What’s the Relationship Between Autism and Self-Harm?

According to research, there is a greater chance of self-harm among those with autism. This discrepancy may be exacerbated by unfavourable and unsupportive circumstances as well as difficulties expressing and communicating emotions.

Self-harm, also referred to as non-suicidal self-injury, is any bodily harm you do to yourself without intending to take your own life. Although cutting is frequently linked to this phrase, there are other types of self-harm. Certain self-harming behaviours, including hair pulling or pinching, can not produce overt symptoms.

A common neurodevelopmental illness that is usually diagnosed in childhood is autism spectrum disorder (ASD). The precise reasons behind ASD remain unclear, but developmental modifications to the brain's composition and abilities have a role in the behavioural, sensory, social, and communication difficulties that arise.

ASD affects individuals differently and occurs on a continuum of severity. However, several characteristics and situations are more common in autistic individuals than in the general population.

For instance, there's a chance that someone with ASD would self-harm more frequently.

Is self-harm more common in autistic people?

Individuals with autism seem to be more likely than the general population to self-harm.

A 2021 review of the literature found that self-harming behaviours are three times more common in autistic individuals than in non-autistic individuals.

According to a 2020 study including data from over 14,000 participants, 42% of autistic individuals self-harmed. Cutting was the least common self-harming behaviour, according to the study, while hand-hitting was the most common.

A study conducted in 2020 on children indicated that self-harming behaviours were more common in female youngsters, while a study conducted in 2022 on teens in the UK found that male teenagers were more likely to self-harm.

Why is there a relationship between self-harm and autism?

Anyone can self-harm. It's seen as a maladaptive coping technique or an ineffective coping strategy you use to ease emotional suffering.

Self-harm can be a maladaptive coping strategy for autistic individuals, but it can also be a means of communication in situations where more conventional means of communication are unavailable.

Environmental factors

According to Natalie Bunner, a board-appointed clinical supervisor and licenced clinical social worker from Lafayette, Louisiana, self-harm in individuals with ASD is frequently made possible by enduring contextual circumstances that make daily life stressful.

According to her, "Autistic children frequently live in environments where people are ignorant of the realities of autism and react in ways that are rejecting, which can negatively impact how they see themselves in the world." "Their sense of worth considerably decreases when they are constantly subjected to criticism from a 'deficit' viewpoint in their surroundings."

Self-harm can occur as a result of this widespread perception of low self-worth or being "less than" non-autistic persons.

Furthermore, because autism spectrum disorder (ASD) is characterised by difficulties with social relationships and communication, an autistic person may find it difficult to use healthy coping mechanisms like hanging out with friends or talking through events.

Challenges with communication

According to Bunner, individuals with ASD who may not have access to other productive forms of communication may turn to self-harm as a way to communicate their emotions.

"Many individuals with autism also experience gaps in their expressive and receptive language abilities," the speaker stated. This indicates that although they are absorbing a lot of information from their surroundings, they are finding it difficult to explain how that information affects their well-being.

Self-harm is one straightforward way that some autistic persons can rapidly and readily express unpleasant feelings like fear, anxiety, sadness, rage, and frustration.

According to Bunner, "children with autism tend to hit themselves during meltdowns due to sensory overload, which leaves bruising on their limbs." "Beating one's head while upset is an additional self-destructive habit. The protection of their physical body is no longer a priority because of their decreased ability to self-preserve when overwhelmed.

Signs of self-harm

Self-harm is not always obvious, and symptoms include concealment behaviours like covering marks or becoming withdrawn in addition to the actual damage.

Symptoms of self-harm in any individual may include:
  • self-punishment for perceived errors
  • having mysterious scars
  • possessing recent burns, bruises, wounds, or markings
  • getting injuries that are out of proportion to their amount of activity
  • bringing up unintentional injuries a lot
  • preserving the availability of sharp items
  • turning reticent or defending their personal space
  • discussing feelings of worthlessness or displaying self-hatred
  • even in hot weather, wearing long sleeves and trousers
According to Bunner, exaggerated wounds, or severe injuries from seemingly insignificant but natural sources like bug bites, are frequently among the earliest indicators of self-harm in individuals with autism.

She said, "For instance, they might bite their cuticles until they bleed, pick at scabs, or scratch their skin when they're anxious." "Although the behaviour seems obsessive, it has evolved into a useful tactic to avoid emotional stress."

It's also crucial to remember that, in contrast to non-autistic people, nonverbal autistic individuals who experience more severe cognitive disabilities frequently do not conceal their self-harming behaviours. Rather, they are more prone to hit, scratch, bite, and pound their heads as self-harming behaviours.

How to support your autistic child who self-harms

Although self-harm doesn't need to be punished, it can worry a carer. Reprimanding your child for self-harm simply serves to exacerbate the unpleasant emotions they are experiencing and may limit their coping strategies even more.

That implies that while self-harm should not be ignored, it should be approached with compassion and support.

Start at the source

Self-harm is the result, not the cause of the problem.

Bunner said, "Be willing to address the behavior's underlying causes." Parents frequently become fixated on stopping self-harming behaviours while ignoring the underlying causes. You must have meaningful, important conversations with your child to understand the true nature of their emotional problems.

Improve the environment

You can lessen your child's exposure to discriminatory or unsupportive factors that could encourage self-harm by making improvements to their surroundings.

Bunner advised making contact with medical professionals, therapists, educators, and other carers who value neurodiversity and are actively educated about the facts surrounding ASD.

Explore alternative coping strategies

Whether your child uses self-harm as an expressive or coping strategy, you may support them in finding healthy substitutes. Regularly talking about emotions is a good place to start. When negative ones come up, you might recommend something your child likes to do, like play with a pet, go outside, or listen to music.

A mental health expert can assist your child in developing new coping mechanisms while taking into account ASD if you're unsure of how to start this process.

Treatment options for self-harm in autistic people

The same guidelines that apply to non-autistic people's self-harm therapy also apply to those with autism. To build a unique treatment plan, your therapist will take into account your unique requirements and symptoms related to ASD.

Psychotherapy and medication are used to treat self-harm. Some persons may need a short stay in a care facility to recover from serious self-harm.

Drugs can aid in the relief of enduring mood disorders including anxiety and despair. In addition to learning new coping mechanisms for uncomfortable feelings, psychotherapy can assist autistic children in exploring their experiences in connection to ASD.

Resources for getting help with self-harm

Use the following resources to find out more about self-harm, have a private conversation with someone, or locate help in your area:
  • FindTreatment.gov
  • SAMHSA National Helpline: 1-800-662-4357
  • Crisis Text Line: Text CONNECT to 741741
  • AACAP Psychiatrist for Children and Adolescents Finder

Bottom line

Compared to non-autistic people, autistic people are more likely to self-harm. Two significant contributing elements to this discrepancy are changing techniques of expressing emotions and unfavourable environmental conditions.

Treatment can teach your child healthy coping mechanisms and help them comprehend and regulate their emotions if they are self-harming.

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