Self-injurious behaviour in people with intellectual disability

Abstract

Purpose of review. To provide a critical evaluation of a broad range of peer reviewed published studies of relevance to self-injurious behaviour in people with intellectual disability and autism spectrum disorders.Recent findings. The review covers the prevalence of self-injurious behaviour, the characteristics of those showing the behaviour, self-injury in autism spectrum disorders, biological influences on self-injurious behaviour, behavioural assessment and psychological and pharmacological interventions Summary: The recent literature describes systematic evaluation of the efficacy of aripiprazole, and parent training combined with risperidone. Meta analyses of behavioural interventions provide evidence of their efficacy and related research describes beneficial modification to behavioural assessment procedures. The prevalence literature provides data on individual characteristics that are associated with persistence and presence of self-injury and that might be considered as risk markers. Pain behaviour appears to be associated with self-injury with implications for theories of the involvement of endorphins and as a casual factor. In combination these research findings demonstrate the multiple influences on selfinjurious behaviour that must be taken into account in the assessment, formulation, intervention process.

Prader–Willi syndrome and autism spectrum disorders: an evolving story

“…Skin picking may lessen with age, is not related to IQ, and is slightly less common in those with mUPD. Neither behavioral nor pharmacological treatments have succeeded in consistently reducing skin picking in PWS.In contrast, those with ASD show more diverse forms of SIBs (e.g., biting and head banging); and compared to others with intellectual or developmental disabilities, those with autism invariably show more frequent and severe SIBs (e.g., Bodfish et al 2000; Oliver and Richards 2010). SIBs in autism are inversely related to IQ and may lessen with age, and other features of SIBs have also recently been identified.…”

Interprofessional team-based primary health care for adults with intellectual and developmental disabilities: a scoping review protocol

“…27 132-134 Challenging behaviours (such as aggression, destruction and self-injury) are shown by 10%-15% of people with learning disabilities, with age-specific prevalence peaking between ages 20 and 49. [135][136][137][138][139][140][141] In a recent study self-injurious behaviour was recorded for 27% of individuals (children and adults) with learning disabilities, and the same study reported self-injurious behaviour for between 45% and 93% of people with certain genetic syndromes. 142 In some instances, challenging behaviours may result from pain associated with untreated medical disorders.…”

Toileting Problems in Children and Adolescents with Parent-Reported Diagnoses of Autism Spectrum Disorder

“…soiled themselves) were more likely to be victims of bullying, subject to both verbal and physical aggression, compared to children who did not experience any toileting difficulties. This is an important finding as such victimisation may exacerbate challenging and self-injurious behaviors which are common in children with intellectual disability and ASD (Oliver & Richards, 2010). Independent toileting can improve an individual's quality of life through improved hygiene and improved self-confidence, as well as reduced stigmatism and reduced physical discomfort that comes from soiled clothes and ben linen (Cicero & Pfadt, 2002, Lott & Kroeger, 2004.…”