Autism & Developmental Disorders, 52, 3586–3597. doi:10.1007/s10803-021-05246-8
