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

Laverty, Catherine, Oliver, Chris, Moss, Joanna, Nelson, Lisa and Richards, Caroline (2020) Persistence and predictors of self-injurious behaviour in autism: A ten-year prospective cohort study Molecular Autism, 11 (1), 8.

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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 T 1 (mean [SD] age in years 13.4 [7.7]) and T 3 (mean [SD] age in years 23.9 [7.7]) 10 years later. Forty-six of these also took part at T 2 (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 T 1and T 2. 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.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Psychology
Authors :
Laverty, Catherine
Oliver, Chris
Nelson, Lisa
Richards, Caroline
Date : 20 January 2020
DOI : 10.1186/s13229-019-0307-z
Copyright Disclaimer : © 2020 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Uncontrolled Keywords : Autism; Impulsivity; Prevalence; Risk marker; Self-injury; Self-restraint
Additional Information : Research Autism and Cerebra provided partial funding for this project.
Depositing User : Diane Maxfield
Date Deposited : 03 Feb 2020 16:03
Last Modified : 03 Feb 2020 16:19

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