Studies show that 30% of children on the autism spectrum engage in self-harm behavior like head banging or skin picking. This is an alarming issue for autism families who are looking for the right solution.
In this guide, we discuss the causes and strategies to help your child reduce autism self-harm behavior. If you’d like to learn more about managing self-injurious behavior, you can download your free guide here:
Why do autistic children hit themselves?
For children with autism, headbanging is a way to self-soothe and communicate needs as a result of some form of anxiety. Babies and toddlers soothe themselves and want to feel the same as they did in their mother’s womb. This is known as vestibular stimulation.
Other habits that feed a child’s vestibular stimulation include head rolling, body rocking, biting, and thumb sucking.
The desire to self-soothe in this way can be for any of the following reasons:
- Physical pain
- Seeking attention
- Sensory processing issues
- Attempting to communicate
According to Dr. Harvey Karp, MD, rhythmic habits trigger the calming reflex in infants and toddlers. Many babies with autism headbang around six months of age, but their neurotypical peers stop doing so by three years of age.
Noha F. Minshawi, Ph.D., assistant professor of clinical psychology at Riley Hospital for Children, says children with autism spectrum disorders show self-injurious behaviors at high rates.
What causes headbanging?
Minshawi also makes the distinction that self-injurious behaviors, such as headbanging in autism, are usually classified as a “highly repetitive behavior.” This means they occur at frequencies up to dozens of instances per minute.
She also notes that headbanging can be episodic and triggered by the same stimuli or appear to start out of nowhere. Monitoring your child and noting what happened right before headbanging can help identify triggers.
When a child diagnosed with autism headbangs past the age of two and a half or three, there is likely one of four things happening:
- The child is in pain
- The child is attempting to communicate
- The child is attention-seeking, or
- The child is experiencing sensory overload or a sensory deficit.
Self-harming behavior as a response to pain
Many parents are confused about why a child would inflict more pain via headbanging if a child is already experiencing discomfort.
They fail to understand the significance of autism self-harm. It’s important that parents recognize headbanging as a distraction from pain.
If you discover that your child regularly uses headbanging to manage pain, a pediatrician can suggest ways to ease your child’s discomfort. This may include checking your child’s body for cuts, bruises, swelling, or other physical signs of injury.
Working with a communication specialist to help your child develop new ways to express where they are experiencing pain could also be helpful.
Some children are able to point to where they are feeling pain, draw a picture of what hurts, or communicate verbally using short phrases.
Verbal children may need prompting to tell you where they are experiencing pain, as headbanging may be their first instinct.
Headbanging as an attempt to communicate
In some cases, autism and headbanging go together, so a child can feel in control. A secondary reason may be that the child is trying to communicate. Nonverbal children will seek ways to communicate, often through movement.
If a child knows headbanging will cause a caregiver to rush over and intervene, they are likely to use this to their advantage to help get their needs met. This goes hand-in-hand with attention-seeking.g.
Headbanging to ‘seek attention’
Children who headbang for attention may be experiencing sensory overload or deficit. At that moment, they may be unable to communicate their needs otherwise.
When children with autism experience sensory overload, their neurotransmitters are unable to process the sensation.
Noise, visuals, smells, and tastes can be uncomfortable and overwhelming for children with autism. The sensation of headbanging is one they can control and on which they can place their focus.
Headbanging caused by sensory processing issues
Children who are overloaded due to sensory processing issues often self-stimulate, also known as stimming. Children who are understimulated, lonely, or bored might headbang to stimulate their vestibular systems.
They stimulate themselves in a way that feels good to them. Understimulated children may often seek attention from headbanging, even if they know they will not receive positive reinforcement.
Parents can provide a distraction from headbanging using tools such as:
- A vibrating pillow
- A weighted blanket
- Gentle touch
- A well-secured bouncing chair (a yoga ball or a rocking chair).
Providing your child with attention, including positive reinforcement, appropriate activities, and options on how to spend their time, may help redirect a child who is headbanging.
Additionally, some children headbang as part of a routine they have developed to help them prepare for sleep. Autistic individuals often find repetitive movements tiring and soothing.
Using bedtime social stories or establishing a routine with your child that includes some form of exercise or kinesthetic movements may help prepare them for sleep.
Some popular options include:
- Stretching
- Yoga poses
- Leg flutters
- Balancing on one leg at a time
Physiological causes of headbanging in autism
There are also some physiological aspects of autism and self-harm. Stephen M. Edelson, Ph.D., suggested physiological reasons for autism headbanging, including biochemical and genetic factors.
His theories suggest that changes in brain chemistry may contribute to headbanging and other self-injurious behaviors.
It’s believed that certain actions might trigger the release of natural chemicals in the brain that reduce pain or create a calming, even pleasurable, sensation—making the behavior more likely to be repeated.
Some parents have reported improvements in severe behaviors, including self-injury, after trying certain nutritional or medical interventions aimed at balancing their child’s biochemistry.
While medications are sometimes used to influence neurotransmitter levels, others have seen positive changes with supplements like vitamin B6, calcium, or DMG.
Dietary changes, such as adopting a gluten-free diet or eliminating foods that may trigger allergic reactions, have also been associated with behavioral improvements in some cases.
Although there is no clear consensus among experts about the effectiveness of these approaches, it may be worth discussing potential options with your child’s pediatrician.
Can headbanging cause brain damage?
For parents of children with autism who engage in headbanging, brain damage is a common concern. Children under three years old will rarely cause long-term damage by headbanging.
Their heads are designed to withstand the impact of learning to walk. Headbanging will rarely cause more trauma than a slip-and-fall accident at this age. However, as children get older, they are at a higher risk of causing lasting damage.
Children who are strong enough to cause injury should receive a functional behavioral intervention to come up with a plan to replace headbanging with healthy coping and communication strategies.
Self-injurious behaviors like headbanging can pose serious physical risks to the individual. They are often deeply concerning for caregivers who are focused on keeping their child safe.
To address these behaviors effectively, it is essential to begin with a functional behavioral assessment. This helps identify the environmental or internal factors that may be contributing to the behavior.
The insights gained from the assessment can then guide the development of behavioral strategies aimed at preventing triggers. They may also replace harmful behaviors with safer, more appropriate alternatives.
How to stop an autistic child from hitting head and themselves
It’s essential to understand why a child with special needs is engaging in hitting before you can effectively address it. First, you need to ensure they don’t have any other medical issues that could lead to them inflicting harm.
Ear infections, stomach ailments, and other bodily pains may also be the cause. It’s also possible that the child uses this behavior to communicate. Anxiety and hyperactivity are two other factors to consider.
You can work with a doctor or an applied behavior analysis specialist for the right response once the reason is clear. You can then develop sensory strategies for headbanging that are suitable for your child.
How can I protect my child from self-harm?
It can be terrifying to witness when a toddler hits themselves in the head, but protective measures can be taken to remedy autism and self-harm. Some children respond well to resistance exercises, including chin-ups or lifting light weights.
Tracking when your child’s headbangs and to what extent will help determine what level of pain they might experience after the episode.
Your pediatrician should be your primary source of information on how to best help a head-banging child. They will be able to assess the likelihood of self-harm, help you identify why your child’s headbangs, and offer solutions and alternatives.
It is recommended to consult a doctor immediately if your child hurts themselves, leaves bumps or bruises, or you think that the child is having seizures.
If you are unsure if your child is headbanging due to a diagnosis of autism or if it is developmentally normal at this point, partner with your pediatrician.
They can refer you to other professionals and treatments that may be helpful. This includes occupational therapy for autism, behavior interventionists, and autism support groups for parents.
Can an autism helmet protect my child?
Providing your child with an autism helmet as prescribed by the pediatrician should help prevent injury. You can also add padding to areas of your home that your child typically headbangs, especially any corners or uneven surfaces.
Strategies for managing self-injurious behavior in autism
Treatment for self-injurious behavior in autism can take many forms and will most likely be a process of trial and error.
In-home accommodations can be made to help an overstimulated child. Some examples are:
- Noise-canceling earplugs or headphones
- Create a special bedroom or space for your child
- Using sensory clothing
- Playing with sensory toys
- Develop communication skills
- Play activities that can help relieve over- or under-stimulation
A parent or caregiver needs to seek professional help to resolve autism and head banging correctly. An occupational therapist (OT) can help you and your child learn alternatives for headbanging.
Many children find sensory therapy with an OT to be helpful. Management strategies may also include yoga and rhythmic therapy, in conjunction with routine sensory input, under the guidance of an occupational therapist.
Creating a safe and supportive environment
Understanding the connection between autism and self-harm is vital for providing appropriate support and intervention.
By recognizing the triggers and signs and implementing effective coping strategies, we can improve the quality of life for children on the autism spectrum who may be struggling with self-harming behavior.
Remember, empathy, patience, and professional assistance are essential in helping children with autism navigate their challenges and lead fulfilling lives.
FAQs
Q: Is self-harm a common behavior among individuals with autism?
A: Self-harm is more prevalent among individuals with autism than in the general population, but it is not universal. Some studies have shown that 30% of autistic children engage in self-harming behavior.
Q: What can trigger self-harming behaviors in children with autism?
A: Triggers can vary but may include sensory overload, communication difficulties, or changes in routine.
Q: How can I support a family member with autism who self-harms?
A: Open communication, seeking professional guidance, and creating a safe environment are essential to providing support.
Q: Is head banging a sign of autism?
A: Head banging can be a sign of autism, especially when used as a way to self-regulate or express frustration. However, it can also occur in children without autism, so it should be evaluated in context with other behaviors.
Q: Why do autistic people hit themselves?
A: Autistic individuals may hit themselves as a form of stimming, to cope with overwhelming sensory input, or to express emotions they struggle to communicate. It can also be a response to stress, anxiety, or frustration.
Q: How do you stop an autistic child from biting himself?
A: To help stop self-biting, identify and reduce triggers while offering safe alternatives for sensory input or emotional expression. Behavioral strategies, sensory supports, and professional guidance can be effective in managing this behavior.
References
Prevalence of Self-injurious Behaviors among Children with Autism https://link.springer.com/article/10.1007/s10803-016-2879-1
Brief Report: Prevalence of Self-injurious Behaviors among Children with Autism Spectrum Disorder—A Population-Based Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5392775
The Happiest Baby on the Block: The New Way to Calm Crying and Help Your Baby Sleep Longer https://journals.lww.com/jrnldbp/Fulltext/2005/02000/The_Happiest_Baby_on_the_Block__The_New_Way_to.15
Blanchard, A., Chihuri, S., DiGuiseppi, C. G., & Li, G. (2021). Risk of self-harm in children and adults with autism spectrum disorder: a systematic review and meta-analysis. JAMA network open, 4(10), e2130272-e2130272. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2785235
Cassidy, S. A., Robertson, A., Townsend, E., O’Connor, R. C., & Rodgers, J. (2020). Advancing our understanding of self-harm, suicidal thoughts and behaviours in autism. Journal of autism and developmental disorders, 50, 3445-3449. https://link.springer.com/article/10.1007/s10803-020-04643-9
Stark, I., Rai, D., Lundberg, M., Culpin, I., Nordström, S. I., Ohlis, A., & Magnusson, C. (2022). Autism and self‐harm: A population‐based and discordant sibling study of young individuals. Acta Psychiatrica Scandinavica, 146(5), 468-477. https://onlinelibrary.wiley.com/doi/abs/10.1111/acps.13479
Shkedy, G., Shkedy, D., & Sandoval-Norton, A. H. (2019). Treating self-injurious behaviors in autism spectrum disorder. Cogent Psychology, 6(1), 1682766. https://www.tandfonline.com/doi/abs/10.1080/23311908.2019.1682766
Steenfeldt-Kristensen, C., Jones, C. A., & Richards, C. (2020). The prevalence of self-injurious behaviour in autism: A meta-analytic study. Journal of autism and developmental disorders, 50, 3857-3873. https://link.springer.com/article/10.1007/s10803-020-04443-1
