Prospective Characterisation of Age-Related Changes in Self-Injurious Behaviour in a Sample of Children With Global Developmental Delay Aged 2-12 Years.

The sample size for adolescents (over age 12) was small, making the observed increases in SIB during this period less certain. Data was collected via caregiver report, which is susceptible to bias and error in recall or interpretation of behaviours. The RBS-EC measures frequency but not severity or tissue damage, making it difficult to distinguish between mild self-directed behaviours and severe self-injury. Information on concurrent treatments or support services was not collected, so the effect of interventions on SIB trajectories could not be determined. Many participants were recruited during the COVID-19 pandemic, which may have influenced behaviour patterns. The sample was predominantly male and largely consisted of children with idiopathic autism, limiting generalisability to other genetic syndromes or female populations.

The authors declare no conflicts of interest.

Do not assume that self-injurious behaviour decreases with age. While total scores may dip in early childhood for some groups, interference with daily life increases with age for children with no or mild intellectual disability, and specific behaviours like skin picking peak near adolescence.