How to Manage and Prevent Self Injurious Behavior In Autism
Self-injurious behaviors (SIB) among individuals with autism spectrum disorder (ASD) present significant challenges for caregivers, educators, and therapists. These behaviors, which can range from head banging to self-biting, are complex and often require specialized approaches for effective management and support. This article aims to help you understand self injurious behavior in autism, how to effectively block unsafe behaviors, and manage self-injurious behaviors.
What Are Self-Injurious Behaviors?
Self injurious behavior in autism encompass a wide range of actions where individuals harm themselves intentionally. This can include hitting or banging their head with their hands, punching themselves, biting their hands or arms, or even more severe actions such as causing themselves concussion-level injuries. These behaviors are not limited to physical harm but may also include self-talk or repetitive actions that could be potentially harmful.
Interventions for Self Injurious Behavior in Autism
Addressing self injurious behavior in autism requires a comprehensive approach that integrates behavioral, environmental, and sometimes medical interventions. Here are some common strategies used:
Functional Behavior Assessment (FBA)
An Functional Behavior Assessment is a systematic process of gathering and analyzing data to determine the function or purpose of a specific behavior. The information gathered from a properly conducted FBA helps parents, educators, and therapists understand underlying causes of self injurious behavior in autism rather than just the symptoms. This leads to better planning of targeted interventions that fit each child’s unique needs.
Environmental Modifications
Set up an environment where the child is less likely to be stressed or triggered by unwanted sensory triggers. Even something simple such as rearranging the chairs in a room or setting up a detailed schedule for activities can have a positive impact on a child during their learning or therapy sessions.
Behavioral Interventions
Replacement Behaviors: Teaching and reinforcing alternative behaviors that serve the same function as SIB, such as using a stress ball or engaging in deep breathing exercises instead of hitting oneself.
Response Blocking: Intervening immediately to physically prevent or interrupt the occurrence of self injurious behavior in autism, followed by redirecting towards a more appropriate behavior.
Blocking Unsafe Behaviors
Response blocking is a punishment technique in ABA that works by physically intervening to prevent a child’s aggressive or unsafe behavior from occurring. Interrupting these behaviors before they can be completed may decrease the chance it happens in the future.
Goal: Maintain a safe environment and redirect learners towards appropriate behaviors.
Here is a step-by-step blocking strategy that can be used in response to an unsafe behavior such as elopement or aggression.
- Identify the Function: Understand why the unsafe behavior occurs (e.g., attention-seeking, escape from demands).
- Block the Unsafe Behavior: Intervene promptly to prevent harm or disruption. (Note: Only individuals trained in safe crisis management should physically intervene)
- Redirect to Replacement Behavior: Immediately guide the learner towards a more suitable alternative behavior that serves the same function as the unsafe behavior.
Do not confuse response blocking with kind extinction even if they have the same goal. Response blocking is a negative punishment technique, where a behavior (stimulus) is removed before anything happens from it. It is different from extinction, where the stimulus is allowed to happen but is not being responded to by any reinforcement.
Replacement Techniques
Blocking is only one part of a comprehensive behavior plan that includes reinforcement or replacement strategies to encourage appropriate behaviors. Differential Reinforcement of Other Behavior (DRO) and Differential Reinforcement of Alternative Behavior (DRA) are techniques used in behavior modification.
DRA focuses on teaching and strengthening a certain behavior to take the place of the disruptive or harmful behavior.
Example: A child often shouts to get attention. Instead, the child is taught to raise their hand to get attention. Everytime the child raises their hand instead of shouting, they receive a token or praise.
In contrast, DRO reinforces the absence of unwanted behavior for a specific period by rewarding periods during which it does not occur.
Example: A child frequently interrupts during class. The teacher sets a 5-minute interval during which the child must not interrupt. If the child does not interrupt during this time, they receive a token or praise. Over time, the interval is increased to encourage longer periods without interruptions.
Managing Self-Injurious Behaviors
The priority in managing self injurious behavior in autism is safety first. Before all else, we need to minimize self-harm and then redirect towards safer activities or coping mechanisms.
Here is an example of an strategic approach on managing SIBs like head-banging, self-biting, or other forms of self-injury that may occur in response to sensory or environmental triggers:
- Immediate Interruption – Act swiftly to interrupt the self-injurious behavior.
- Redirect to Alternative Behavior – Offer an alternative behavior that either fulfills the same sensory need or ensures immediate safety.
- Function-Based Approach – If the function of the behavior is known (e.g., sensory stimulation), redirect to a behavior that meets that same sensory need.
Remember that a thorough assessment must be conducted to understand the connection between a self-injurious behavior and autism. Identifying the triggers or deficits that lead to such behavior can help in creating an effective, long-term intervention plan.
Example scenario: A child begins head-banging after experiencing frustration. The therapist or educator interrupts the behavior, redirects the child to take deep breaths, and reinforces a calm and appropriate coping mechanism like squeezing a stress ball.
Supporting Individuals and Families
Supporting individuals with autism who engage in SIB requires a group effort from everyone involved, from their parent to their educators and caregivers.
- Be consistent. Behavioral strategies must be implemented consistently at home, school, and in the therapy clinic to lessen the occurrence predictability and reduces the likelihood of self-injurious behavior in autism.
- Education and Training: Make sure that caregivers and educators are trained in recognizing triggers and implementing effective interventions.
- Family Involvement: Engaging families in understanding and supporting interventions at home, thereby promoting consistency and reinforcement across different environments.
Addressing self injurious behavior in autism requires proactive planning, immediate intervention, and ongoing assessment in ABA settings.
Our BCBAs here at Ujala Life are trained how to manage self injurious behavior in autism and blocking unsafe behavior. However, our main focus is to provide naturalistic, compassion-based ABA therapy services that emphasize empathy, kindness, and understanding towards children with special needs. Contact us for more information about our services near Union, NJ.
