I have read recently and understand that some parents are desperately
seeking advice for handling their child's self-injurious behavior.
Self-injurious behavior, also known as SIBs, are classified as any
aggression towards oneself. The most common forms of self-injurious
aggression is hitting or biting but some older children may also be
involved with cutting. Other forms of SIBs may also include head
butting, body slamming, picking or scratching, and using other objects
to hit. Before talking about strategies that help to replace these SIBs
and decrease the severity of the injury, let's discuss how critical SIBs
are.
If
your child is demonstrating SIB, then it is time to get a behavior
consultant involved if there is not one already. The reason for this is
because it is crucial to get to the root of the problem and find out
exactly why your child is acting out in an aggressive way. He may be
desperate with communicating his needs and incredibly frustrated. She
may be seeking out deep sensory input. He may be trying to gain access
to some tangible that he can't have. Unless a functional behavior
assessment is done, you will not be able to truly address the SIB
because you won't know exactly what is causing it. I will focus another
few posts on functions of behavior but it is important to note that when
you know the function of the behavior, you can act proactively to help
prevent and/or at least decrease the behavior that is inappropriate. So
seeking out the help of a professional behavior consultant may be your
first step. Now, this may take some time to get set up. In fact, just
getting an agency, evaluation, behavior consultant, and/or services in
place, (if you do not have already) can take a tremendous amount of
time. So, here are some tips that you can try now to handle the everyday
occurrences until you have more help in place.
I know it must be
SO incredibly frustrating and disheartening to see your child hurting
himself. You're willing to try anything because you know your child may
end up causing himself severe injury, if not hospitalization. You also
may be very puzzled as to why your child is acting this way. Some
children will casually bite their hand and stop biting because it hurts.
This is a natural consequence. They will stop biting because they feel
pain. However, many children with Autism Spectrum Disorders do not feel
pain like typical children do. Many of them have an extremely high
tolerance for pain and may not even cry when they get hurt. Many of them
also seek out deep sensory input. They crave, not only deep pressure,
but some kind of impact to their bodies in order to help feel more
regulated. These are children with sensory processing disorders known as
the "sensory seekers." Biting can be due to an oral fixation, the need
for sensory input to the mouth. As odd as it may sound, children who are
orally fixed and may be biting, may continue to bite because it brings
them a sense of joy and regulation, NOT pain. Don't forget that most
SIBS are caused by some level of frustration in the child, not just
sensory needs. A biter may be seeking input but may also be acting out
of frustration for another need or want. That is why a behavior
assessment needs to be done to truly understand the cause.
Let'
also discuss the issue of restraint. When a child is acting out against
himself or someone else, retraining him/her can be an option. HOWEVER,
it is very important to note 3 things. 1. Restraining a child should
only be done to help prevent further injury to the child or someone
else, especially in extreme measures. 2. There is a protocol, a
heirarchy, and training involved with restraining a child appropriately
so that you and the child do not continue to get hurt in the process. If
you are not trained properly, nor understand the protocol, then I would
not recommend restraint in any way. 3. If restraining the child makes
matters worse, i.e. causes your child to completely lose control, fight
back, and increase rage, frustration, SIBS, and/or aggression, then
restraint should not be used. I will discuss the methodology of
restraint in other posts but please keep these tips in mind if
considering it as a reactive measure to SIBs.
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