Have you ever wondered what it would be like to be in torturous pain and not being able to tell someone where it hurts. As babies we have all experienced the frustration. What would it be like for a young person?
This would be a plight that any person challenged with oral communication will have experienced. Any person with speech disorders will empathize.
Most people who are permanently disabled in speech will learn sign language if they can.
What if you had a toothache and were temporarily muted? You don’t know sign language so you invent your own and get your message across so you can get your pain mitigated.
If you had something more internal that was bothering you may have a harder time describing it. It may become frustrating and difficult to tell the doctor where it hurts . What if you had developmental disabilities and had not the ability to even say your name?
How can you tell anyone where it hurts? Sometimes the pain inside is hard to explain.
Jennifer L. Stornelli wrote an article titled ‘Self-injurious Behaviors in Children with Autism Sensory issues aren’t the only factors that may be at work’ published on AdvanceWeb. The article was full of information on related to autism and self injurious behavior (SIB).
Self-injurious behaviors (SIB) are not uncommon in children with autism and are particularly prevalent in lower functioning children, children with MR and/or children who are non-verbal. According to Simpson (2004), 5-17 percent of persons with mental retardation and autism do “serious harm” to themselves through self-injurious behaviors.
So what causes a person to cause pain to themselves?
There are endless sources that suggest that pain or significant discomfort in various parts of the body can lead to SIB. Dr. Timothy Buie, Pediatric Gastroenterologist at Massachusettes General Hospital suggests that undiagnosed GI issues can lead to SIB in some autistic patients. Athough it is uncertain whether GI problems are more common in children with autism than in the general population, Buie believes that, based on the frequency of gastro problems he has verified among his autistic patients, a thorough GI history and workup should be a part of the overall medical assessment for every individual with autism (Mahikoa, 2006).
Buie, in conjunction with pediatric neurologist Dr. Margaret Bauman, has identified several “warning signs” that, if seen in a patient, warrant a GI evaluation. Some of these signs include:
· chronic diarrhea or constipation,
· feeding/eating disorders,
· change in sleep patterns,
· food allergies or apparent changes with particular food exposure, and/or
· behavior changes, especially self-injurious, aggressive or mouthing behaviors.
Parents should be aware of these signs in children and keep track of their behavior related to these events. Leading to another possible cause brings us the question, does pain feel good? What pleasure could a person derive out of causing self injury?
Stephen M. Edelson, PhD, from the Center for the Study of Autism in Salem, OR, suggests that SIB can induce an opiate-like response in the brain due to the release of beta-endorphins (2012). It has been theorized that this feeling of pleasure can then reinforce the behavior and lead to an increased likelihood of recurrence.
It seems anything is possible. I used to think the only pleasure a person would get out of banging their head against the wall would come in between the bangs. All in all it could just be a way of avoiding tasks that trigger fear or emotional blocks. It could be other behavioral actions even emotional responses such as a plea for help or attention.
Is it Behavioral?
In some cases, these aggressive or repetitive behaviors serve a clear function with regard to social consequences. The SIB may function as a means to avoid a task, gain attention or communicate frustration…
“I’m trying to tell you something!”
In some instances, self-injurious behaviors may be due to a communication breakdown. Children with autism often have difficulty expressing their thoughts, wants, needs or ideas. They may over-rely on the familiar people in their lives to anticipate what they need or interpret what they want at any given time. This is a flawed system, however, for obvious reasons and often leads to frustration and aggravation when their needs are not adequately conveyed.
If a child does have an effective communication system (high-tech device, PECS book, etc.) it is critical to ensure its availability at all times, across all settings, and with all individuals. Furthermore, it is the responsibility of everyone in that child’s life to respect those communication tools as that child’s “voice” and to encourage them to be as independent as possible in communicating their wants and needs. It is not helpful to make assumptions without giving them the opportunity for autonomy.
We can sometimes limit frustration before it gets to the point of engaging in an SIB by honoring the child’s choice to avoid or discontinue a task when the situation allows. Offering an alternative, modifying the task, or providing additional assistance to complete the task are simple strategies that can mitigate or prevent unnecessary frustration.
This was an excellent article and we encourage you to read it at http://occupational-therapy.advanceweb.com
Self injurious behavior is mysterious on an outer level because most people just can’t relate to inflicting pain on themselves. Life alone does a good job of doing that. Autistic children have a hard time communicating and this type of frustration could cause them to due themselves harm. Understanding what may be some of the causes of a persons frustration may be the key to understanding why they would want to harm themselves.
Did you gain a deeper understanding of this type of behavior? Please share the understanding with others.