Self-injurious behaviour is a common yet serious issue that is prevalent amongst children with autism spectrum disorder (ASD). Such behaviours of self-injury may be in the form of small actions, like pinching, skin picking, nibbling and biting themselves. Larger and more extreme actions, like head-banging, hair-pulling, scratching and, slapping themselves, may also be observable.
All other non-lethal forms of intentional self-harm that have not been listed above should also be considered along the same vein, and tended to with the same degree of urgency and care.
While it is not all that odd for babies and toddlers to engage in some form of self-injurious behaviour—especially during temper tantrums—most of them eventually outgrow such tendencies as they learn to better express their feelings and frustrations. However, when it comes to children with autism, delays and difficulties in communication skill development can hinder progress in this regard. Sometimes, these delays and difficulties may also be part of the reason that they are frustrated and the only way they can vent their frustrations may be through such self-injurious actions.
About one in every four children with autism display some form of self-injurious behaviour. Parents of children with ASD should thus keep a keen eye out for any signs of self-harm in case the behaviour itself goes unnoticed — bruising, bite marks, cuts, scratches, hair loss, and wounds that do not heal are typical warning signs that must not be ignored.
Why Autistic Meltdowns and Tantrums Can Trigger Self-Injurious Behaviour
Self-injurious behaviour in children with autism may occur for various reasons. It may be used as a coping mechanism for children with autism or react to situations or outcomes they feel they otherwise have no control over. Some other reasons why children with autism engage in self-injurious behaviour during autistic meltdowns and tantrums include:
To regulate emotions
To increase or decrease sensory stimulation
To self-punish for perceived wrongdoings
To attempt expression or social communication
To receive benefits from positive reinforcement acheived from past outcomesprevious experiences
The lattermost reason is likely fuelled by unintentional actions on the parents’ parts—for example, handing your child their favourite toy or immediately removing them from overstimulating environments when they display self-injurious behaviour. By recognising and understanding these behaviours, it may help parents to rectify the unintentional reinforcements of the behaviour in future instances.
As for the remaining aforementioned reasons for self-injurious behaviour in children with autism, there are three ways you can help cull your child’s tendency for non-suicidal self-injury.
What to Do When Your Child with Autism Engages in Self-Injury
Before going into the three methods proper, it is essential that parents understand the need for causal identification when dealing with self-injurious behaviour in children with autism. The best approach to eliminating self-injurious behaviour is to remove the roots and triggers that prelude to such episodes.
Early intervention schools in Singapore and speech therapy for children are some of the avenues that can help alleviate your child’s inclination towards self-injury, but it is likely to be a slow yet steady process. In the meantime, knowing how to help your child at home can make a world of difference for your child’s safety and development:
1. Review Your Child’s Schedule
Reviewing and tweaking the schedule of a child with autism to avoid, minimise or rearrange challenging portions of their day is a great place to start. Manipulation of sleep schedules, particularly, has been proven to be extremely effective. This can take the form of an afternoon nap after a night of reduced sleep, or a faded bedtime routine to decrease instances of night-time awakenings that can result in disrupted rest.
As much as possible, try to avoid scheduling stress-inducing activities one after the other — ie. scheduling a full morning of school followed directly by a series of enrichment classes and therapy sessions all within one day. Iit is best to space these activities out by inserting activities in-between that your child with autism is more comfortable with.
Written or pictorial schedules should also be made available and accessible to your child with autism to help reduce their stress and anxiety. Seeing and interacting with such visual schedules can provide a tangible support for reminders to pre-empt them for the next activity and make the day less uncertain for them.
Just remember that once you have a schedule that works, stop making changes and ket your child get accustomed to them.
2. Presenting Demands Differently
Learning to present your demands differently to your child with autism may be an important step to prevent self-injurious behaviour as an attempt to escape from said demands. These demands can range from academic tasks to social interactions, to even behaviours while doing daily activities such as toileting and dressing.
Spacing out difficult demands with simple demands in between may help your child be more receptive to completing what is asked of them. You parents can also leverage on the likes of the Embedded Instruction Method to alter methods of demand presentation for higher likelihood of comfortable compliance. For instance, if your child with autism enjoys dancing but dislikes getting dressed or undressed, you can create a dance routine out of the latter by putting on some music and teaching them the required actions of dressing and undressing as dance steps instead.
3. Reinforcement-Based Intervention
Lastly, the third most important thing you can do for your child to help them stave off self-injurious behaviour is to provide positive reinforcement for displaying other forms of communication instead of self-injury, or for being able to have extended periods of time with reduced self-injury occurrences.
Providing positive reinforcement for positive behaviour while introducing replacement skills or actions that can be used in place of self-injury can significantly reduce—and, in time, even eliminate—self-injurious behaviour in children with autism. Likewise, any unintentional reinforcement of self-harming behaviour should be eliminated immediately to discourage continuation.
The Need for Early Intervention and Child Therapy
As previously addressed, self-injurious behaviour in children with autism may stem from a variety of reasons including delays and difficulties in communication skill development. As such, help from certified professionals are not only recommended, but a requisite to extinguishing self-injurious behaviour in most cases.
MindChamps Allied Care offers speech therapy for kids in Singapore, along with early intervention programmes that incorporate an environment and trained teachers who understand principles used in child therapy and educational support. We also believe in a holistic approach when helping children with developmental delays, and will work with you to cultivate successful communication skills and facilitate your child’s emotional regulation by sharing teaching strategies that can be extended to your home. You can look forward to continual updates and feedback on your child’s progress and improvements at our early intervention school.
Find a MindChamps Allied Care child therapy centre near you today, and book an appointment with us to find out more.