The Prevalence of Self-injurious Behaviour in Autism: A Meta-analytic Study
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ORIGINAL PAPER
The Prevalence of Self‑injurious Behaviour in Autism: A Meta‑analytic Study Catherine Steenfeldt‑Kristensen1,2 · Chris A. Jones1 · Caroline Richards1
© The Author(s) 2020
Abstract Self-injurious behaviour is purportedly common in autism, but prevalence rates have not yet been synthesised meta-analytically. In the present study, data from 14,379 participants in thirty-seven papers were analysed to generate a pooled prevalence estimate of self-injury in autism of 42% (confidence intervals 0.38–0.47). Hand-hitting topography was the most common form of self-injury (23%), self-cutting topography the least common (3%). Sub-group analyses revealed no association between study quality, participant intellectual disability or age and overall prevalence rate of self-injury. However, females obtained higher prevalence rates than males (p = .013) and hair pulling and self-scratching were associated with intellectual disability (p = .008 and p = .002, respectively). The results confirm very high rates of self-injury in autism and highlight within group risk-markers. Keywords Autism · Self-injurious behaviour · Prevalence · Intellectual disability · Self-harm
Introduction The prevalence of autism within the general population varies, with recent population estimates ranging from 1 in 100 (Baird et al. 2006; Centre for Disease Control 2009) to 1 in 68 (Centre for Disease Control 2014) and higher rates of autism reported in males than in females (Baird et al. 2006; Fombonne 2009; Saracino et al. 2010). It is well established that the consequences and co-morbidities of autism pose a significant challenge for individuals, families and services (Altiere and von Kluge 2009; Hastings and Brown 2002; Hastings 2003; Knapp et al. 2009). For example, individuals with autism are at a greater risk of having co-morbid medical and psychiatric conditions such as sleep disorders Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10803-020-04443-1) contains supplementary material, which is available to authorized users. * Caroline Richards [email protected] 1
School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
Children’s Neurodevelopmental Service, Coventry and Warwickshire Partnership Trust, City of Coventry Health Centre, Paybody Building, 2 Stoney Stanton Road, Coventry CV1 4FS, UK
2
(Mannion et al. 2013), mental health problems (Bradley et al. 2004; Brereton et al. 2006; Ghaziuddin et al. 1992), and intellectual disability (Matson and Shoemaker 2009). In particular, the high prevalence of co-morbid intellectual disability in those with autism (Matson and Shoemaker 2009) means that some individuals require specialist care and support throughout their lifetime. Given the substantial impact on quality of life for those with autism, it is important to further our understanding of the factors that contribute most significantly to the development and consequences of co-morbid disorders in autism, such as symptom severity, presence and/o
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