We assessed potential factors associated with “current” or “ever” self-injurious behaviors, reported in the Autism Diagnostic Interview–Revised, among children with autism spectrum disorder (n = 692) from the Study to Explore Early Development. Data on factors examined were obtained from questionnaires, standardized clinical instruments, and birth certificates. We employed a log-binomial regression to assess these associations. Although most associations were quite similar for currently and ever exhibiting self-injurious behaviors, a few differences were noted. We documented previously unreported associations of current self-injurious behaviors with maternal age and cesarean delivery, and ever self-injurious behaviors with maternal age, child sex, gestational age, and maternal race. We also confirmed previously reported associations with adaptive skills, somatic conditions (sleep, gastrointestinal, and sensory abnormalities), and other behavioral problems. These findings are informative for clinical practice and future research.
American Psychiatric Association (APA) (2000) Diagnostic and Statistical Manual of Mental Disorders. 4th ed.Text revision. Washington, DC: American Psychiatric Publishing.
2.
American Psychiatric Association (APA) (2013) Diagnostic and Statistical Manual of Mental Disorders. 5th ed.Arlington, VA: American Psychiatric Publishing.
3.
BaghdadliAPascalCGrisiS. (2003) Risk factors for self-injurious behaviors among 222 young children with autistic disorders. Journal of Intellectual Disability Research47: 622–627.
4.
BerksonGTupaM (2000) The early development of stereotyped and self-injurious behaviors. Journal of Early Intervention23: 1–19.
5.
BuieTCampbellDFuchsGIII. (2010) Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report. Pediatrics125: S1–S18.
6.
CarrE (1977) The motivation of self-injurious behavior: a review of some hypotheses. Psychological Bulletin84: 800–816.
7.
CarrollDHallettVMcDougleC. (2014) Examination of aggression and self-injurious in children with autism spectrum disorders and serious behaviors problems. Child and Adolescent Psychiatric Clinics of North America23: 57–72.
8.
ChristensenTRingdahlJBoschJ. (2009) Constipation associated with self-injurious and aggressive behavior exhibited by a child diagnosed with autism. Education & Treatment of Children32: 89–103.
9.
DempseyJDempseyAGGuffeyD. (2016) Brief report: further examination of self-injurious behaviors in children and adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders46: 1872–1879.
10.
DevineD (2014) Self-injurious behaviors in autistic children: a neuro-developmental theory of social and environment isolation. Psychopharmacology231: 979–997.
11.
DuerdenEOakleyHMak-FanK. (2012) Risk factors associated with self-injurious behaviors in children and adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders42: 2460–2470.
12.
EsbensenASeltzerMLamK. (2009) Age-related differences in restricted repetitive behaviors in autism spectrum disorders. Journal of Autism and Developmental Disorders39: 57–66.
13.
FallCSachdevHOsmondC. (2015) Association between maternal age at childbirth and child adult outcomes in the offspring: a prospective study in five low-income and middle-income countries (COHORTS collaboration). The Lancet3: e366–e376.
14.
FeeVEMatsonJL (1992) Definition, classification, and taxonomy. In: LuiselliJKMatsonJLSinghN (eds) Self-Injurious Behavior: Analysis, Assessment, and Treatment. New York: Springer-Verlag, pp.3–20.
15.
GiarelliEWigginsLRiceC. (2010) Sex differences in the evaluation and diagnosis of autism spectrum disorders among children. Disability and Health Journal3: 107–116.
16.
GoldmanSMcGrewSJohnsonK. (2011) Sleep is associated with problem behaviors in children and adolescents with autism spectrum disorders. Research in Autism Spectrum Disorders5: 1223–1229.
17.
GothamKPicklesALordC (2009) Standardizing ADOS-G scores for a measure of severity in autism spectrum disorders. Journal of Autism and Developmental Disorders39: 693–705.
18.
GuessDCarrEG (1991) Emergence and maintenance of stereotypy and self-injury. American Journal on Mental Retardation96: 299–319.
19.
HartleySSikoraDMcCoyR (2008) Prevalence and risk factors of maladaptive behavior in young children with autistic disorder. Journal of Intellectual Disability Research52: 819–829.
20.
HorovitzMMatsonJRieskeR. (2011) The relationship between race and challenging behaviors in infants and toddlers with autistic disorder and pervasive developmental disorder-not otherwise specified. Developmental Neurorehabilitation14: 208–214.
21.
IanuzziDChengEBroder-FingertS. (2015) Emergency department utilization by individuals with autism. Journal of Autism and Developmental Disorders45: 1096–1102.
22.
IsaksenJBrynVDisethT. (2013) Children with autism spectrum disorders—the importance of medical investigations. European Journal of Paediatric Neurology17: 68–76.
23.
JangJMatsonJCervantesP. (2013) The relation between race and comorbid symptoms in infants and toddlers with autism spectrum disorders. Research in Autism Spectrum Disorders7: 1433–1438.
24.
KangVWagnerGMingX (2014) Gastrointestinal dysfunction in children with autism spectrum disorders. Autism Research7: 501–506.
25.
KanneSMazurekM (2011) Aggression in children and adolescents with ASD: prevalence and risk factors. Journal of Autism and Developmental Disorders41: 926–937.
26.
KerstjensJDe WinterABocca-TjeertesI. (2012) Risk of developmental delay increases exponentially as gestational age of preterm infants decreases: a cohort study age 4 years. Developmental Medicine and Child Neurology54: 1096–1101.
27.
KozlowskiAMatsonJRieskeR (2012) Gender effects on challenging behaviors in children with autism spectrum disorders. Research in Autism Spectrum Disorders6: 958–964.
28.
KurtzPChinMHueteJ. (2003) Functional analysis and treatment of self-injurious behavior in young children: a summary of 30 cases. Journal of Applied Behavior Analysis36: 205–219.
29.
KurtzPChinMHueteJ. (2012) Identification of emerging self-injurious behaviors in young children: a preliminary study. Journal of Mental Health Research in Intellectual Disabilities1: 260–285.
30.
LanceEYorkJLeeLC. (2014) Association between regression and self-injurious behaviors among children with ASD. Research in Developmental Disabilities35: 408–413.
31.
LordCRisiSLambrechtL. (2000) The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders30: 205–223.
32.
LordCRutterMLe CouteurAL (1994) Autism diagnostic interview-revised: a revised version of the diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders24: 659–685.
33.
MaennerMArnesonCLevyS. (2012) Brief report: association between behavioral features and gastrointestinal problems among children with autism spectrum disorder. Journal of Autism and Developmental Disorders42: 1520–1525.
34.
MatsonJGoldinR (2013) Comorbidity and autism: trends, topics and future directions. Research in Autism Spectrum Disorders7: 1228–1233.
35.
MinshawiNHurwitzSFodstadJ. (2014a) The association between self-injurious behaviors and autism spectrum disorders. Psychology Research and Behavior Management7: 125–136.
36.
MinshawiNHurwitzSMorrissD. (2014b) Multidisciplinary assessment and treatment of self-injurious behaviors in autism spectrum disorders and intellectual disability: integration of psychological and biological theory and approach. Journal of Autism and Developmental Disorders45: 1541–1568.
37.
MossJRichardsCNelsonL. (2012) Prevalence of autism spectrum disorders symptomatology and related behavioural characteristics in individuals with Down syndrome. Autism17: 390–404.
38.
MullenE (1995) Mullen Scales of Early Learning. Circle Pines, MN: American Guidance Service, Inc.
39.
MurphyOHealyOLeaderG (2009) Risk factors for challenging behaviors among 157 children with autism spectrum disorders in Ireland. Research in Autism Spectrum Disorders3: 474–482.
40.
RattazCMichelonCBaghdadliA (2015) Symptom severity as a risk factor for self-injurious behaviours in adolescents with autism spectrum disorders. Journal of Intellectual Disability Research59: 730–740.
41.
RubensteinEWigginsLLeeLC (2015) A review of the differences in developmental, psychiatric, and medical endophenotypes between males and females with autism spectrum disorders. Journal of Developmental and Physical Disabilities27: 119–139.
42.
SchendelDDiGuiseppiCCroenL. (2012) The Study to Explore Early Development (SEED): a multisite epidemiologic study of autism by the Centers for Autism and Developmental Disabilities Research and Epidemiology (CADDRE) Network. Journal of Autism and Developmental Disorders42: 2121–2140.
43.
SchoplerERicherERennerB (1986) The Childhood Autism Rating Scale (CARS). New York: Irvington.
44.
SchroederSMarquisJGReeseRM. (2014) Risk factors for self-injurious, aggression, stereotyped behavior among young children at risk for intellectual and developmental disabilities. American Journal on Intellectual and Developmental Disabilities119: 351–370.
45.
SellNGiarelliEBlumN. (2012) A comparison of autism spectrum disorder DSM-IV criteria and associated features among African American and white children in Philadelphia County. Disability and Health Journal5: 9–17.
46.
SokeGNRosenbergSAHammanRF. (2016a) Brief report: prevalence of self-injurious behaviors among children with autism spectrum disorder: a population-based study. Journal of Autism and Developmental Disorders46: 3607–3614.
47.
SokeGNRosenbergSAHammanRF. (2016b) Factors associated with self-injurious behaviors in children with autism spectrum disorder: findings from two national epidemiologic databases. Journal of Autism and Developmental Disorders.
48.
SparrowSCicchettiDBallaD (2005) The Vineland Adaptive Behavior Scales-2 (Survey Form). Circle Pines, MN: American Guidance Service, Inc.
49.
SymonsFJClarkRHattonD. (2003) Self-injurious behavior in young boys with fragile X syndrome. American Journal of Medical Genetics118: 115–121.
50.
SymonsFJSperryLADropikPL. (2005) The early development of stereotypy and self-injury: a review of research methods. Journal of Intellectual Disability Research49: 144–158.
WalkerCKKrakowiakPBakerA. (2015) Preeclampsia, placental insufficiency, and autism spectrum disorder or developmental delay. JAMA Pediatrics169: 1–9.
53.
WeissJ (2002) Self-injurious behaviors in autism: a literature review. Journal on Developmental Disabilities9: 129–143.
54.
WigginsLLevySDanielsJ. (2015a) Autism spectrum disorder symptoms among children enrolled in the Study to Explore Early Development (SEED). Journal of Autism and Developmental Disorders45: 3183–3194.
55.
WigginsLReynoldsARiceC. (2015b) Using standardized diagnostic instruments to classify children with autism in the Study to Explore Early Development. Journal of Autism and Developmental Disorders45: 1271–1280.
56.
WigginsLRiceCBaioJ (2009) Developmental regression in children with autism spectrum disorders identified by a population-based surveillance system. Autism13: 357–374.
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