Effective Interventions in the Treatment of Self-Harming Behavior in Children and Adolescents with Autism Spectrum Disorder: A Review.

Abstract

Background/Objectives: Autism spectrum disorder (ASD) is frequently associated with self-injurious behaviors, posing significant risks to individuals and considerable challenges for families and professionals. While various interventions have been proposed, evidence regarding their relative effectiveness remains fragmented. The general aim of this study was to perform a narrative review to analyze effective non-pharmacological interventions targeting self-injurious behaviors (SIBs) in autistic children and adolescents, addressing the following research question: Which non-pharmacological interventions are effective in reducing self-injurious behaviors in autistic children and adolescents, and under what conditions? The review focused on identifying treatment types, contexts of implementation, and outcome efficacy. Methods: This review was conducted based on a search in WoS, SCOPUS and PubMed databases. According to the PICOS criteria, we included studies involving children and adolescents with ASD and interventions for self-injurious behaviors. We compared different types of interventions and evaluated outcomes in terms of reduction in SIBs. Eligible studies were those reporting quantitative or qualitative outcomes on SIB interventions, published within the past 10 years. Results: Thirteen studies met the inclusion criteria. The interventions included applied behavior analysis (ABA), cognitive behavioral therapy (CBT), sensory integration therapy, and pharmacology. The reported outcomes generally indicated reductions in the frequency and severity of self-injurious behaviors. However, many studies lacked long-term follow-up data, and few addressed the generalization of treatment effects. Methodological variability limited both the comparability across studies and the generalization of results. Conclusions: This review emphasized a multidisciplinary, individualized approach to treating self-injurious behaviors in autistic youth. ABA emerged as the most effective intervention, while CBT proved beneficial for higher-functioning adolescents, and sensory therapies addressed specific challenges. Combined treatments showed promise, and family involvement and long-term research remain essential.