Autism and Self Injurious Behavior
I am returning to the school where I had taught for several years. Last week I saw a student that was there when I was a teacher. His new teacher did not know his history but had seen his behavior. When this student came to the school he had calluses on his hands. The calluses were from biting his hands. We decided to ignore his hand biting and work on his communication problems. Ignoring his hand biting was hard on us. We wanted to interfere and stop the hand biting. Doing this encouraged the hand biting to continue.
My feelings about hand biting are that the student realizes that it is improper for him to hurt other people. The student hurts the only person he feels he can hurt, himself. For this procedure to work he has to do it in front of an audience that cares. This student reverted to perform once for his new teacher. He started to bite his hand and to make sure he had her attention head butted the teacher. Ignoring the hand biting and self-hitting is hard to his audience and on the student. If you pretend not to care about his biting and hitting himself, the student will stop doing this self-injurious behavior.
There are two problems that have to be addressed when the student is biting his hand. What was happening immediately before he started biting and why did the student object to this occurrence. You then have to give the student a way to express his displeasure that does not involve self-injurious behavior. Hand signals, sign language, grunts or whatever you can get the student to do that gets your attention. You have to pay attention when he makes these gestures. You may have to explain to the student that he will have to participate even though he does not want to. You have acknowledged his position, and given him the opportunity to express his feelings.
This student no longer had calluses on his hands. His hands were absolutely smooth. He still has trouble communicating but his communication is working well enough that he no longer has to bite himself to express his displeasure.
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My son has severe autism and nonverbal (uses signs to communicate) and developed very high rates of SIB while in public school. We took him out of public school because they arrogantly said they knew the function of his SIB was only task avoidance and did not need to do an FBA. Months and many $$ later we paid for a Functional Analysis done by a PhD in behavior psych with expertise in autism behavior problems. The functions of his SIB were multiple: task avoidance, gain attention, gain or avoid sensory, request an item or event. Our expert wrote up a detailed BIP which the school refused to use. They later came up with a BIP that asked my son “what do you want?” after every SIB or aggression. They thought they should work on communication after he had a SIB instead of before. And when he could have something he asked for they told him “not now”. What do you think happened? His use of SIB to request skyrocketed and his SIB in general became uncountable.His use of sign language to request went down. As soon as we were able we put him a private autism school and went into debt to do so. We filed for due process and are waiting for our appeal to go before a real judge. After 2 yrs in private school his SIB is down to less than 1/hr. We don’t see it at home. The private school had a BIP that addressed the different functions of his behavior and they gave him functional communication and tolerance skills. He is back in public school and the jury is still out on how that is going. All this to say that every child with autism is different and no generalizations can or should be made by anyone. There are some definate don’ts though, like don’t ask a self injurious child what do they want everytime they self injure.
This post is SO not appropriate!
My son hurts himself badly,regardless if he has a “audience” or not.
Saying “ignore it” is NOT OK!!!
BAD advice!
Perhaps someday you will have a child w/ severe autism and SIB to RAISE
yeah. the kid i babysit does it a lot. but now that his wrists are calloused, he also tends to bite harder and doesn’t seem to realize or understand that doing so to other people hurts them. to be blunt, he’s very impatient and has a hard time understanding the concept of waiting or allowing others to rest before resuming an activity (such as jumping on the trampoline.) over the past month, he’s become more communicative and will now point to foods that he wants rather than biting his wrist, but SIB is still something his family and I have a difficult time preventing. often, what seems to work with my particular child when he is extremely frustrated is to label his emotions and then distract him. when he bites himself for reasons i can’t understand, i tend to ignore it unless he begins crying. it epic fails on my end because i have to take care of two other boys (his little brothers).
i also agree with the other xangans when they say that the solution offered in this post is a bit oversimplified. but i appreciate this tip b/c it’s definitely a wonderful starting point for people who need ideas on how to begin understanding and preventing SIB.
Thats rough, i dont know if i could just stand by and watch a child hurt themselves, even if it is a coping mechanism and even if acknowledging the behavior is encouraging it. Yikes.
I feel as though you are making a generalization here that this will work for all children with SIB. It won’t, I guarentee you… because it’s NOT that simple most of the time.
Sometimes you will never figure out what the trigger of the behaviour is, and sometimes you will never find a consequence that will work.
Some children don’t do this for attention or because something is wrong… like the man above me mention, sometimes they do it just to feel like they’re a part of the world (AND WHAT IS WRONG WITH THAT?)
To be completely honest most children with low functioning autism have a high pain tolerance and probably don’t realize HOW much the biting SHOULD hurt… so… despite it being hard for the other person to watch, if the child isn’t really being harmed by it… is it really a battle to fight with?
We were always taught to pick our battles wisely, and sometimes SIB is not the one to work on first.
There’s so many reasons for SIB and not all of them require behaviour modification. 🙂
I still bite my hands it helps bring me back into my body and gives me control over what is happening. I need to do it and it works, I really don’t care if it looks strange to other people. In over a 1/2 century I haven’t found a substitute.
I am glad to hear that the student no longer has the hand-biting issue. My little cousin used to bang his head against the wall when he did not like something or got frustrated. I remember the amount of times he bled from doing so. I was 5 years old and my memory of it minimal, but I do recall the head banging; it would scare me. Communication is so important; even for the smallest things. I would not think about biting myself to show irritation, but then again I know how to express myself verbally. It must be extremely frustrating not to be able to express feelings and desires. I write blogs on http://www.myspeechtherapycenter.com about communication wellness and awareness. I believe it is keen to spread the word and advise those who are not aware of the reality of autism and other language difficulties. Thank you for sharing this post!
As a teacher for children with autism, I see SIB all the time in many different forms. I agree that antecedent behavior must be observed before SIB, as well as the consequence after. There may be several different causes, whether it be avoidance of a situation or attention, etc. Communication is definitely key.
I also agree that some children with autism are very sensitive to stimuli, such as loud noises. Again, communication is the best, and hopefully an alternative opportunity is available instead of escalating the situation. 🙂
my brother has communicatio problems to. he gets frustrated alot. usually i know what he wants,or my mom knows.but its hard.
plz watch,i made this for a project i did on autism for school last year.
Quite an
oversimplification of a very complex problem.
This reminds me of
a teacher my son had a couple of years ago who although knew the
reason for my son’s behavior still insisted that he sit through a loud
school assembly which then had not only escalated the situation but also
reinforced that no matter whether he communicated or not to his
teacher, his hard fought efforts would be ignored.