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Potential Risk Factors for the Development of Self-Injurious Behavior among Infants at Risk for Autism Spectrum Disorder

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      Abstract

      Prevalence of self-injurious behavior (SIB) is as high as 50% among children with autism spectrum disorder (ASD). Identification of risk factors for the development of SIB is critical to early intervention and prevention. However, there is little empirical research utilizing a prospective design to identify early risk factors for SIB. The purpose of this study was to evaluate behavioral characteristics predicting SIB at age 2 years among 235 infants at high familial risk for ASD. Logistic regression results indicated that presence of SIB or proto-SIB and lower developmental functioning at age 12 months significantly predicted SIB at 24 months. A pattern of persistent SIB over this period was associated with a diagnosis of autism and poorer cognitive and adaptive outcomes.

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      Most cited references 53

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      Varieties of repetitive behavior in autism: comparisons to mental retardation.

      Systematic study of abnormal repetitive behaviors in autism has been lacking despite the diagnostic significance of such behavior. The occurrence of specific topographies of repetitive behaviors as well as their severity was assessed in individuals with mental retardation with and without autism. The occurrence of each behavior category, except dyskinesias, was higher in the autism group and autistic subjects exhibited a significantly greater number of topographies of stereotypy and compulsions. Both groups had significant patterns of repetitive behavior co-occurrence. Autistic subjects had significantly greater severity ratings for compulsions, stereotypy, and self-injury. Repetitive behavior severity also predicted severity of autism. Although abnormal repetition is not specific to autism, an elevated pattern of occurrence and severity appears to characterize the disorder.
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        Risk markers associated with challenging behaviours in people with intellectual disabilities: a meta-analytic study.

        A meta-analysis of prevalence and cohort studies conducted over the last 30 years was carried out to identify risk markers for challenging behaviour shown by individuals with intellectual disabilities (IDs). A total of 86 potential studies was identified from the review, with 22 (25.6%) containing sufficient data to enable a statistical analysis to be conducted. Results indicated that males were significantly more likely to show aggression than females, and that individuals with a severe/profound degree of ID were significantly more likely to show self-injury and stereotypy than individuals with a mild/moderate degree of ID. Individuals with a diagnosis of autism were significantly more likely to show self-injury, aggression and disruption to the environment whilst individuals with deficits in receptive and expressive communication were significantly more likely to show self-injury. In most cases, tests for heterogeneity were statistically significant, as expected. The meta-analysis highlighted the paucity of methodologically robust studies of risk markers for challenging behaviours and the lack of data on incidence, prevalence and chronicity of challenging behaviour in this population.
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          Atypical behaviors in children with autism and children with a history of language impairment.

          The frequency, course, and inter-relationships of atypical eating, sleeping, self-injurious behavior, aggression and temper tantrums in children with autism and children with a history of language impairment (HLI), was investigated using a parent interview that was created to examine these problem behaviors. The relationships between these behaviors and language, IQ, severity of autistic symptoms and depression were also assessed. Atypical eating behavior, abnormal sleep patterns, temper tantrums, and self-injurious behavior were significantly more common in the children with autism than those with HLI. Within the autism group, children who exhibited more atypical behaviors tended to have a lower nonverbal IQ, lower levels of expressive language, more severe social deficits and more repetitive behaviors. No relationship between the number of atypical behaviors and measures of cognitive or language ability was noted in the HLI group. However, having more atypical behaviors was related to increased restricted, repetitive behaviors in children with HLI. The atypical behaviors could be divided into two groups: abnormal eating and sleeping, which were independent and tended to begin early in life; and self-injury, tantrums and aggression, which began later and were inter-related. Sleep abnormalities were more common in children (groups combined) diagnosed with major depression.
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            Author and article information

            Affiliations
            [1 ]GRID grid.17635.36, Department of Educational Psychology, , University of Minnesota, ; 56 East River Rd., Minneapolis, MN 55455 USA
            [2 ]GRID grid.4367.6, Department of Psychiatry, , Washington University in St. Louis, ; St. Louis, MO USA
            [3 ]GRID grid.34477.33, Department of Radiology, , University of Washington, ; Seattle, WA USA
            [4 ]GRID grid.17635.36, Institute of Child Development, , University of Minnesota, ; Minneapolis, MN USA
            [5 ]GRID grid.34477.33, Department of Speech and Hearing Sciences, , University of Washington, ; Seattle, WA USA
            [6 ]GRID grid.239552.a, Center for Autism Research, , Children’s Hospital of Philadelphia, ; Philadelphia, PA USA
            [7 ]GRID grid.17089.37, Department of Pediatrics, , University of Alberta, ; Edmonton, AB Canada
            [8 ]GRID grid.10698.36, Department of Psychiatry, , University of North Carolina at Chapel Hill, ; Chapel Hill, NC USA
            Contributors
            ORCID: http://orcid.org/0000-0003-4300-8195, jjwolff@umn.edu
            Journal
            J Autism Dev Disord
            J Autism Dev Disord
            Journal of Autism and Developmental Disorders
            Springer US (New York )
            0162-3257
            1573-3432
            20 February 2017
            20 February 2017
            2017
            : 47
            : 5
            : 1403-1415
            28220358 5385192 3057 10.1007/s10803-017-3057-9
            © The Author(s) 2017

            Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

            Funding
            Funded by: FundRef http://dx.doi.org/10.13039/100000025, National Institute of Mental Health;
            Award ID: K01MH101653
            Award Recipient :
            Funded by: FundRef http://dx.doi.org/10.13039/100000071, National Institute of Child Health and Human Development;
            Award ID: R01HD05574
            Award ID: P30HD03110
            Award Recipient :
            Funded by: FundRef http://dx.doi.org/10.13039/100000073, Autism Speaks;
            Funded by: FundRef http://dx.doi.org/10.13039/100000893, Simons Foundation;
            Categories
            Original Paper
            Custom metadata
            © Springer Science+Business Media New York 2017

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