Multiple and Single Functions of Self-Injurious Behavior in Autistic Adults with an Intellectual Disability

ABSTRACT

Background

Understanding the operant function of self-injurious behavior in autistic individuals is imperative to understanding its etiology and designing effective prevention strategies.

Methods

We conducted a postal survey of residential care facilities including two functional assessment tools: QABF and IfES. Questionnaires for N = 178 residents were returned.

Results

For 21.2% a single, and for 62.9% multiple functions were identified by the QABF, with the most frequent function being escape (51.8%). The IfES identified unable to cope with a situation as primary antecedent for 39.8% of the residents. Non-vocal individuals presented a higher number of functions and had overall higher subscale scores.

Conclusion

The study was the first to investigate single and multiple functions of SIB within a large sample of autistic adults. Results suggest that multiple functions of SIB are common with negative reinforcement contingencies being most important. Results have to be interpreted with caution due to psychometric limitations of the instruments used.

KEYWORDS:

• QABF
• IfES
• functional assessment
• autism
• self-injury

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

¹ Facilities specialized on autistic residents providing 24 h care services.

² Inclusion criteria: autism diagnosis (F84.0 or F84.1), intellectual disability, at least one incident of SIB in the last two months, living in the facility for at least 6 months.

³ The criterion of 50 or more expressed words reflects an easy to measure important milestone in infant language development (Kauschke, 2012).

⁴ For an overview regarding the debate about fixed vs. flexible alpha-levels see, Lakens et al. (2018).

⁵ This type of study was already published in 1998 (Dawson et al., 1998), however its generalizability is limited due to the small sample size (n = 12 per subgroup).

Additional information

Funding

This work was supported by the Stiftung Irene e.V - Gemeinnützige Stiftung zum Wohle autistischer Menschen.