Assessment and Treatment of Self Injury

This discussion with Dr. Brian Iwata delves into the complexities of self-injurious behavior (SIB) in individuals with autism and intellectual disabilities. Dr. Iwata outlines the various forms of SIB, from head-banging and biting to rarer behaviors like pica and air swallowing, emphasizing the significant health risks and challenges in treatment. He explores different assessment approaches, including functional behavior assessments and physiological theories, such as pain insensitivity and the endogenous opioid hypothesis. The conversation highlights the importance of understanding the function of SIB—whether for sensory stimulation, attention, or escape—to develop effective, individualized interventions. The discussion also touches on medical evaluations, protective strategies, and innovative assessment tools like trauma scales and digital imaging for wound analysis, underlining a comprehensive approach to managing and reducing SIB in affected individuals.