Psychosocial and Behavioural Factors Associated with Self Injurious Behaviour (SIB) in Individuals with Autism Spectrum Disorders (ASD)

Background: Self-injurious behaviour (SIB) is a persistent and distressing difficulty which may be more prevalent and enduring for individuals with an Autism Spectrum Disorder (ASD). SIB has been largely conceptualised in research as a challenging behaviour or a repetitive and restricted behaviour, rather than a unique construct to research. As its own construct, the aetiology of SIB has been conceptualised from a neurobiological perspective, however there remains a need to explore psychosocial and behavioural factors associated with SIB and ASD. A review was conducted to compile evidence and establish current understanding of this behaviour.

Method: 6 databases were systematically searched for research exploring factors relating specifically to SIB limited to ASD populations. Studies were critically appraised using a tool developed for the purpose of this review, adapted from the CASP, AXIS and STROBE quality appraisal tools.

Results: 15 studies met the eligibility criteria. SIB was found to be associated with impairments in adaptive ability, communicative ability, IQ, sleep, atypical sensory processing, and impulsivity/ over-activity. There were mixed findings supporting an association between autism severity and self-injury.

Conclusions: The development of SIB in ASD populations is complex. The range of factors associated with SIB and ASD imply a clinical need for a robust assessment and a multi-disciplinary approach to intervention. Theoretical perspectives regarding the role of impaired behavioural inhibition, communication, and sensory processing difficulties are considered. Limitations and future research are discussed.

Keywords: Autism, ASD, Self-injurious Behaviour, Associations, Review