Self InjurySelf-injurious behaviourSelf-injury can be one of the most distressing and difficult behaviours that parents, carers, family members and people with autism themselves may face. Sometimes referred to as self-harm, self-injurious behaviour is any activity in which a person inflicts harm or injury on themselves. About half of people with autism engage self-injurious behaviour at some point in their life. People with Autism are significantly more likely to self harm than non-Autistics. It can take many different forms, including:* head banging (on floors, walls or other surfaces)* hand or arm biting* hair pulling* eye gouging* face or head slapping* skin picking, scratching or pinching* forceful head shaking. People with Autism may engage in self-injurious behaviours as children and may yet return to these as adults during times of stress, illness or change.Usual behavioural intervention approaches are not always appropriate. Seek professional guidance for any self-injurious behaviour which is difficult to manage or resistant to intervention, or for any behaviour which places the person at risk of harm.CausesThe reasons a person engages in self-injurious behaviours can be wide and varied, and will often involve a complex interaction between multiple factors:* they feel they are not listened to * they have been told off* they have little or no choice about things* they have been bullied * they are involved in arguments, or hear other people arguing * they are feeling unwell* they have memories of a bereavement* they have memories of abuse.Medical and Dental IssuesPeople with autism may have difficulty communicating to others that something is wrong physically and particular self-injurious behaviours (such as ear slapping or head banging) may be their way of coping with pain or communicating discomfort.Mental HealthSome self-injurious behaviour may indicate underlying mental health issues such as depression or anxiety.Repetitive BehavioursRepetitive behaviours, obsessions and routines are common in people with autism, and some forms of self-injury may be expressions of this feature.Developmental StagesSome self-injurious behaviour may be persisting remnants of earlier motor behaviours which occur during particular developmental periods (eg hand mouthing which may continue beyond infancy).CommunicationSudden self-injurious behaviour can get a very quick response from other people, and many such behaviours occur in people who have no other functional way of communicating their needs, wants and feelings. Head slapping, or banging the head on a hard surface, may be a way of communicating frustration, getting a preferred object of activity, or reducing demands.Hand biting may help someone cope with anxiety or excitement.Skin picking or eye gouging may be a response to lack of stimulation or boredom.Learned BehavioursThe person may learn that self-injurious behaviour can be a very powerful way of controlling the environment. A behaviour (eg head slapping) which was initially a response to physical pain or discomfort could eventually become a way of avoiding or ending an undesired situation (eg turning the television off, interrupting an argument taking place nearby).