Guidance for Dealing with Self-Injurious Behaviors
Self-injurious behavior (SIB) is experienced by many parents of children and adults diagnosed with autism and other developmental disorders. Self-Injury is when a person engages in behavior that could result in them physically harming themselves. Common self-injurious behavior includes head banging on hard surfaces, hand or arm biting, hair pulling, eye gouging, face or head slapping, skin picking, scratching or pinching.
Self-injurious behavior can result in serious harm to the person or even death. For many parents and other caregivers who observe these dangerous behaviors, it may be difficult not to do whatever is necessary just to make the behavior stop. But caregivers should be careful about advice from professionals and websites suggesting they provide preferred items or activities, reduce demands, and remove physical and sensory discomforts as the preferred or most effective interventions for dealing with self-injurious behavior. These responses to self-injury will likely stop the behavior from occurring in the moment but will likely end up making the situation worse over time.
For the best results in dealing with the problem of self-injury long term, it is best to enlist the help of a Board-Certified Behavior Analyst (BCBA) with a background in self-injury. The BCBA should start by conducting a functional behavior assessment (FBA) that includes a caregiver interview and direct assessment that involves presenting different situations for the behavior (or precursors) to occur or not to determine the function (the why) of the self-injury. Finally, the assessment should conclude with recommendations as part of a behavior support plan (BSP) for actions the caregivers can take to reduce the frequency (how often) and intensity (how severe) of self-injurious behavior in the future.
As a caregiver, it’s important to know that there is no quick fix for dealing with self-injurious behavior. A quality behavior support plan should include procedures for what to do:
- Before the behavior occurs (to prevent it)
- When the behavior occurs (to stop it and prevent injury)
- After the behavior occurs (to make it less likely to happen again)
Self-injury tends to occur as a means for the individual to communicate what their needs are. Some common needs are:
- Touch/hold me
- I don’t want to do this
- I don’t like the way this makes me feel
- I’m bored or under stimulated
- I want my favorite toy
- I like how it feels when I do this
A properly completed behavior assessment is essential for identifying the specific needs of each individual. Misidentifying the reason for the self-injury during the assessment can result in a treatment plan that does not reduce the behavior and may even make it worse. Building more effective communication skills, as part of prevention, is the key to long-term success in eliminating self-injury. If a person can tell you their needs, they no longer have a need to harm themselves. For example, an individual who used to cause bleeding and bruising on a weekly basis and then learns to talk using simple sentences (e.g. “I want break”, “I want iPad”) could then be observed going weeks or even months without injury. Others have done it, and so can your child.
If you believe you may need help dealing with self-injurious behavior or if you would like more information about ABA-based therapy, we invite you to schedule a complimentary 30-minute phone or in-person consultation or visit ABA-based therapy.