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. 2020 Jan 20;11(1):8.
doi: 10.1186/s13229-019-0307-z. eCollection 2020.

Persistence and predictors of self-injurious behaviour in autism: a ten-year prospective cohort study

Catherine Laverty  1   2 , Chris Oliver  2 , Jo Moss  3 , Lisa Nelson  2 , Caroline Richards  1   2
Affiliations

Persistence and predictors of self-injurious behaviour in autism: a ten-year prospective cohort study

Catherine Laverty et al. Mol Autism. .

Abstract

Background: Self-injurious behaviours, such as head banging, hair pulling, skin picking and scratching, are common in individuals with autism. Despite high prevalence rates, there is a paucity of longitudinal research to refine models of risk and mechanism and inform service planning. In this longitudinal study, we investigated self-injury in a cohort of individuals with autism over 10 years to identify behavioural and demographic characteristics associated with persistent self-injury.

Methods: Carers of 67 individuals with autism completed questionnaires relating to the presence of self-injury and relevant risk markers at T1 (mean [SD] age in years 13.4 [7.7]) and T3 (mean [SD] age in years 23.9 [7.7]) 10 years later. Forty-six of these also took part at T2 (3 years after initial participation). Analysis assessed demographic and behavioural risk markers for self-injury, as well as the predictive value of items assessed at T1and T2.

Results: Self-injury was persistent in 44% of individuals over the 10-year period, with behavioural characteristics of impulsivity (p < .001) and overactivity (p = .002), identified as risk markers for persistence. A predictive model of self-injury was derived from LASSO analysis, with baseline impulsivity, interest and pleasure, stereotyped behaviour, social communication and adaptive functioning predicting self-injury over 10 years.

Conclusions: In this unique longitudinal investigation into the persistence of self-injury in a non-clinical sample of individuals with autism over a 10 year period, we have identified a novel, robust and stable profile of behavioural characteristics associated with persistent self-injury. Findings support an early intervention strategy targeted towards individuals identified to be at a higher risk of developing self-injurious behaviour.

Keywords: Autism; Impulsivity; Prevalence; Risk marker; Self-injury; Self-restraint.

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Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
T1 MIPQ, RBQ, TAQ, and SCQ total and subscale scores for absent, transient and persistent groups
Fig. 2
Fig. 2
T1 MIPQ, RBQ, TAQ, and SCQ total and subscale scores for individuals with and without self-restraint behaviours at T3
Fig. 3
Fig. 3
Solution path plotting Self-Injury variable coefficients against the L1 norm
Fig. 4
Fig. 4
Solution path plotting self-restraint variable coefficients against the L1 norm
Fig. 5
Fig. 5
Cross-validation plot for Self-Injury predictors, estimating optimal Lambda minimum and maximum estimates using the deviance metric
Fig. 6
Fig. 6
Cross-validation plot for self-restraint predictors, estimating optimal Lambda minimum and maximum estimates using the deviance metric
See this image and copyright information in PMC

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