Abstract
BackgroundThere are few studies documenting the persistence of self-injury in individuals with autism spectrum disorder (ASD) and consequently limited data on behavioural and demographic characteristics associated with persistence. In this longitudinal study, we investigated self-injury in a cohort of individuals with ASD over 3 years to identify behavioural and demographic characteristics associated with persistence.MethodsCarers of 67 individuals with ASD (Median age of individuals with ASD in years = 13.5, Interquartile Range = 10.00–17.00), completed questionnaires relating to the presence and topography of self-injury at T1 and three years later at T2. Analyses were conducted to evaluate the persistence of self-injury and to evaluate the behavioural and demographic characteristics associated with persistence of self-injury.ResultsAt T2 self-injurious behaviour had persisted in 77.8 % of individuals. Behavioural correlates of being non-verbal, having lower ability and higher levels of overactivity, impulsivity and repetitive behaviour, were associated with self-injury at both time points. Risk markers of impulsivity (p = 0.021) and deficits in social interaction (p = 0.026) at T1 were associated with the persistence of self-injury over 3 years.ConclusionsImpulsivity and deficits in social interaction are associated with persistent self-injury in ASD and thus may act as behavioural risk markers. The identification of these risk markers evidences a role for behaviour dysregulation in the development and maintenance of self-injury. The findings have clinical implications for proactive intervention; these behavioural characteristics may be utilised to identify ‘at risk’ individuals for whom self-injury is likely to be persistent and therefore those individuals for whom early intervention may be most warranted.
Highlights
There are few studies documenting the persistence of self-injury in individuals with autism spectrum disorder (ASD) and limited data on behavioural and demographic characteristics associated with persistence
Changes in demographic and behavioural characteristics over time Prior to analysis, the demographic and behavioural characteristics of the sample included at T2 were compared to the demographic and behavioural characteristics of the same sample at T1. This was done in order to evaluate whether any changes had occurred in demographic and behavioural characteristics that may interact with the persistence of self-injury
The results revealed that the majority of variables that were associated with the presence of self-injury at T1 were associated with self-injury at T2
Summary
There are few studies documenting the persistence of self-injury in individuals with autism spectrum disorder (ASD) and limited data on behavioural and demographic characteristics associated with persistence. Self-injurious behaviour is common in autism spectrum disorder (ASD), with estimates ranging from 35 to 60 % [1,2,3,4,5]. These prevalence estimates are significantly higher than those reported for populations with intellectual disability of heterogeneous aetiology [6,7,8]. Estimates of the persistence of self-injury in individuals with intellectual disabilities vary considerably. The majority of studies demonstrate that self-injury can be persistent in individuals with
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