I have worked with many children who exhibit severe self injurious behavior, usually in the forms of hitting or slapping themselves, head banging, or biting themselves. Self injurious behavior is usually an attempt to “escape or avoid” a situation that is unpleasant for them. It can also be a response to pain or discomfort. Self abuse is often the result of adults placing children into situations that overwhelm them. Often the child does not know how to communicate the need to escape, or people are not listening to them. They become overwhelmed, panic, and ‘fight or flight” sets in. This intense behavior often reduces once the child develops speech or other forms of communication. Once the child can communicate their needs and wants, and can effectively protest, then acting out behavior often lessens. Unfortunately, for many child we often do not listen to them, or respect what they are telling us. If not allowed to protest then acting will occur.
Much self injurious behavior, and other forms of acting out, can be reduced by (1) understanding the child’s sensitivities and comfort zones, and (2) respecting these comfort zones. Often the child is not just being oppositional, but may be in “panic” due to sensory overload. The child may be refusing the broccoli because the texture, taste, or smell may be too overwhelming for him. Once the brain goes into panic mode, there is nothing you can do to change it. The same can be true for placing the child in situations of “uncertainty”. Uncertainty can set off extreme anxiety, and set off panic. In addition, these extreme reactions can also occur when the expectations or demands are much greater than the child’s ability to cope with them. Task performance anxiety can cause a lot of self injurious behavior. Finally, trying to force children into situations where they do not feel safe, will trigger extreme behavioral reactions.
Children with autism are often pressured into situations that are overwhelming for them. Frequently they do not know how to communicate their distress, or we ignore their protest and try to force compliance. All of these situations mentioned above are usually do to adults pressuring the child into situation that overwhelm them. That is why we must identify their “comfort zones” (please fill out a Comfort Zone Profile) and make sure the adults in their lives respect these comfort zones. Identify the vulnerabilities, what are their safe zones, and stay within them , as you slowly stretch them. As parents one of your primary responsibilities is assuring that adults in your child’s life has a good understanding of the child’s sensitivities and comfort zones, Until the child becomes old enough to advocate for themselves, we need to be their voice.
Teaching a way to communicate their needs and wants is a must for reducing self injuries behavior. . Even if the child is nonverbal, teach the child to use gestures, sign language, or pictures to communicate what they want, and to protest what they do not want. Once capable of basic communication, teach the child to say “No” and “help.” To help empower your child to escape overwhelming demands teach them to say “no” or “help.” This way they can protest and escape overwhelming demands, or as for help. Many children are afraid to ask for help, so it needs to be encouraged, and reinforced. We also need to respect these protests, so the child feels empowered to escape overwhelming demands, and/or ask for help in coping with them. We often either ignore their pleas, or treat them as “noncompliance” and force compliance anyway. The child either feels incapable, or scared to protest, and releases his stress by harming himself. Now, unfortunately when their acceptable protest is ignored or denied, their self abuse allows them to successfully escape the demands. Since it is often severe, we back off from the demands. Consequently self abuse is reinforced, while protesting appropriately is denied. We need to make sure each child knows how to communicate “no” and “help” so they can either escape the situation, or seek assistance in dealing with it. From there we need to make sure people respect and honor the protests. So ask yourself (1) do I know what my child’s vulnerabilities and comfort zones are, and (2) does my child have a way of consistently communicating “no” and “help.” From there advocate that everyone knows and respects the child’s comfort zones, and honors their protests and requests for help. These are the two primary means of respecting and validating the child’s need to feel “safe, accepted, and competent.”
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