The national charity Cerebra has published a comprehensive guide to self-injury in children with a learning disability in order to help parents and carers better understand and potentially reduce self-injurious behaviours.
Self-injury refers to non-accidental behaviours that are initiated by the child themselves and have the potential to lead to physical harm. This may include behaviours such as head banging, biting or scratching.
The guide has been designed for parents/carers of children with moderate to profound learning disability and cooccurring conditions such as autism and genetic syndromes. This is because self-injurious behaviours are more likely to occur in these groups, as well as those who show repetitive or impulsive behaviours.
Cerebra Network Director Professor Caroline Richards, one of the authors of the guide, said: “Self-injurious behaviour (SIB) is common in children with intellectual disability and is a clinical concern for families and clinicians. Our brand new SIB guide brings together the latest evidence based practice in an informative and accessible format, to support assessment and improvement in SIB for people with intellectual disability.”
‘Self injury in children with an intellectual disability’ explains what self-injury is, what can cause it, and which interventions may help to reduce such behaviours. It is divided into five parts:
The guide includes valuable information about the sources of self-injury, including pain and discomfort, being tired of anxious, and sensory stimulation. It is supported by useful examples of what this may look like in children, as well tips on how these behaviours could be reduced.
This is supported by the PEACE (Peace, Environment, Anxiety, Control and Exhaustion) acronym which can help parents and carers to consider what the cause of self-injury is before moving onto intervention. Cerebra says this is important as parents and carers must first have a good understanding of the behaviour in order to identify any positive improvements or negative changes.
Before starting any intervention, the guide recommends recording the frequency of self-injury and ensuring that the child exhibiting the behaviour is safe. Interventions may include replacing self-injury with more adaptive behaviour, reinforcing other behaviours, and reducing the aversiveness of antecedents.
The guide also advises when to seek help and who from, suggesting that parents and carers contact their GP is they have made attempts at managing the behaviour themselves but this has been unsuccessful.
“The Cerebra Be Well Checklist is a really brilliant resource that can help parents or caregivers go through this process in a structured way. Completing an ABC chart and documenting the frequency of self-injury are both really helpful pieces of evidence to bring to any professionals involved in your child’s care. Remember that as a parent or caregiver, you are the expert and spend the most time with your child so you are in a good position to begin to document any patterns of behaviour you notice,” the authors conclude.
