Self-Injurious Behaviors with Increased Likelihood of Injury in Autistic Youth: The Role of Distress Linked to a Strong Preference for Sameness
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| Title: | Self-Injurious Behaviors with Increased Likelihood of Injury in Autistic Youth: The Role of Distress Linked to a Strong Preference for Sameness |
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| Language: | English |
| Authors: | Emily F. Ferguson (ORCID |
| Source: | Autism: The International Journal of Research and Practice. 2026 30(6):1620-1631. |
| Availability: | SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com |
| Peer Reviewed: | Y |
| Page Count: | 12 |
| Publication Date: | 2026 |
| Sponsoring Agency: | National Institute of Mental Health (NIMH) (DHHS/NIH) |
| Contract Number: | R21MH121876 |
| Document Type: | Journal Articles Reports - Research |
| Descriptors: | Autism Spectrum Disorders, Youth, Self Destructive Behavior, Prediction, Sensory Experience, Repetition, Speech Skills, Student Characteristics, Behavior |
| DOI: | 10.1177/13623613251396036 |
| ISSN: | 1362-3613 1461-7005 |
| Abstract: | Self-injurious behaviors in autistic youth vary widely in their form, intensity, and potential for physical injury. This study explored predictors of two categories of self-injurious behaviors that were delineated based on their potential for physical injury (self-injurious behavior--High Likelihood and self-injurious behavior--Low Likelihood), with a focus on the role of distress linked to a strong preference for routines (otherwise known as insistence on sameness). The sample included 1892 autistic youth (M[subscript age] = 10.82, SD[subscript age] = 4.14; 22% females) across the United States. Distress associated with insistence on sameness was the strongest predictor of total self-injurious behavior scores, self-injurious behavior--Low Likelihood, and self-injurious behavior--High Likelihood, after controlling for demographic factors and speech level, and remained a unique predictor after accounting for variance explained by other restricted and repetitive behaviors. Sensory hypersensitivity and sensory-seeking were strong unique predictors of all self-injurious behaviors, while hyposensitivity was a weaker predictor of self-injurious behavior total and self-injurious behavior--Low Likelihood, and a non-significant predictor of self-injurious behavior--High Likelihood. Among demographic factors, lower household income was the strongest predictor of all self-injurious behaviors. Higher speech level was a positive predictor of self-injurious behavior--Low Likelihood but a negative predictor of self-injurious behavior--High Likelihood. These findings demonstrate the role of distress associated with insistence on sameness in manifestations of self-injurious behaviors and highlight the importance of exploring predictors at a more granular level to inform targeted interventions and support. |
| Abstractor: | As Provided |
| Entry Date: | 2026 |
| Accession Number: | EJ1506441 |
| Database: | ERIC |
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| Abstract: | Self-injurious behaviors in autistic youth vary widely in their form, intensity, and potential for physical injury. This study explored predictors of two categories of self-injurious behaviors that were delineated based on their potential for physical injury (self-injurious behavior--High Likelihood and self-injurious behavior--Low Likelihood), with a focus on the role of distress linked to a strong preference for routines (otherwise known as insistence on sameness). The sample included 1892 autistic youth (M[subscript age] = 10.82, SD[subscript age] = 4.14; 22% females) across the United States. Distress associated with insistence on sameness was the strongest predictor of total self-injurious behavior scores, self-injurious behavior--Low Likelihood, and self-injurious behavior--High Likelihood, after controlling for demographic factors and speech level, and remained a unique predictor after accounting for variance explained by other restricted and repetitive behaviors. Sensory hypersensitivity and sensory-seeking were strong unique predictors of all self-injurious behaviors, while hyposensitivity was a weaker predictor of self-injurious behavior total and self-injurious behavior--Low Likelihood, and a non-significant predictor of self-injurious behavior--High Likelihood. Among demographic factors, lower household income was the strongest predictor of all self-injurious behaviors. Higher speech level was a positive predictor of self-injurious behavior--Low Likelihood but a negative predictor of self-injurious behavior--High Likelihood. These findings demonstrate the role of distress associated with insistence on sameness in manifestations of self-injurious behaviors and highlight the importance of exploring predictors at a more granular level to inform targeted interventions and support. |
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| ISSN: | 1362-3613 1461-7005 |
| DOI: | 10.1177/13623613251396036 |
