Monday, 11 July 2011
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Self-Injurious Behavior
After conversing with an adult on twitter who is on the autism spectrum with self-injurious tendencies, I elected to step away a moment from detailing my Cub’s journey of diagnosis and resulting emotional aftermath of autism/ADHD to focus on one behavior that affects many children like her.
While recovering from a particularly nasty bout of flu at the age of 2, I woke to find Cub with bloody scratches/marks on her porcelain cheeks. The first thought that came to my head was someone had to have hurt her, even though nobody else was in the home but the two of us, and I began mentally preparing myself to find and kick the bastard’s ass who done so. But then I saw her reach up with her delicate little fingers and scratch herself…repeatedly. I was stunned. What the hell is she doing?! And why?! This last question has haunted me ever since because, at less than a month away of being 5, she still does it. Anyway, back to this first occurrence. During this time she was attending a free pilot program that was started by one of the prestigious colleges in our area and they had experts in various fields available to study and teach children on the autism spectrum. The first thing I did was strap her into the car seat and head over to this school so that they can tell me what to do and friggin fix it. One of her teachers met with us and watched her for about an hour asking me assorted questions on how she has been eating, sleeping, etc. We tried to pinpoint any specific thing that has changed. My homework over the course of the week was to diligently watch her and see what it could be that was triggering this new behavior. Long story short, it turned out to be her afternoon naps. They were disturbing her slumber at night and caused her to be awake between 2am – 4am. Our daily routine usually consisted of beginning at 7:30am to eat breakfast and go to school, so she had only had time to fall back asleep for a couple of hours. She is completely nonverbal so I had no idea! She couldn’t turn to me and tell me how tired she was and how this flu that she had just experienced drained her further and made her more fatigued. Instead, she drove inward and took her grievance out on herself. The ass I now wanted to kick was mine (a bit unfair but guilt is not a tenant easily evicted, no matter how threatening the notice).
After her naps were taken away she eventually stopped hurting herself and we could go back to directing our attention to the speech, OT therapy. However, as I mentioned earlier, the behavior just went dormant and decided to come back with a vengeance right before she turned 4. During this stint it decided to stick around for double the time and was even more fierce and brutal. After exhausting the entire panel of teacher’s advice, seeing a DAN (defeat autism now) doctor, and getting her tested for allergies, she was STILL pinching. This is when the meds decided to make their entrance. I have always been against any sort of medication but when you see your own baby physically scratch/pinch her entire body bloody with a pleading look in her eyes, well, you will sacrifice a friggin cow to the friggin gods on your own friggin front lawn just to give her relief. Another doctor was brought in and after a half a day observing her she was prescribed Prozac. A week later she aged out of that free pilot program and was put into a reputable daycare/school for special needs children for a full day. The self harm stopped. At that EXACT period in time I was unsure why: was it the meds or new school? (I know the real reason now, but that is a post for a later time). All was well and calm for a few blissful months.
As of now it has been almost six months since the behavior resurfaced and she has, again, went through a plethora of doctors and more meds. At present it is still going strong with no end in sight. So, as of yet, this story does not end with a happy ending. We are still working on it though, and will do so until the bastard goes away and never comes back. In the meantime, I have discovered some links that I found helpful in my research for the why’s, how’s, and WTF’s of this behavior that you may find helpful if you are a parent in a similar situation.
http://www.autism-help.org/behavior-self-injury-autism.htm
http://www.togetherforautism.org/articles/self_injurious_behavior.php
http://www.autism.com/ind_self-injurious_behavior_treat.asp
http://www.brighttots.com/Autism/Self_injury.html
Marijan
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Comments (3)
Until my manager told me that biting myself and hitting myself was self-harming, it had never occurred to me it was anything other than a means of regulating my reaction to sensory and information over load. I rely on the intense sensations to help me recover or retain focus. I am nearly 58 and cannot see myself stopping now.
There is something about controlled pain that is oddly calming. I have a spot on my hand that I am compelled to bite when I'm extremely overloaded. I have yet to bite it hard enough to break the skin though. I keep my fingernails VERY short so that I don't scratch myself. I (thankfully) stopped banging my head on things to calm down. (I used to bang my head on my desk at school.) I find myself doing this when I am not able to do anything else that usually calms me down. If I'm forced to be still for too long, for example.
You could always do an ABC analysis at home. What happens before the behavior occurs? What kind of behavior is displayed? What are the consequences (or events) following the behavior?
I think a lot of self-injurious behaviors are automatically maintained. A person I work with scratches, pinches herself, and pulls her own hair out. We have determined that the behaviors serve a function that provides internal stimulation/reinforcement for that person. So in the case of it "relieving stress" as one would say, that is a form of internal reinforcement.