Factors Associated with Self-Injurious Behaviors in Children with Autism Spectrum Disorder: Findings from Two Large National Samples.
G N Soke, S A Rosenberg, R F Hamman and 9 others
PMID 27830427WHAT IT FOUND
Self-injury in children with autism is linked to sleep problems, sensory issues, aggression, anxiety, and lower adaptive skills.
It is also associated with younger age and lower socioeconomic status. These findings support asking about self-injury when these other behaviors or factors are present.
Key findings
01Self-injurious behaviors were significantly associated with impairment in adaptive behavior, developmental regression, maladaptive behaviors (aggression, hyperactivity, anxiety), sleep problems, and sensory processing abnormalities.
02In the clinic-based sample, self-injury was associated with younger age, lower maternal education, and public insurance, but not with gastrointestinal problems, autism severity, or parental age.
03Self-injury was not significantly associated with child sex or race/ethnicity in either dataset.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The cross-sectional design cannot determine causality or temporal relationships between SIB and associated factors. Selection bias is possible because the AS-ATN sample required English fluency and access to specialized care, and ADDM sites were not nationally representative. Many variables were only available in one dataset, limiting direct comparison. SIB ascertainment differed between datasets (records vs. parental report), which may affect consistency. Multiple testing was not adjusted for, increasing the risk of false positives. Key factors like perinatal history, environmental toxins, and specific interventions received were not available in the data.
Declared interests
The study used data from the Autism Speaks-Autism Treatment Network (AS-ATN) and the CDC's ADDM Network. Autism Speaks is a major funder and organizer of the AS-ATN registry. The text does not declare specific individual financial conflicts of interest for the authors, but the reliance on industry-affiliated data sources is noted.
The easy way to misread this
Do not interpret these associations as evidence that treating sleep or sensory issues will stop self-injury. The study is cross-sectional and cannot prove that these factors cause SIB or that addressing them will resolve it.