Question:

I have a 6-year-boy with an autism spectrum disorder. He has no verbal communication and pinches and bites his arms and legs. I cannot identify a clear antecedent to this behavior. It happens at any time, in any place, and with any person. Based on his assessment, it is possibly sensory in origin. He also scratches and pinches others who are working with him. He uses visual schedules. We have tried a weighted vest and increased proprioceptive activities and chewy tubes. None of these interventions have made a significant difference in his behavior, although he tolerated them. We recently tried a huggy vest, which he disliked immensely, so we discontinued it. Could you offer any advice?

Answer:

Self-injurious behaviors can often be very challenging to address. Usually, these kids are UNDER-responders who crave intense input that causes a release of endorphins. Your best bet is probably to try to get an endorphin release through other intense forms of sensory input. The things you’ve tried so far are typically for the purpose of calming: proprioceptive input, weighted vest, and chewing tubes. Try alerting types of input instead and see if it helps:

  • crashing play such as having him jump from a stool into a crash pad or bean bag, or swinging on a platform swing to crash against a mat on the wall, or prone on scooter board to crash into a pillow pile
  • jumping on a mini-trampoline
  • light touch with feathers, etc.
  • playing tag or chase
  • slides
  • fast, multidirectional swinging
  • prone on scooter board to go down a ramp

Build these types of activities into his schedule to create a sensory diet that provides a steady flow of alerting input (green arrow if you are using BrainWorks).

It’s also important to remember that while these behaviors are often sensory in nature, we also commonly see them as a result of frustration and/or anxiety. His frustration may be due to his inability to communicate. Work closely with the speech therapist to see if there is anything that could enhance his communication.

I hope this helps! Please keep me posted if you find something that works for this child. And let me know if I can be of further help!

Best Wishes,
Gwen