Autism Therapy: self injury

definition of self injury: Behavior or action that results in harm to oneself. Examples of self-injurious behavior include biting, head banging, and cutting.

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Behavior Interventions, by Soares, DA, Vannest KJ, and Harrison J., published in 2009, summarized Dec 16, 2009

Using a computer to keep track of academic success may help reduce self-injury and other unwanted behaviors in children with autism.

This case study described success for one adolescent (13 years old) with Asperger’s syndrome who used a computer as positive reinforcement. The boy kept a record of his own success at completing school tasks. The boy completed more tasks and had less self-injury behavior and fewer tantrums during the weeks that he used the computer system. When researchers stopped his use of the system, he again had tantrums, self-injury, and trouble completing tasks. The authors said that this system is a promising way to offer some independence and would be relatively easy to use in classrooms.


Research in Autism Spectrum Disorders, by Murphy, O., Healy O., and Leader G., published in 2009, summarized Nov 16, 2009

Self-injury behaviors in children with autism may be more intense in children with severe intellectual disability than in other children with autism.

This study asked whether self injury, aggressive, and stereotypy behaviors were more common in some groups of children with autism than others. The researchers tested age, gender, therapy interventions, and intellectual disabilities. Age and gender were not a factor. Children getting applied behavior analysis therapy (ABA) had aggressive behaviors more often than other children, but the authors think that might be because children with behavioral problems are more likely to get therapy. Children with severe intellectual disabilities had more intense self-injury behaviors than other children with autism.


CNS Drugs, by Masi, G., Cosenza A., Millepiedi S., Muratori F., Pari C., and Salvadori F., published in 2009, summarized Aug 25, 2009

Aripiprazole (Abilify®) may be helpful for children and adolescents with autism who have severe behavioral problems.

This article describes a study of 34 autism patients (4-15 years old) who had severe behavioral problems such as aggression, self injury, and hyperactivity. These patients were treated through a psychiatric hospital (inpatient or outpatient) because of their severe behavioral problems. Patients were treated with 3-13 mg/day of aripiprazole for at least 12 weeks. The authors tested skills and behaviors between 4-12 months after the start of treatment. Of all the patients in the study, 37% were much improved or very much improved, and 29% had no change or got worse. Side effects were agitation (27% of patients) and sleep problems (15% of patients).


European Child and Adolescent Psychiatry, by Wachtel, LE, Contrucci_Kuhn SA, Griffin M., Thompson A., Dhossche DM, and Reti IM, published in 2009, summarized Jul 15, 2009

Electroconvulsive therapy reduced severe self-injury behavior in a boy with autism, allowing him to attend school.

This case study reported electroconvulsive therapy (ECT) for an 8-year-old boy with autism, mental retardation, mood swings, and extreme self-injury behavior. He was trying to hurt himself an average of 109 times per hour. Applied behavior analysis (ABA) therapy and drug therapy did not work. He had to stay in the hospital. He wore arm restraints with metal strips to limit where his arms could reach. And he wore full-body protective padding so he wouldn’t hurt himself. He was treated with ECT 3 times per week for 5 weeks. ECT therapy is a medical procedure that uses a brief electric current to the brain in a closely-monitored medical setting under full anesthesia. Doctors also use neuromuscular blockade (temporary full relaxation of muscles) during the procedure. After 5 weeks of ECT, he no longer needed restraints and protective padding. This child was able to return home after 2 years in a hospital, attend school and learn for the first time, and also participate in meaningful family life. The authors said this was the first report of successful ECT for self-injury behavior. They recommended that doctors consider ECT when other therapies don’t work.


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One parent's story of success

Oct 26, 2006 by Anonymous

My daughter Katie was diagnosed with PDD-NOS when she was 26 months. A follow-up visit to a Developmental Pediatrician suggested a move to the diagnoses of Autism as she fit the DSM-IV criteria. The suggestion was that it would also be easier for me to get appropriate services for my daughter, in which case she was very correct.

Our story is long as most of us who experience this diagnosis and I won't get into the advocacy and struggles we encountered along the way. When Katie was diagnosed my research confirmed that an ABA type approach would most likely produce the best results. I understood that the most benefit would be made if we began early. And I understood that we needed a program that involved my daughter in 30+ hours of intervention.

We relocated rather then continue to debate approaches with our EI team. We enrolled our daughter in the Margaret Murphy Center for Children in Lewiston, Maine. They used an approach that follows the teaching's of ABA, an approach referred to as Verbal Behavioral Therapy, www.drcarbone.com.

Katie began at 32 months for 15 hours a week. She napped after that and I involved her in social activities in the afternoon. There were lots of drills and repetition, but within 2 months, the child who had no need for any expression of language, the child who made no requests, began using sign language. In 4 months she had 20 signs that she was using appropriately.

When she turned 3 Katie qualified for 30 hours of ABA. Three was a tough age. As Katie became more a part of the world and wanted more from it, she also tantrumed more and appeared even more "autistic" to me. We observed an increase in stereopathy, she started flapping, and her tantrums sometimes involved self-injurious behavior. I expressed my concerns during this time. The team adjusted Katie's program and gave her more flexibility which resulted in improved behavior.

Designing a program around a child's particular needs rather the keeping a program "by the book" is very possible and can still produce fabulous results. There are many misconceptions about ABA. Don't believe it, find out for yourself. I called different centers and spoke to parents. I observed and pick the location that I felt comfortable with. I had two other children so therapy in the home would not work for us.

I had difficulty figuring out how to support Katie at home, she wouldn't do for me what she would do at school. But then I'm the mom and decided to keep it that way. I found support from another agency that provided in-home support to children with significant disabilities. We trained her at Katie's school. She played with Katie in the afternoon while I engaged my other children and prepared dinner.

I enrolled Katie in Gymnastics, swim lessons and attended a church with a Sunday School program so she could be with typical peers her own age.

All of these steps were critical in determining Katie's readiness for preschool part-time while continuing her program.

Katie's language soared shortly after enrolling in a preschool program. There were concerns about the acceptance of Katie's behaviors by her peers. Her peers were fabulous, and a community began to be developed of people who understood Katie and accepted her for who she was.

Katie used to be happy playing alone, but now she would prefer to be among her friends more then anything else. Katie is a typical 5 year old child in her kindergarten class. She has many friends and goes on playdates. Another mother picks her up afterschool one day a week for a playdate and then takes her daughter and mine to gymnastics where I meet them after my son's piano lessons. My girlfriend doesn't believe that Katie has autism and thinks it must have been a mistaken diagnosis. I chose not to tell her about what Katie looked like at three.

We no longer use formal ABA techniques. Katie is still working on fine tuning her social and communication skills. But if you were to meet her and strike up a conversation, you would not notice her to be any different then any other child of her age. Katie's outlook is bright as a result of using ABA techniques to help address her autism.



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  • Synonyms for self injury include: self injurious, self injurious behavior, self injurious behaviour, self-injurious, self-injurious behavior, self-injurious behaviour, self-injury
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