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Self-Injurious Behavior in Children With Autism


Children with ASD often engage in self-destructive behavior (SIB). According to recent study, 20% to 50% of kids with ASD also experience SIB, which is one of the most prevalent and severe behavioral problems (Kuhn & Triggs, 2009). For people with ASD and their families, SIB may have devastating effects, lead to social isolation, and reduce quality of life. Therefore, it is important to comprehend, prevent, and treat SIB in kids with ASD. SIB caused by autism has several causes and risk factors. Neurochemical imbalances and genetic factors may have a role. SIB may also result from traumatic or stressful circumstances. SIB may be a result of communication and emotional management problems. Children with ASD who are SIB-engaged may receive a variety of therapies (Kuhn & Triggs, 2009). Behavioral treatments that are widely used include functional analysis and positive reinforcement. Antipsychotic medications might be beneficial. Some kids’ SIB may be decreased by music therapy and sensory integration. Their effectiveness varies. To locate the finest ones, further study is thus required. It has significant ramifications for both research and practice. SIB is complicated and variable in children with ASD, necessitating a more comprehensive strategy. 2009 (Kuhn & Triggs). Evidence-based therapies tailored to each child’s needs and improved communication between parents, educators, and healthcare professionals should be part of the plan. To identify the causes of SIB and create more efficient preventative and therapeutic measures, additional investigation is required. Autism-related self-injury will be covered in this capstone essay. The study of SIB literature and treatments aims to advance knowledge and provide useful suggestions for further study and use. By creating SIB treatments, the paper aims to improve the lives of autistic children and their families. Children with autism are increasingly being identified as engaging in self-harm. One of the most prevalent and severe behavioral problems, SIB affects 20%–50% of children with ASD (Kuhn & Triggs, 2009). Family members and caregivers may experience stress, mental pain, and even bodily injury as a result of the child’s conduct. Consequently, a lot of autistic kids suffer with self-harm. The best SIB treatments need more investigation. To address this behavior, parents, schools, and healthcare professionals must collaborate. We can enhance therapies and the quality of life for autistic children and their families by better understanding SIB in these kids. As a result, the study includes a concise assessment of six research on self-harming behavior in autistic children.

Summary Review

When an initial functional analysis identifies automatic reinforcement as the maintenance variable for self-injurious behavior (SIB) in autistic children, Kuhn and Triggs (2009) examine social factors. Automatic reinforcement was shown to be the sustaining variable for three autistic children taking part in SIB in the first functional study. Whether social factors support SIB was the subject of a second investigation (Kuhn & Triggs, 2009). The social analysis advised the therapist to commend the child for appropriate conduct. According to the study’s findings (Kuhn & Triggs, 2009), the social component decreased SIB for all three participants. Even while automatic reinforcement is the key factor that keeps SIB in place, social factors also play a role. The article clarifies SIB in autistic children and highlights the need for a comprehensive strategy to comprehend and handle it (Kuhn & Triggs, 2009). The research has an emphasis on several functional analyses and explores the role of social factors in SIB maintenance (Kuhn & Triggs, 2009). Thus, for children with autism, this may improve SIB outcomes.

In developmental disabilities, such as autism, Hagopian et al. (2015) identify and describe subtypes of self-injurious behavior (SIB) perpetuated by automatic reinforcement. The research (Hagopian et al., 2015) examined the literature on SIB and automatic reinforcement as well as data from 14 developmentally impaired persons who utilized SIB. The scientists identified three SIB subtypes that are sustained by automatic reinforcement: sensory, escape, and automatic positive reinforcement. Hand flapping and head pounding are examples of sensory SIB. Acts like beating oneself up to evade an obligation are examples of escape SIB. Pulling on one’s hair or picking at one’s skin are two instances of SIB. According to the study’s findings (Hagopian et al., 2015), the topography, frequency, and treatment responsiveness of the several automatic reinforcement-maintained SIB subtypes varied. In comparison to other groups, individuals with developmental challenges had a higher prevalence of sensory SIB and a worse response to therapy. The findings sheds light on the complex automatic reinforcement-maintained SIB in developmental disorders (Hagopian et al., 2015). To clarify its functions and methods, the authors divide automatic reinforcement-maintained SIB into subtypes. As a result, this information may be used to develop more effective SIB subtype-specific medicines.

The noncontingent delivery of random reinforcers to treat self-injurious behavior (SIB) in developmental disabilities, notably autism, is the subject of a 1997 research by Fischer et al. In order to treat four developmentally impaired people who were involved in SIB, Fischer et al. (1997) used non-contingent supply of requested goods and activities. In all four cases, the noncontingent administration of random reinforcers greatly decreased SIB. By providing alternative reinforcement, this strategy may reduce SIB motivation, according to researchers. The research (Fischer et al., 1997) underlines the need of functional analysis in determining SIB-maintaining factors prior to making an intervention decision. It’s possible that noncontingent distribution of random reinforcers won’t help those whose SIB is maintained by other factors, such as a desire to avoid obligations or attention. The research provides information on how to treat SIB in individuals with developmental disabilities using noncontingent arbitrary reinforcers (Fischer et al., 1997). According to Fischer et al. (1997), this approach would be a good addition to SIB therapy, but larger samples and additional demographic data are required to prove its effectiveness.

In their 2003 report, Kurtz et al. reviewed functional assessments and treatments for 30 young children with developmental disabilities, including autism, who engaged in self-injurious behavior (SIB). To determine SIB-maintaining factors and evaluate the effectiveness of the intervention, a multi-element technique was used. Functional evaluations, automated reinforcement, escape from demands-maintained SIB, and social reinforcement all support this. The authors claim that recognizing the sustaining properties of SIB therapy is necessary for their success (Kurtz et al., 2003). Testing was done on response blocking, noncontingent reinforcement, and differential reward of alternative behavior. Most people who received interventions had a reduction in SIB, albeit the most successful ones varied by keeping some factors constant. According to the authors (Kurtz et al., 2003), young children with developmental challenges need individualized, function-based SIB interventions. Functional analyses may potentially reveal the root causes of SIB and direct the selection of interventions. The research aids in diagnosing and treating SIB in young kids who are experiencing developmental issues (Kurtz et al., 2003). The results highlight the need for child-specific treatment modalities and suggest that function-based interventions may lessen SIB.

The adverse effects of extinction in the treatment of self-harming behavior (SIB) in developmental disorders, such as autism, are studied by Lerman et al. in 1999. Extinction is a common tactic for decreasing behavior by getting rid of its reinforcing effects. The research looked at how aggression and bursting might lead to extinction (Lerman et al., 1999). Bursting is a brief increase in the frequency or intensity of conduct, while aggression is any physical or verbal action intended to cause harm to another. According to the research, SIB extinction therapies led to an increase in bursting and aggression. Aggression was 80%, and bursting was 94%. According to the authors (Lerman et al., 1999), these adverse effects may make SIB extinction therapy less effective. According to Lerman et al. (1999), the research also looked at the intensity, bursting, and antagonism of SIBs. In those with severe SIB, bursts and hostile behavior during extinction therapy were more common. The research (Lerman et al., 1999) emphasizes the detrimental consequences of extinction on SIB therapy for developmental disabilities. Their usage may be limited by burst and aggression during extinction therapy. In order to develop SIB therapies with fewer side effects, the authors advise conducting a larger trial.

A case study on the identification and functional analysis of antecedent behavior to treat self-injurious behavior (SIB) in a kid with autism is presented by Dracobly & Smith (2012). The authors advise identifying and treating behavioral behaviors that might lead to SIB. A 5-year-old autistic boy who headbutted and hurt himself was the subject of research (Dracobly & Smith, 2012). The child’s SIB was maintained through automatic reinforcement, according to functional analysis. SIB was preceded by stereotyped hand flapping and pacing. As a result, they were recognized and addressed in the research (Dracobly & Smith, 2012). To address antecedent behaviors and lessen SIB, the authors used DRA and response blocking. DRA urged kids to grasp toys rather than headbang. Response blocking literally stopped the kid from hitting his head, preventing injury. According to the study’s findings (Dracobly & Smith, 2012), the treatment plan improved appropriate behavior while reducing SIB. The authors stress the importance of addressing antecedent behaviors in SIB therapy and suggest that this approach could be effective for others who have similar inclinations. The article clarifies SIB and preceding behaviors in autism. In order to address antecedent behaviors and lessen SIB, the case study places an emphasis on functional analyses and evidence-based interventions including DRA and response blocking (Dracobly & Smith, 2012). According to the authors, this method could have an effect on SIB therapy for developmental disabilities.

Summary of the Research Study

Self-injurious behavior (SIB) is challenging to address in children with autism spectrum disorder (ASD). The evaluation’s sources include the etiology, risk factors, functional analyses, and treatment options for SIB. Kuhn & Triggs 2009 investigated the social factors that influence SIB in children with ASD after initial functional analysis revealed that SIB is maintained by automatic reinforcement. Even when it is thought that behavior is being reinforced automatically, social factors like attention and financial possessions may have an impact. The automatic reinforcement-maintained SIB subtypes were studied by Hagopian et al. in 2015. They highlighted the significance of subtype identification for successful treatment and identified four subtypes: sensory, repetitive, ritualistic, and destructive. Fischer et al.’s 1997 study looked at employing non-contingent arbitrary reinforcers to treat SIB. In certain instances, this strategy minimized SIB. They advise combining it with other treatments, however. Functional analyses and SIB therapy were studied by Kurtz et al. (2003) in young ASD youngsters. The escape and attention-seeking functions of SIB were effectively addressed using function-based therapy. Extinction is a common SIB therapy. Lerman et al. (1999) assessed its detrimental consequences. The extinction makes people more aggressive and exhibit other unhelpful behaviors. It has to be properly implemented and monitored as a result. SIB therapy from precursor behavior identification and functional analysis was studied by Lerman et al. in 2012. They emphasized the need of applying a range of therapy modalities and recognizing antecedent behaviors that may signal SIB. These publications suggest a multifaceted strategy for treating SIB in children with ASD. After determining the purpose of the behavior, non-contingent reinforcement, extinction, and function-based interventions should be taken into consideration. To minimize side effects and optimize benefits, these medicines must be properly applied and monitored.


In conclusion, self-harm associated with autism is a challenging problem. Numerous factors and continued behavior might be harmful to the person and their family. The design of a SIB intervention seems to need the functional behavior assessment (FBA). Additionally, non-contingent reinforcement, differential rewarding of alternative behavior, and training in functional communication are all supported by the most recent studies in SIB therapy for autism. However, more research is required to comprehend SIB mechanisms and develop more potent treatments. Additionally, it’s critical to take into account moral dilemmas and negative outcomes such SIB bursts caused by extinction. In order to address self-injurious behavior in autistic children, healthcare professionals, educational institutions, and families must collaborate. Children with autism often engage in self-destructive behavior, which need prompt treatment. As a result, it has drawn increasing attention recently. The capstone study discovered that self-harming behavior associated with autism is complex and involves environmental, biological, and psychological factors. These studies also emphasized the significance of functional behavior assessment (FBA) in understanding the function of behavior and designing effective treatments. Functional communication training, non-contingent reward, and differential reinforcement of alternative conduct have all been shown to lessen self-harm in individuals with autism. However, SIB therapy for autism must be customized to meet the requirements of each patient. The development and use of medicines must be done in an ethical manner due to adverse effects including extinction-induced bursts of SIB. Families, educators, and healthcare professionals must collaborate. Treatment of self-injurious behavior in autistic children necessitates a multidisciplinary strategy that takes the person’s needs and autonomy into account. As a result, SIB in kids with autism is a complicated problem that calls for in-depth knowledge of the causes, the requirements of the person, and evidence-based remedies. Functional behavior evaluation, SIB in autism, and the effectiveness of various interventions have all been made clear by the study. To further understand SIB mechanisms and develop treatments, more research is nonetheless required.


Dracobly, J. D., & Smith, R. G. (2012). Progressing from identification and functional analysis of precursor behavior to treating self‐injurious behavior. Journal of Applied Behavior Analysis, 45(2), 361–374.

Fischer, S. M., Iwata, B. A., & Mazaleski, J. L. (1997). Noncontingent delivery of arbitrary reinforcers as a treatment for self‐injurious behavior. Journal of Applied Behavior Analysis, 30(2), 239-249.

Hagopian, L. P., Rooker, G. W., & Zarcone, J. R. (2015). Delineating subtypes of self‐injurious behavior maintained by automatic reinforcement. Journal of Applied Behavior Analysis, 48(3), 523-543.

Kuhn, S. A. C., & Triggs, M. (2009). Analysis of social variables when an initial functional analysis indicates automatic reinforcement as the maintaining variable for self‐injurious behavior. Journal of Applied Behavior Analysis, 42(3), 679–683.

Kurtz, P. F., Chin, M. D., Huete, J. M., Tarbox, R. S., O’Connor, J. T., Paclawskyj, T. R., & Rush, K. S. (2003). Functional analysis and treatment of self‐injurious behavior in young children: A summary of 30 cases. Journal of applied behavior analysis, 36(2), 205–219.

Lerman, D. C., Iwata, B. A., & Wallace, M. D. (1999). Side effects of extinction: Prevalence of bursting and aggression during the treatment of self‐injurious behavior. Journal of Applied Behavior Analysis, 32(1), 1–8.


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