Understanding and Treating Self-Injurious Behavior in Developmental Disabilities

Introduction:

Self-injurious behavior is one of the most challenging issues faced by individuals with developmental disabilities. This blog aims to provide a comprehensive understanding of the causes of self-injurious behavior and suggest interventions based on these causes. We’ll explore various physiological and social factors that contribute to self-injury and delve into research to support these insights.

Functional Analysis:

Before delving into causes and interventions, conducting a functional analysis is crucial. This analysis involves gathering detailed information about the individual’s self-injury and its relationship with their physical and social environment. Key questions to address include who was present, what happened before, during, and after the behavior, when, and where it occurred. This data can uncover the reasons behind the behavior (Wacker, D. P., Northup, J., & Lambert, J. M., 1997).

Physiological Reasons:

Self-injurious behavior can be linked to various physiological factors, such as biochemical imbalances, seizures, genetic disorders, arousal levels, pain, and sensory sensitivity.

1. Biochemical Factors: Some individuals engage in self-injury due to changes in neurotransmitter levels in their brains. Low serotonin or high dopamine levels have been associated with self-injury. Nutritional and medical interventions, including dietary changes and vitamin supplements, can help normalize biochemistry.
   • Research: Herman, B. H., et al. (1989) observed the cessation of self-injury in an autistic boy through the use of drugs (Journal of Autism and Developmental Disorders).
2. Seizures: Self-injurious behavior can be linked to seizure activity in the frontal and temporal lobes. Identifying the connection between stressors and self-injury is crucial. Medical interventions and drugs may be necessary to control seizures.
   • Research: Gedye, A. (1992) discusses the connection between epilepsy and self-injury (Journal of Intellectual and Developmental Disability).
3. Genetic Factors: Genetic disorders like Lesch-Nyhan Syndrome, Fragile X Syndrome, and Cornelia de Lange Syndrome can lead to self-injury. Biochemical interventions, drugs, and behavioral modification techniques are often recommended.
   • Research: Harris, J. C. (1993) discusses self-injury in the context of neurodevelopmental disorders and genetics (Journal of Intellectual Disability Research).
4. Arousal: Some individuals self-injure to regulate their arousal levels. This could be a response to either under-arousal or over-arousal. Activities like exercise and relaxation techniques can help manage these levels.
   • Research: Baumeister, A. A., & Rollings, J. P. (1976) discuss the role of arousal in self-injury (Frontiers in Physiological Psychology).

Pain and Sensory Factors:

Self-injury can also be a way to manage or alleviate physical pain or sensory sensitivities. Dietary changes, supplements, and other interventions can be effective in these cases.

– **Research**: Gualtieri, C. T., et al. (1989) discuss etiological factors in self-injury, including pain (Psychiatric Clinics).

– **Research**: Rapp, D. J. (1991) addresses pain-related self-injury and its connection to sensory issues (American Journal on Mental Retardation).

Sensory Factors:

Excessive self-rubbing or scratching may be an extreme form of self-stimulation. The person may not feel normal levels of physical stimulation; and as a result, they damage the skin to receive stimulation or increase arousal.

– **Research**: Luiselli, J. K. (1990) discusses sensory extinction as a treatment for self-injurious behavior (Behavioral Interventions).

Social Causes:

In many cases, self-injury is a reaction to social triggers, often stemming from communication problems, the need for social attention, or the desire to obtain something, or to escape or avoid a situation.

1. Communication Issues: Poor receptive or expressive language skills can lead to frustration and, subsequently, self-injury. Teaching functional communication skills is key.
   • Research: Durand, V. M., & Cremmins, D. B. (1988) discuss functional communication training to reduce challenging behavior (Journal of Applied Behavior Analysis).
2. Social Attention: Self-injury can be a means of gaining social attention. Caregivers should employ strategies like ignoring the behavior when it is not harmful, and rewarding positive behavior.
   • Research: Carr, E. G., et al. (1976) discuss stimulus control of self-destructive behavior in response to social attention (Journal of Abnormal Child Psychology).
3. Obtaining Tangibles: Some individuals may resort to self-injury to obtain specific objects or events. Caregivers must ensure that self-injury is not rewarded with the desired item.
   • Research: Maisto, E., et al. (1978) report that individuals may engage in self-injury to obtain objects or events they want (Survey).
4. Avoidance/Escape: Self-injury can be an avoidance or escape tactic in response to aversive social interactions. Consistency in following through with requests or demands is crucial.

Conclusion:

Self-injurious behavior is a complex issue with a range of potential causes. Understanding the underlying reasons is paramount to developing effective interventions. A positive and proactive approach, focusing on understanding and addressing the unique needs of individuals with developmental disabilities, can lead to improved outcomes and a higher quality of life for those who engage in self-injurious behavior.

Incorporating insights from scientific research, we can work towards more effective strategies to address self-injurious behavior and improve the lives of individuals with developmental disabilities.

Research Credit : by Stephen M. Edelson, Ph.D. : Executive director of the Autism Research Institute.