Current Perspectives on Interventions for Self-Injurious Behavior of Children with Autism Spectrum Disorder: A Systematic Review of the Literature

Abstract

Our purpose in this systematic review was to identify, evaluate, and summarize the single-case research design studies examining behavioral interventions to address self-injurious behavior for young children with autism spectrum disorder. We identified 24 studies published between 2000 and 2016 that met the inclusion criteria. We reviewed and coded each study across five content areas using systematic procedures. These content areas consisted of the methodological quality of single-case research designs, children's demographic information, conditions under which the intervention was implemented, characteristics of intervention, and outcomes. Our findings indicate that procedural integrity data were reported for only one study and social validity for two studies. The majority of studies were implemented by researchers or therapists in the school setting. For 24 of 30 children included in the studies reviewed, the authors taught a replacement behavior selected on the basis of an assessment conducted prior to intervention. All authors reported a decrease in the self-injurious behavior post-intervention. A limited number of authors examined generalization and maintenance of low rates of self-injurious behavior. Limitations of the present review and future directions and implications for research and practice are discussed.

Short‐term trajectories of restricted and repetitive behaviors in minimally verbal children with autism spectrum disorder

“…There were a number of behaviors that were not frequently observed within the CCX, namely sensory aversion, insistence on sameness, repetitive AAC use, and SIB. These behaviors (with the exception of repetitive AAC use) are reported as common in ASD (Baranek et al, 2007; Boyd et al, 2010; Chezan et al, 2017; Soke et al, 2018). Sensory aversions are reported in between 45% and 95% of individuals with ASD (Baranek et al, 2007; Ben‐Sasson et al, 2007; Tomchek & Dunn, 2007).…”

Professionals’ attitudes towards people with intellectual disabilities who self-harm: A literature review

“…Self-harm, whether presented by someone with or without an intellectual disability, is concerning. It is an immediate sign that the individual is distressed and needs support; it is also a known risk marker for further mental health problems ( Borschmann and Kinner, 2019 ) and it may reduce the likelihood of friendships and, where relevant, successful placements ( Chezan et al, 2017 ; Minshawi et al, 2015 ). With the increase in levels of self-harm in the UK ( McManus et al, 2019 ) and the ongoing concerns about the experiences of people with intellectual disabilities who self-harm ( Heslop and Lovell, 2013 ; Richards and Symons, 2018 ), together with the rising international concern of the potential marginalisation of people with intellectual disabilities in terms of COVID-19 ( Clegg, 2020 ), it has never been more apposite that the response and approach to self-harm is as good as it can be.…”

“…The small number of studies in Group A in comparison to Group B, indicates the paucity of research examining attitudes of staff supporting people with intellectual disabilities who self-harm; it is partly impacted by a tendency in the literature to discuss self-harm in amongst wider concerns around challenging behaviour ( Chezan et al, 2017 ; van den Bogaard et al, 2019 ); indeed, several studies were excluded on these grounds ( Bailey et al, 2006 ; Male, 2003 ; Wilderjans et al, 2014 ). This has been highlighted as a disadvantage when wanting to consider people with intellectual disabilities who self-harm without conflating it with other concerns ( Chezan et al, 2017 ; Minshawi et al, 2015 ). However, even accounting for the studies excluded on these grounds, there was simply less research available that met the criteria for Group A, highlighting the need for more research in this area.…”

“…There are distinct theories of causation for self-injurious behaviour: behavioural and biological theories have tended to dominate the literature ( Chezan et al, 2017 ; Oliver and Richards, 2015 ). Operant learning is the prevailing behavioural theory ( Symons et al, 2012 ).…”

Maintaining Safety and Facilitating Inclusion: Using Applied Behavior Analysis to Address Self-Injurious Behaviors Within General Education Classrooms

“… a Matson and LoVullo (2008). b Chezan, Gable, McWhorter, and White (2017). c Machalicek, O’Reilly, Beretvas, Sigafoos, and Lancioni (2007).…”