Risk Factors Associated with Self-Injurious Behaviors in Children and Adolescents with Autism Spectrum Disorders
Abstract
While self-injurious behaviors (SIB) can cause significant morbidity for children with autism spectrum disorders (ASD), little is known about its associated risk factors. We assessed 7 factors that may influence self-injury in a large cohort of children with ASD: (a) atypical sensory processing; (b) impaired cognitive ability; (c) abnormal functional communication; (d) abnormal social functioning; (e) age; (f) the need for sameness; (g) rituals and compulsions. Half (52.3%, n = 126) of the children (n = 241, aged 2-19 years) demonstrated SIB. Abnormal sensory processing was the strongest single predictor of self-injury followed by sameness, impaired cognitive ability and social functioning. Since atypical sensory processing and sameness have a greater relative impact on SIB, treatment approaches that focus on these factors may be beneficial in reducing self-harm in children with ASD.
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These self-injurious behaviours appear to differ in nature from NSSI in typically developing populations: they occur in front of others without attempts to disguise them, being most commonly associated with intellectual disability and severe receptive and expressive language deficits.
“These self-injurious behaviours, which have been the focus of autism research in children and adults [12–14], appear to differ in nature from NSSI in the typically developing populations: they occur in front of others without attempts to disguise them, being most commonly associated with intellectual disability and severe receptive and expressive language deficits.”
From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [13]
Sensory differences in autism are associated with ritualistic and repetitive behaviours including self-injury, and are the strongest predictors of self-injury.
“Importantly, sensory differences in autism are associated with ritualistic and repetitive behaviours including self-injury [49], and are even the strongest predictors of self-injury [13].”
From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [13]
Self-injurious behaviour in ASC is conceptualised differently than NSSI in the general population, as primarily a restricted and repetitive behaviour characteristic of ASC.
“For example, self-injurious behaviour in ASC [34] is conceptualised rather differently than NSSI in the general population, as primarily a restricted and repetitive behaviour characteristic of ASC [35].”
From Risk markers for suicidality in autistic adults (2018) · cites this paper as [34]
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- Authors
- Duerden, E. G., Oatley, H. K., Mak-Fan, K. M., McGrath, P. A., Taylor, M. J., Szatmari, P., & Roberts, S. W.
- Affiliations
- Hospital for Sick Children (CA)
- University of Toronto (CA)
- Holland Bloorview Kids Rehabilitation Hospital (CA)
- Corresponding author
- Duerden, Emma G.
- Venue
- Journal of Autism and Developmental Disorders
- Published
- 2012-03-16
- Volume
- 42
- Issue
- 11
- Pages
- 2460-2470
- ISSN
- 0162-3257 (ISSN-L)
- 1573-3432
- OpenAlex
- W2146221612
- Cited by
- 198
- References
- 78
- Citations by year
- 2026: 8 · 2025: 16 · 2024: 11 · 2023: 27 · 2022: 11 · 2021: 18 · 2020: 17 · 2019: 17 · 2018: 14 · 2017: 12 · 2016: 13 · 2015: 9 · 2014: 14 · 2013: 8 · 2012: 3
- FWCI
- 5.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Autism and Developmental Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- self-harm, autism spectrum disorder, risk factors, sensory processing, sameness, cognitive ability, social functioning, functional communication, children and adolescents
- MeSH terms
- Adolescent, Child, Child Development Disorders, Pervasive, Child, Preschool, Cognition, Female, Humans, Male, Risk Factors, Sensation, Severity of Illness Index, Self-Injurious Behavior, Young Adult, Pain Perception
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