OTSLPQualitativeAutism : the international journal of research and practice2025

(Re)thinking about self-harm and autism: Findings from an online qualitative study on self-harm in autistic adults.

Sarah Je Marsden, Rachael Eastham, Alexandra Kaley

PMID 39229884

WHAT IT FOUND

Autistic adults in online forums described self-harm as tied to sensory overload, meltdowns, and harmful stimming, not only conventional cutting.

They said professionals misread their communication, making help-seeking unsafe.

Key findings

01Hitting during overload and stimming within self-harm threads were described by forum participants.

02Participants described barriers to seeking help, including professionals lacking autism knowledge, misdiagnoses, and feeling dismissed.

03Online peers offered empathy and practical suggestions, such as substituting pain with an elastic band, ice, or hot wax.

STILL TO COME

How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs

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What it does not show

The study did not report the number of participants or threads analysed. It used only public forum posts, so people without technology access or who did not post were not represented. Demographic information was not available, so the findings cannot show how age, gender, location, or co-occurring conditions may have shaped experience. No verbatim quotes were used, so readers cannot check the exact wording of participants. The researcher identified as autistic and may have been drawn to accounts that resonated with their own experience. Findings are themes about experience, not evidence that any treatment works. The study could not separate autism traits from trauma, anxiety, depression, service failures, or other causes. The researcher's insider perspective and lack of member checking may have shaped the themes.

Declared interests

The authors declared no potential conflicts of interest and received no financial support.

The easy way to misread this

Do not read the online support strategies as tested interventions. The study reports forum experiences, not outcomes, and cannot show that any strategy reduces self-harm.

Read it on PubMed →