Many With Autism Engage in SIBs. But What Are They, and What Can Be Done to Help?A. Stout
Head-banging. Self-biting. Excessive skin-picking and scratching. These are all examples of self-injurious behaviors, or SIBs.
SIBs are common among individuals with autism, but for parents and other onlookers, they can be incredibly scary. Many parents, caregivers, and other loved ones worry about the individual’s potential to cause serious damage. If your loved one exhibits SIBs, read on to learn more—from understanding what purpose they serve to getting ideas on how to handle and protect your loved one from self-harm.
People on the spectrum may engage in SIBs for a variety of reasons, including but not limited to the following:
1. Sensory Overload (or Underload)
Many autistic people feel that the only way to alleviate the screaming within their heads is to physically hurt themselves. The reason why is understandable: pain is a huge distraction. It demands to be felt. Pain indicates something is not right, so pain takes center stage in terms of sensory input.
Alternatively, individuals on the spectrum may be aching for some kind of sensory input, and pain is, needless to say, a very significant way to get that input, as harmful as it may be.
2. Medical Issues
Sometimes if an autistic person is experiencing pain in one area of their body, they may harm themselves to cope or draw attention away from that pain. This is a big one that is easy to miss and should be the first cause to investigate; if your child or loved one starts engaging in self-injurious behavior, they may have a physical issue that they are not able to communicate. One autistic girl, for example, would incessantly bang her head against the wall. After three years, the family finally figured out that she had a severe case of head lice that was causing her immense pain. When they took care of the louse, the behavior stopped.
If your child figures out that they can get you right to their side if they start hurting themselves, they might engage in that behavior when they want to get your attention or communicate with you. Sometimes they may not have the words to express what they’re thinking or feeling, so they will self-injure as a form of communication.
In some cases, children will engage in self-injurious behaviors if they find that doing such things get them out of things they don’t want to do. They may also self-injure in order to gain something, whether that’s attention or another reward of some sort.
What to Do During SIBs
First and foremost, stay calm. Easier said than done, I know. But if you react by shouting, punishing, or scolding your child, it’s likely going to make things even worse.
Second of all, if there is an identifiable and removable trigger—a scratchy tag on the back of a shirt, a loud environment, too much visual input, etc.—remove the trigger. Take off the article of clothing or leave the area that is causing the child to feel overwhelmed. This may seem fairly obvious, but it’s still worth mentioning.
Third, try to redirect the behavior into something that will provide strong sensory stimulation but will not be dangerous. It may take some trial and error to figure out what works best, but examples you might try include listening to loud music, deep pressure, holding an ice cube, touching a vibrating massager to the chest or face, or spinning or swinging.
If your child is not engaging in SIBs out of sensory overload or underload, you may consider taking different steps or modifying the ones above. For example, if you suspect a medical issue is present, you might work with them to help them communicate about their pain and where on their body they are hurting. This may include pointing to somewhere on the body or using a form of AAC.
If your child is engaging in SIBs to get something they want, do your best to ignore their behavior, unless it is a danger to themselves. If so, handle it as best you can calmly and without reinforcing the behavior in any way (i.e. pay little attention to them, don’t let them get out of something they don’t want to do, or don’t give them what they want). Then provide a more positive way to express themselves and reinforce their behavior when they use it. You’ll likely want to work with your child’s therapist on this.
Ways to Prevent SIBs
Identify and avoid triggers. This solution, while fairly obvious, is a super important way to prevent SIBs. Look at what happens before they engage in SIBs. Are there any patterns? Does there seem to be a cause of some sort? Does the child present any warning signs, such as screwing up their face or pulling their hair, before the self-injury starts? If you can find any patterns and figure out what the triggers are, you can work to avoid them. And recognizing signs that SIBs are about to happen can allow you to intervene before things escalate.
Provide functional communication. If SIBs are a way your child communicates, it’s important to give them an alternative and healthier mode of communication so that they will not feel the need to hurt themselves in order to communicate. This could include just about any form of verbal communication or AAC like PECS, sign language, gestures, etc.
Work with your child’s therapist. Ultimately, your child’s therapist is the number one source you should be turning to in figuring out how to prevent and deal with SIBs. They will be able to give you individualized advice and will be able to work with you and your child on a personal level.
Want to learn more?
Check out the next page to see how a teacher managed to curb her student’s self-injurious behaviors.