Why Autism Head Banging Happens and how to Help?

Navigating the challenges of self-injurious behaviors (SIBs), including head banging behavior, can be emotionally challenging for families of children with autism spectrum disorder (ASD). These behaviors, which may include head-banging, skin picking, or self-biting, can deeply affect both the child’s quality of life and their family’s well-being. SIBs are more common among children with ASD, emphasizing the importance of understanding why these behaviors occur and how to manage them with effective strategies.

This guide will explore the causes, potential interventions, and strategies for addressing SIBs in children with autism, equipping families and caregivers with the information they need to make informed, compassionate choices.

Self-injurious behaviors (SIBs) are actions that cause physical harm to oneself, often seen in individuals with autism spectrum disorder (ASD). These behaviors can manifest in various forms, such as head banging, hand biting, skin picking, and excessive self-rubbing and scratching. For autistic children, these actions can be a way to cope with overwhelming emotions or sensory input. Understanding these behaviors is crucial for caregivers, as it helps in developing effective interventions that can improve the child’s quality of life and overall well-being.

Self-injurious behaviors involve actions that cause physical harm to oneself and are observed in approximately 42% of children with autism (Steenfeldt-Kristensen, Jones, Richards, 2020).​ These behaviors might appear early in childhood, with some children engaging in these actions as young as 12 months. Though they vary in form, common types include head-banging, self-biting, pinching, and scratching. Recognizing the triggers and documenting instances when a child engages in such behaviors is crucial to understanding underlying motivations and developing effective interventions.

The causes behind SIBs are complex and can often be traced to a combination of sensory, communicative, and behavioral factors:

1. Sensory Needs: Many children with ASD engage in SIBs as a way to meet their sensory needs. This behavior might temporarily relieve an internal discomfort or overwhelm by providing intense physical sensation (Wan Yunus, Liu, Bissett, and Penkala, 2015). Self-injury may also serve as a way to achieve sensory stimulation, helping individuals adjust their levels of arousal in response to their environment.
2. Communication Difficulties: When children lack effective means to communicate, SIBs may emerge as a substitute. For non-verbal children, SIBs can be an expression of unmet needs, distress, or frustration​ (Shkedy G, Shkedy D, Sandoval-Norton, and Cerniglia, 2019). Self-injurious behavior can sometimes stem from physical pain and serve as a means for individuals to signal their needs or avoid unpleasant situations.
3. Escape or Avoidance: In certain cases, children may engage in SIBs to escape an undesired situation or task, or to shift focus away from a source of stress ​(Alakhzami and Chitiyo, 2022).

Identifying triggers and patterns is a vital step in managing self-injurious behaviors in autistic children. Triggers can vary widely, including sensory overload, frustration, anxiety, or communication difficulties. By closely observing and documenting the circumstances surrounding SIB episodes, caregivers can uncover patterns that provide valuable insights into the underlying causes. Functional behavioral assessments (FBAs) are particularly useful in this process, as they help identify the function of SIBs for the individual. Additionally, maintaining a behavior diary to record what happens before, during, and after the behavior can reveal specific triggers and patterns, enabling more targeted and effective interventions.

To address SIBs, professionals often use Functional Behavioral Assessments (FBAs). Applied behavior analysis (ABA) is frequently employed to develop personalized intervention plans for managing specific behaviors. These assessments, which include observing the child and conducting interviews, aim to identify what triggers the behavior and how it functions within the child’s environment. The insights gained help tailor effective intervention strategies that align with each child’s unique needs​ (Minshawi, Hurwitz, Morriss, and McDougle, 2015)​ and Minshawi et al. (2014).

Interventions for SIBs vary widely and often need to be customized to meet the specific needs of each child. Here’s an overview of some common approaches:

Treating self-injurious behavior often involves using medication as part of a comprehensive treatment plan, especially for individuals with autism. Medications like antipsychotics and antidepressants can be effective in managing symptoms, but treatment should also incorporate behavioral interventions and address underlying causes for a holistic approach.

1. Sensory-Based Interventions for Sensory Overload

Sensory-based interventions (SBIs) address the sensory factors that often underlie SIBs. Tactile approaches, such as gentle massage, have shown promise in helping reduce these behaviors by providing a calming effect. Sensory tools like weighted vests or swings are sometimes used, though their effectiveness may vary from child to child​, Wan Yunus et al. (2015). Incorporating coping skills into these interventions can help manage anxiety, replace self-injurious patterns, and enhance overall communication.

2. Behavioral Strategies

Behavioral interventions are typically used to modify the child’s environment or teach alternative behaviors that can fulfill the same needs as self injury and SIBs:

• Antecedent-Based Strategies: Modifying routines or reducing triggers in the environment can help minimize the onset of self injury and SIBs. For example, adjusting the amount of sensory input the child receives or organizing a quieter setting may help prevent overstimulation​ Minshawi et al. (2015).

• Reinforcement-Based Strategies: Using positive reinforcement to encourage desirable behaviors can be an effective way to replace self injury and SIBs with healthier actions. For instance, rewarding calm behavior or alternative communication methods can gradually lessen the occurrence of self injury and SIBs​(Multidisciplinary Asses…).

• Functional Communication Training (FCT): FCT equips children with alternative communication techniques, such as using words or picture cards, to express their needs. Studies show significant reductions in self injury and SIBs when children learn to ask for breaks or help instead of engaging in harmful behaviors​ (Alakhzami and Chitiyo, 2022).

3. Medical Interventions

For some children, medical intervention may also be considered, especially if SIBs are suspected to have underlying physical causes, such as pain or discomfort from a health condition. In such cases, addressing these issues often results in a reduction of SIBs​ Shkedy et al. (2019). Additionally, nutritional and medical interventions have been reported by parents to significantly reduce self-injurious behaviors through dietary changes and specific nutritional supplements.

Effective communication and prevention strategies are essential in managing self-injurious behaviors in autistic children. Communication strategies can include using augmentative and alternative communication (AAC) devices, providing visual schedules, or using social stories to help children express their needs and understand their environment. Prevention strategies involve identifying and avoiding known triggers, providing sensory alternatives, and teaching coping mechanisms. For instance, offering a weighted blanket or using a swing can help reduce sensory overload and frustration. Teaching alternative coping mechanisms, such as deep breathing or counting, can also help reduce the frequency and intensity of SIBs, providing children with healthier ways to manage their emotions and sensory input.

Alternative therapies, such as music therapy and animal-assisted therapy, have shown promise in reducing self-injurious behaviors in autistic children. Music therapy uses music as a therapeutic tool to address physical, emotional, cognitive, and social needs, creating a calming and sensory-friendly environment. Animal-assisted therapy involves interacting with animals, which can promote physical and emotional healing. These therapies can help reduce the likelihood of sensory overload or frustration by providing a soothing and engaging experience. Additionally, they can teach alternative coping mechanisms and offer a sense of comfort and relaxation, contributing to a reduction in self-injurious behaviors and an overall improvement in the child’s well-being.

A nurturing environment can greatly contribute to managing SIBs. Parents and caregivers can play a critical role by:

• Creating Safe Spaces: Providing a safe and calming space within the home can serve as a comforting area for the child to decompress when needed.

• Building Consistent Routines: Predictable routines offer children with ASD a sense of security and reduce potential stressors that may trigger SIBs. Understanding and addressing self-injurious behavior is crucial in these routines.

• Encouraging Positive Communication: Actively reinforcing alternative communication skills builds confidence and helps children rely less on SIBs for expression.

Managing SIBs can be emotionally taxing, and seeking support can make a world of difference. Family counseling, support groups, and connecting with professionals familiar with autism can provide relief and practical guidance. Addressing caregiver stress and supporting parents emotionally is key in fostering a resilient, compassionate environment for both child and family. Professional support is also crucial in managing self-injurious behavior, which can significantly impact communication and emotional regulation.

Self-injurious behaviors in children with autism require a comprehensive, empathetic approach to improve quality of life. By gaining an understanding of the underlying causes and collaborating with professionals, families can effectively address these behaviors. With patience, tailored strategies, and supportive networks, it is possible to help children manage these behaviors in a way that promotes overall well-being and development Minshawi​ et al. (2015), Minshawi et al. (2014), Minshawi et al. (2014) and ​Shkedy et al. (2019).

An autistic child might hit his head to cope with discomfort or stress. This can be due to feeling overwhelmed, having trouble communicating, or wanting to avoid a situation. Understanding why and when this happens is important to help them.

To help your autistic child stop banging his head, it’s crucial to understand the underlying reasons for this behavior, which can stem from sensory needs, communication difficulties, or as a response to certain situations.

Examples of self-injurious behaviors in children with autism spectrum disorder include head banging, hand biting, skin picking, and excessive self-rubbing and scratching. These behaviors can be a way for autistic children to cope with overwhelming emotions or sensory input.

         American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC : Author

       Steenfeldt-Kristensen C, Jones CA, Richards C. The Prevalence of Self-injurious Behaviour in Autism: A Meta-analytic Study. Journal of Autism & Developmental Disorders. 2020;50(11):3857-3873. doi:10.1007/s10803-020-04443-1

       Minshawi, N. F., Hurwitz, S., Fodstad, J. C., Biebl, S., Morriss, D. H., & McDougle, C. J. (2014). The association between self-injurious behaviors and autism spectrum disorders. Psychology Research and Behavior Management, 7, 125-136. doi:https://doi.org/10.2147/PRBM.S44635

       Shkedy G, Shkedy D, Sandoval-Norton AH, Cerniglia L. Treating self-injurious behaviors in autism spectrum disorder. Cogent Psychology. 2019;6(1):1-14. doi:10.1080/23311908.2019.1682766

       Wan Yunus F, Liu K, Bissett M, Penkala S. Sensory-Based Intervention for Children with Behavioral Problems: A Systematic Review. Journal of Autism & Developmental Disorders. 2015;45(11):3565-3579. doi:10.1007/s10803-015-2503-9

       Minshawi N, Hurwitz S, Morriss D, McDougle C. Multidisciplinary Assessment and Treatment of Self-Injurious Behavior in Autism Spectrum Disorder and Intellectual Disability: Integration of Psychological and Biological Theory and Approach. Journal of Autism & Developmental Disorders. 2015;45(6):1541-1568. doi:10.1007/s10803-014-2307-3

       Baghdadli A, Pascal C, Grisi S, Aussilloux C. Risk factors for self-injurious behaviours among 222 young children with autistic disorders. Journal of Intellectual Disability Research. 2003;47(8):622-627. doi:10.1046/j.1365-2788.2003.00507.x

       Maryam Alakhzami, Morgan Chitiyo. Using Functional Communication Training to Reduce Self‑Injurious Behavior for Individuals with Autism Spectrum Disorder. Journal of Autism & Developmental Disorders. (2022) 52:3586–3597. doi.org/10.1007/s10803-021-05246-8

     Hey there! I’m Eddie Corletto, the passionate mind behind kidscalma.com. A proud father of an autistic teenager. A special education teacher with over ten years of experience in the classroom. I hold a master’s degree specializing in Autism and Sensory Processing Disorders. I am deeply committed to supporting autistic children and their families. Kidscalma is my platform to share both my professional and personal experiences. I specialize in creating helpful resources for parents and educators supporting children on the Autism spectrum, Sensory Processing Disorder, and other learning disabilities. When I’m not in my classroom or writing, you might catch me hiking with my family or cycling around the scenic roads of California’s Central Coast. I believe our children can achieve amazing things every day. Connect with me on Facebook or subscribe to my blog for more insights and resources!

Why Autism Head Banging Happens and how to Help?

Eddie Corletto, M.Ed. Special Education
Published November 12, 2024

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