Persistence and predictors of self-injurious behaviour in autism: a ten-year prospective cohort study.
Catherine Laverty, Chris Oliver, Jo Moss and 2 others
PMID 31988707WHAT IT FOUND
Self-injury persisted in 44% of autistic individuals over 10 years.
Impulsivity and overactivity measured in childhood predicted both persistent self-injury and self-restraint a decade later, identifying high-risk patients for early intervention.
Key findings
01Self-injury was persistent in 44% of individuals who displayed it at baseline, while it remitted in 56% over the 10-year period.
02High levels of impulsivity and overactivity at baseline significantly predicted the presence of self-injury 10 years later.
03Impulsivity and overactivity were the only behavioural variables that predicted self-injury both cross-sectionally and longitudinally.
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
High attrition rate: only 67 of 241 invited participants completed the study, and the final sample had significantly lower activity/impulsivity scores than those who declined, potentially biasing results. Small sample size limits the generalisability of statistical findings. The sample was disproportionately from higher socioeconomic backgrounds and highly educated families. Measures were not adapted for the ageing participants, which may affect the validity of some scores (e.g., SCQ) in older adolescents/adults. Self-restraint behaviours were recorded only as present/absent, without data on duration or severity.
Declared interests
Funded by Research Autism and Cerebra. The text does not specify if the funders designed the study or wrote the manuscript, only listing them as the funder.
The easy way to misread this
Do not assume that self-injury will naturally resolve for all patients. While 56% of the sample saw remission, 44% had persistent self-injury over 10 years, particularly those with high childhood impulsivity and overactivity. Additionally, the lack of significant service use differences suggests that current professional interventions may not be effectively targeting or reducing persistence in this cohort.