A Compassionate Guide to Understanding and Addressing Self-Harm in Autistic Children
Children with autism spectrum disorder (ASD) can sometimes engage in self-harming behaviors. For caregivers, reducing these behaviors is understandably a top priority.
Defining Self-Harm in Autistic Children
Self-harm, or self-injury, may include actions like head-banging, biting, scratching cutting, or hitting. These behaviors can be alarming. It’s important to keep in mind that there’s a reason why these behaviors are happening. They may be a form of communication or a coping strategy for your child [1].
Understanding Why Autistic Children Might Self-Harm
Autistic children may resort to self-harm for various reasons, often linked to their unique sensory experiences, communication challenges, or difficulties in emotion regulation:
Sensory Regulation: Some autistic children experience the world more intensely. Self-harm may be a way to cope with overwhelming sensory input or to generate sensory stimulation [2].
Communication: For non-vocal or minimally vocal autistic children, self-harming behaviors might be their way of expressing frustration, discomfort, or other intense emotions [3].
Emotion Regulation: Autistic children often struggle with identifying and managing their emotions. Self-harm can sometimes be a response to distressing emotions or situations [4].
Recognizing and Addressing Self-Harm
Self-harm is evident when caregivers witness the behavior, but some children may self-harm in private and the signs may not be as noticeable. Some signs for caregivers to watch out for include unexplained injuries like bruises, cuts, or burns, frequent bandages, an unusual insistence on wearing long-sleeved clothes in hot weather, and social withdrawal or increased isolation [5]. If you notice these signs, you can help to reduce future incidents by:
Seeking Professional Help: A mental health professional, such as a child psychologist or behavioral therapist, can provide strategies and techniques to reduce self-harming behavior and improve emotion regulation [6].
Creating a Safe Environment: Ensure your child's environment is safe and minimize access to objects that could be used for self-harm.
Developing New Communication Strategies: Work with a speech and language therapist to help your child develop more effective communication methods [7].
Exploring a Sensory Diet: Occupational therapists and other therapists who support sensory processing can create a "sensory diet,” which is a tailored set of activities that can provide the sensory input your child needs in safe and healthy ways [8].
When to Seek Immediate Help
If your child's self-harming behavior escalates, or if they are in immediate danger, seek professional help immediately. Contact your healthcare provider, local emergency services, or a crisis hotline. Remember, you're not alone, and there are professionals trained to handle these situations.
Navigating self-harm in autistic children is complex and challenging, but with understanding, compassion, and the right support, you can help your child reduce these behaviors. Prioritize your child’s safety, advocate for their needs, and remember you don’t have to navigate the journey alone.
References
[1] Minshawi, N. F., Hurwitz, S., Morriss, D., & McDougle, C. J. (2015). Multidisciplinary assessment and treatment of self-injurious behavior in autism spectrum disorder and intellectual disability: integration of psychological and biological theory and approach. Journal of Autism and Developmental Disorders, 45(6), 1541–1568. DOI: 10.1007/s10803-014-2307-3
[2] Kern, J. K., Trivedi, M. H., Garver, C. R., Grannemann, B. D., Andrews, A. A., Savla, J. S., Johnson, D. G., Mehta, J. A., & Schroeder, J. L. (2006). The pattern of sensory processing abnormalities in autism. Autism, 10(5), 480–494. https://doi.org/10.1177/1362361306066564
[3] Mirenda, P., Smith, I. M., Vaillancourt, T., Georgiades, S., Duku, E., Szatmari, P., Bryson, S., Fombonne, E., Roberts, W., Volden, J., Waddell, C., & Zwaigenbaum, L. (2010). Validating the Repetitive Behavior Scale-revised in young children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 40(12), 1521–1530. https://doi.org/10.1007/s10803-010-1012-0
[4] Jahromi, L. B., Meek, S. E., & Ober-Reynolds, S. (2012). Emotion regulation in the context of frustration in children with high functioning autism and their typical peers. Journal of Child Psychology and Psychiatry, 53(12), 1250–1258. https://doi.org/10.1111/j.1469-7610.2012.02560.x
[5] Duerden, E. G., Oatley, H. K., Mak-Fan, K. M., McGrath, P. A., Taylor, M. J., Szatmari, P., & Roberts, S. W. (2012). Risk factors associated with self-injurious behaviors in children and adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(11), 2460–2470. https://doi.org/10.1007/s10803-012-1497-9
[6] Minshawi, N. F., & Hurwitz, S. (2016). The ties that bind: A network approach to understanding comorbidity among developmental disorders. Journal of Developmental & Behavioral Pediatrics, 37(8), 639–645. https://doi.org/10.1097/DBP.0000000000000339
[7] Paul, R., & Sutherland, D. (2005). Enhancing early language in children with autism spectrum disorders. In: Charman, T., & Stone, W. (eds.) Social and communication development in autism spectrum disorders: Early identification, diagnosis, and intervention. The Guilford Press, pp. 112–142.
[8] Case-Smith, J., Weaver, L. L., & Fristad, M. A. (2015). A systematic review of sensory processing interventions for children with autism spectrum disorders. Autism
