Autism And Self Harm

Navigate the sensitive realm of autism and self-harm with empathy and understanding. Join us in shedding light on this complex issue, fostering conversations that break stigmas, and building a supportive community.

steven zauderer
Steven Zauderer
January 25, 2024
min read

Understanding Self-Injury in Autism

When it comes to autism, understanding self-injury is crucial for providing appropriate support and intervention. In this section, we will explore what self-injury entails and the prevalence of self-injury in individuals with autism.

What is Self-Injury?

Self-injury, also known as self-harm or self-mutilation, refers to the act of intentionally causing harm to oneself. Self-injury is not a characteristic of autism itself, but it can occur in individuals with autism as a way to cope with overwhelming emotions, sensory overload, or communication difficulties.

Self-injurious behaviors can take various forms, including but not limited to:

  • Head banging
  • Biting or scratching oneself
  • Hitting or slapping oneself
  • Pulling hair or eyelashes
  • Picking at skin or wounds
  • Inserting objects into the body

It is crucial to approach self-injury with empathy and understanding. It is not a behavior done with intent to manipulate or seek attention, but rather a complex manifestation of underlying challenges that individuals with autism may face.

person with band aid on middle finger

Prevalence of Self-Injury in Autism

Self-injury is relatively common among individuals with autism. Research studies have reported varying prevalence rates, but it is estimated that approximately 20-30% of individuals with autism engage in self-injurious behaviors. Severity and frequency of self-injury can vary greatly among individuals.

Understanding the prevalence of self-injury in autism highlights the need for effective strategies and interventions to address this challenging behavior. By gaining insight into the causes and triggers behind self-injury, caregivers and healthcare professionals can work together to develop appropriate support plans tailored to the unique needs of individuals with autism.

The next sections will delve deeper into the causes and triggers of self-injury in autism, as well as strategies for recognizing and managing self-injurious behaviors.

Causes and Triggers

Understanding the causes and triggers of self-injury in individuals with autism is crucial in developing effective strategies for management and support. Two key factors that contribute to self-injurious behaviors in autism are sensory overload and sensory seeking, as well as communication and emotional regulation challenges.

Sensory Overload and Sensory Seeking

For many individuals with autism, sensory processing difficulties can lead to self-injurious behaviors. Sensory overload occurs when an individual becomes overwhelmed by sensory stimuli from their environment. This can include sounds, lights, textures, or even certain smells. When faced with sensory overload, individuals with autism may engage in self-injury as a way to cope with the overwhelming sensations.

On the other hand, some individuals with autism may engage in self-injury as a form of sensory seeking. They may be seeking specific sensations, such as pressure or pain, as a way to regulate their sensory experiences. This can help them feel more grounded and in control.

Sensory overload and sensory seeking are not mutually exclusive. An individual with autism may experience both at different times or in different situations. Understanding these sensory experiences can aid in developing appropriate interventions and strategies to address self-injurious behaviors.

Communication and Emotional Regulation Challenges

Communication and emotional regulation challenges are also significant contributors to self-injurious behaviors in individuals with autism. Many individuals with autism have difficulty expressing their needs, wants, and emotions effectively. This communication challenge can lead to frustration, anxiety, and a feeling of being misunderstood.

Unable to express themselves verbally or through conventional means, some individuals with autism may resort to self-injury as a way to communicate their distress or seek attention. They may engage in self-injurious behaviors to express their pain, frustration, or even as a means to communicate a specific need.

Additionally, difficulties in emotional regulation can contribute to self-injury. Individuals with autism may struggle with regulating their emotions, leading to heightened emotional states and a lack of coping mechanisms. Self-injury may serve as a way to regulate or release overwhelming emotions.

By understanding the causes and triggers of self-injury in autism, caregivers, educators, and healthcare professionals can develop targeted approaches to support and manage self-injurious behaviors. It is important to work collaboratively with professionals to identify individualized strategies that address sensory needs, enhance communication skills, and promote emotional regulation.

Creating a supportive environment, implementing sensory regulation strategies, and providing effective communication and social skills training are essential steps in managing self-injury in individuals with autism.

Recognizing Self-Injurious Behaviors

Understanding and recognizing self-injurious behaviors in individuals with autism is crucial for providing appropriate support and intervention. It is important to be aware of the common forms of self-injury in autism and the signs and symptoms to watch out for.

Common Forms of Self-Injury in Autism

Self-injurious behaviors can manifest in various ways among individuals with autism. While the specific form of self-injury may vary from person to person, some common types include:

Form of Self-Injury and Description

  • Head Banging: Repetitive banging of the head against objects or surfaces.
  • Skin Picking or Scratching: Frequent picking or scratching of the skin, often resulting in wounds or sores.
  • Biting: Biting oneself or others, which can lead to injury.
  • Hair Pulling: Pulling out one's own hair, leading to hair loss or bald spots.
  • Hitting or Slapping: Striking oneself or others with hands or objects.
  • Pinching or Scratching: Pinching or scratching oneself, causing pain and potential injury.

Self-injury can vary greatly among individuals with autism, and some individuals may exhibit multiple forms of self-injurious behaviors.

Signs and Symptoms to Watch Out For

Recognizing the signs and symptoms of self-injurious behaviors in individuals with autism is crucial for early intervention and support. Some common signs to watch out for include:

  • Frequent or repetitive engagement in self-injurious behaviors.
  • Visible injuries, such as bruises, cuts, or bite marks.
  • Wearing long sleeves or pants even in warm weather to hide injuries.
  • Changes in behavior, such as increased agitation, anxiety, or withdrawal.
  • Vocalizations or expressions of distress during or after engaging in self-injurious behaviors.
  • Social isolation or difficulty interacting with others.

It is important to remember that every individual with autism is unique, and the signs and symptoms of self-injury can vary. If you suspect that someone may be engaging in self-injurious behaviors, it is essential to seek professional guidance and support to develop an appropriate intervention plan.

By recognizing and understanding the common forms of self-injury in autism and being vigilant for signs and symptoms, caregivers and support professionals can take necessary steps to provide appropriate intervention and support to individuals with autism.

Managing Self-Injury in Autism

When it comes to managing self-injury in individuals with autism, it is crucial to create a supportive environment, implement sensory regulation strategies, and provide communication and social skills training.

Creating a Supportive Environment

Creating a supportive environment is vital for individuals with autism who engage in self-injurious behaviors. Here are some strategies to consider:

  • Visual supports: Use visual supports such as schedules, social stories, and visual cues to help individuals with autism understand expectations and navigate daily routines.
  • Structured and predictable routines: Establishing structured and predictable routines can help individuals with autism feel more secure and reduce anxiety, which may contribute to self-injurious behaviors.
  • Positive reinforcement: Implement a system of positive reinforcement to encourage and reward desired behaviors. This can include verbal praise, tokens, or other preferred rewards that motivate the individual.
  • Safe and calming spaces: Designate a safe and calming space where the individual can retreat when feeling overwhelmed or agitated. This space should be equipped with sensory tools and activities that promote relaxation.

Sensory Regulation Strategies

Sensory regulation strategies can play a significant role in managing self-injurious behaviors in individuals with autism. Here are some effective strategies to consider:

  • Sensory diet: Develop a sensory diet that includes activities and exercises designed to meet the individual's sensory needs. This can involve providing sensory input through activities such as deep pressure, swinging, or using sensory tools like weighted blankets or fidget toys.
  • Environmental modifications: Make adjustments to the environment to minimize sensory triggers. This may involve reducing noise levels, providing appropriate lighting, and creating spaces where the individual can retreat to regulate their sensory input.
  • Visual supports: Utilize visual supports to help individuals with autism understand and anticipate sensory experiences. Visual schedules and cue cards can provide guidance and promote self-regulation.

Communication and Social Skills Training

Improving communication and social skills can be instrumental in managing self-injury in individuals with autism. Here are some approaches to consider:

  • Functional communication training: Teach alternative communication methods, such as the use of picture exchange systems, sign language, or augmentative and alternative communication (AAC) devices. This enables individuals with autism to express their needs and frustrations effectively.
  • Social skills training: Provide structured social skills training to help individuals with autism develop appropriate social behaviors and interactions. This can include teaching skills such as turn-taking, initiating and maintaining conversations, and understanding nonverbal cues.
  • Emotional regulation training: Teach individuals with autism strategies to identify and regulate their emotions effectively. This can involve providing coping strategies, such as deep breathing exercises or using visual supports to express emotions.

By creating a supportive environment, implementing sensory regulation strategies, and providing communication and social skills training, individuals with autism can be better equipped to manage self-injurious behaviors and lead fulfilling lives. It is important to work closely with professionals, caregivers, and educators to develop personalized strategies that address the unique needs of each individual.

Seeking Professional Help

When it comes to managing self-injury in autism, seeking professional help is an important step towards understanding and addressing the underlying causes and triggers. Collaborating with healthcare providers who specialize in autism can provide valuable guidance and support. There are several evidence-based interventions that can be utilized to help individuals with autism who engage in self-injurious behaviors. Let's explore some of these approaches.

Collaborating with Healthcare Providers

Collaborating with healthcare providers, such as doctors, psychologists, and psychiatrists, is crucial in developing an effective treatment plan for self-injury in autism. These professionals have the expertise to assess the individual's needs and guide the intervention process. They can also help identify any underlying medical conditions or mental health concerns that may contribute to self-injurious behaviors.

Healthcare providers will work closely with caregivers and individuals with autism to develop personalized strategies and interventions. This collaborative approach ensures that the treatment plan aligns with the unique needs and goals of the individual.

Applied Behavior Analysis (ABA)

Applied Behavior Analysis (ABA) is a widely recognized and evidence-based intervention for individuals with autism. ABA focuses on understanding and modifying behavior through systematic analysis and positive reinforcement. This approach can be effective in reducing self-injurious behaviors by teaching alternative and more adaptive ways to communicate and cope with challenging situations.

ABA programs are typically tailored to the specific needs of the individual and may involve interventions such as functional behavior assessments, skill-building exercises, and behavior management techniques. The involvement of a trained ABA therapist is crucial in implementing and monitoring progress throughout the intervention.

Occupational Therapy (OT)

Occupational therapy (OT) is another valuable intervention for individuals with autism who engage in self-injury. Occupational therapists are skilled at addressing sensory and motor challenges and can help individuals develop skills to enhance their daily functioning and overall quality of life.

In the context of self-injury, occupational therapy focuses on sensory regulation, self-soothing techniques, and the development of alternative coping strategies. Occupational therapists work closely with individuals with autism to identify triggers, develop sensory diets, and implement sensory integration techniques to manage self-injurious behaviors effectively.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a therapeutic approach that can be beneficial for individuals with autism who engage in self-injury. CBT aims to identify and modify negative thought patterns and behaviors by promoting self-awareness and teaching effective coping strategies.

CBT can help individuals with autism develop a better understanding of their emotions, thoughts, and behaviors, and learn alternative ways to manage stress and anxiety. It also provides a safe and supportive environment for individuals to explore and address the underlying causes of self-injury.

Seeking professional help and utilizing evidence-based interventions like ABA, OT, and CBT can significantly contribute to managing self-injury in autism. Collaborating with healthcare providers ensures that the intervention approaches are tailored to the individual's unique needs and promotes their overall well-being.

Support for Caregivers

Caring for a person with autism who engages in self-injury can be challenging and emotionally draining. It's important for caregivers to prioritize their own well-being and seek support to effectively manage the situation. Here are some essential strategies and resources to support caregivers of individuals with autism and self-injury.

Self-Care and Coping Strategies

Taking care of yourself is crucial when supporting a person with autism and self-injury. Practicing self-care and utilizing coping strategies can help you manage stress and maintain your own mental health. Consider incorporating the following strategies into your routine:

  • Take breaks: Allow yourself regular breaks to rest, recharge, and engage in activities that you enjoy.
  • Seek emotional support: Connect with friends, family, or support groups to share your feelings, concerns, and experiences.
  • Practice stress management: Engage in stress-reducing activities, such as exercise, meditation, or deep breathing exercises.
  • Maintain healthy boundaries: Set boundaries to ensure you have time for yourself and your own needs.
  • Educate yourself: Learn more about autism and self-injury through reputable sources to better understand the condition and develop effective strategies.

Building a Support System

Building a strong support system can provide invaluable assistance and understanding. Consider the following ways to establish a network of support:

  • Connect with other caregivers: Join local or online support groups where you can connect with other caregivers facing similar challenges.
  • Reach out to professionals: Consult with professionals, such as therapists or counselors, who specialize in autism and self-injury. They can provide guidance and support.
  • Involve family and friends: Share your experiences and seek assistance from trusted family members and friends who can offer help and understanding.
  • Collaborate with school or community resources: Engage with professionals in the school or community who can provide additional support or resources.

Accessing Respite Care and Support Services

Caring for a person with autism and self-injury can be demanding, and it is essential to have access to respite care and support services. These resources can provide temporary relief and assistance when needed. Consider the following options:

  • Respite care: Explore respite care services that offer short-term relief by providing trained caregivers who can care for the individual with autism.
  • Support services: Seek out support services that can provide guidance, information, and resources specific to autism and self-injury. These services may include helplines, online forums, or local organizations.

Remember, as a caregiver, it is important to prioritize your own well-being. By practicing self-care, building a support system, and accessing available resources, you can better navigate the challenges of caring for a person with autism and self-injury.


It's essential to approach it with empathy, understanding, and a recognition of the challenges individuals may face. Remember, each person's journey is unique, and self-harm is a complex issue that requires compassion and support.

Let's strive to create a world where those on the autism spectrum, and everyone else, feel heard and understood. It's crucial to foster open conversations, break stigmas, and provide a supportive environment. If you or someone you know is dealing with these challenges, reach out to professionals, friends, or family—because together, we can make a difference.


steven zauderer

CEO of CrossRiverTherapy - a national ABA therapy company based in the USA.

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