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Psychosocial and behavioural factors associated with self injurious behaviour (SIB) in individuals with autism spectrum disorders (ASD)

Highlights•Adaptive functioning, communication, IQ, sleep, sensory processing, impulsivity and over-activity are associated with SIB.•MDTs should be utilised to provide early assessment and differential treatments.•Longitudinal designs are needed to explore SIB in ASD populations over the lifespan.AbstractBackgroundSelf-injurious behaviour (SIB) is a persistent and distressing difficulty which may be more prevalent and enduring for individuals with an Autism Spectrum Disorder (ASD). SIB has been largely conceptualised in research as a challenging behaviour or a repetitive and restricted behaviour, rather than a unique construct to research. As its own construct, the aetiology of SIB has been conceptualised from a neurobiological perspective, however there remains a need to explore psychosocial and behavioural factors associated with SIB and ASD. A review was conducted to compile evidence and establish current understanding of this behaviour.Method6 databases were systematically searched for research exploring factors relating specifically to SIB limited to ASD populations. Studies were critically appraised using a tool developed for the purpose of this review, adapted from the CASP, AXIS and STROBE quality appraisal tools.Results15 studies met the eligibility criteria. SIB was found to be associated with impairments in adaptive ability, communicative ability, IQ, sleep, atypical sensory processing, and impulsivity/over-activity. There were mixed findings supporting an association between autism severity and self-injury.ConclusionsThe development of SIB in ASD populations is complex. The range of factors associated with SIB and ASD imply a clinical need for a robust assessment and a multi-disciplinary approach to intervention. Theoretical perspectives regarding the role of impaired behavioural inhibition, communication, and sensory processing difficulties are considered. Limitations and future research are discussed.

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