Self-Injurious Behaviour

Self-injurious behaviour is any behaviour that results in someone causing physical harm to him or herself. Common types of this behaviour shown by people with severe learning disabilities include: eye poking, self-biting, head banging and skin picking. People have an increased risk of displaying this type of behaviour if they have:

• Severe or profound learning disabilities 
• Sensory impairments (e.g. blind, deaf)
• Poor expressive language skills (e.g. no speech)
• Poor mobility
• Autism

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Behaviour support

Help with this type of behaviour is usually given by psychologists or behavioural specialists. They will try to work out what ‘message’ the person is trying to say and then teach them a better way to ‘say’ it. The reasoning behind this is that:

• Children (or adults) with severe learning disabilities and self-injury have often learnt to ‘use’ their self-injury to communicate with others.
• They are not always doing this on purpose.
• They may have discovered by accident that if, for example, they hit their head, their mother or carer will come over and give them a drink or a cuddle.
• The ‘messages’ that self-injury often seems to convey include ‘come here’, ‘go away’, ‘I want a drink’ (or food or a toy), ‘I’m bored’ or ‘I need help’.

It is hard to teach better ways to ‘say’ things, when someone has very few language skills. Professionals have tried teaching people to use new signs or picture cards to replace self-injury and show their teachers or carers what it is they want. This is often the treatment of choice.

Medication and protective devices

There is not much research to show that medicine can help with reducing self-injurious behaviour. People often try to use protective devices (e.g. helmets, arm splints or padding) if a person’s self-injury is very severe. These devices are best used as short term measures, as people can become dependent on them and they can limit how much the person can move.

What can you do to help?

Family carers and teachers can do a range of things when a person is showing self-injurious behaviour:

• Consider pain as a cause
• Teach communication skills
• Ensure that the person is safe, but try not to react to the self-injury as though it were a ‘message’
• Seek advice from a psychologist or behavioural specialist