An Overview of Managing Self-injurious Behaviors in Neurodevelopmental Disorders

Abstract

Self-injurious behavior is a common symptom in neurodevelopmental disorders which is often the least understood and difficult to treat. In this narrative review, we intend to focus on the symptomatology, causal and risk factors for SIBs along with the nonpharmacological and pharmacological management of SIBs in NDD. A manual search was done using the electronic databases of Pubmed, Google scholar on relevant publications or cross-references till December 2022 and the data was then collated to give the prevalence, epidemiology, risk factors, treatment and management of SIB in NDD. Results showed that the behaviors begin in developmental phase and are seen in nearly 30% of children with NDD. Many SIBs become chronic over time and are characterized by being repetitive in nature, compulsive or episodic. They could be superficial or deep and are best treated by nonpharmacological methods using functional behavior assessment (FBA). Despite lack of robust evidence for psychotropics some second-generation antipsychotics have been approved for pharmacological treatment of SIB. We can conclude that until more data are available, clinicians must continue to rely upon the limited available evidence, clinical judgement, and expertise, and carefully monitored response(s) to therapy when managing SIBs in children. SIB is outcome of multiple factors that initiate and maintain the behavior. Judicious use of various groups of pharmacological agents is advised. Physician preferences, history of response and safety are part of pharmacological interventions.