My son has started to hurt himself



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LarissaM
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Wed Feb 25, 2009 10:46 am

My 9 year old son with AS was doing pretty well at the beginning of this school year. He had made some new friends and was enjoying his activities. School was going OK.

In the late fall, he started banging his head on a regular basis when he became frustrated. Anything can set him off - being surprised, disappointed, frustrated, disciplined for something, bumping his own toe. He would then repeatedly bang his head on the floor, table, wall, headboard, etc. He has now expanded this to punching himself in the head with a closed fist and also trying to pull out his hair. These episodes happen several times weekly, and can go on for hours.

The doctor has made adjustments to his ADHD medication while this was ongoing and he has been off of stimulants for a couple of months. Unfortunately this only reduced the problem slightly. The next medical recommendation is risperdal, which my husband and I are not comfortable with.

The psychologist has given suggestions, but when flooded with anger and frustration, my son cannot access any of them.

Has anyone had any success addressing their child's self-injuring behavior?



lelia
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Wed Feb 25, 2009 12:33 pm

You might want to check out Jessica Kingsley Publishing for books about that issue.



Artemisia
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Wed Feb 25, 2009 12:39 pm

My 10 year old son does this too (punching his own head, and occasionally other things like trying to choke himself). In school, his teacher has made great headway by not tolerating the behaviour. It won't be medicated away. It's something he's making an active choice to do, a strategy to get out of doing something he doesn't want to to, or a way of expressing his frustration at having done something he's not happy with himself for having done. When the teacher tells him to stop, he stops. The episodes are much less frequent now.

I don't know if your son's motives are similar, but I think it's worth exploring.



Jimbeaux
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Wed Feb 25, 2009 12:53 pm

My girlfriend's son Billy (9 yr old Aspie) does this too occasionally to get out of doing things or to "punish" himself when he knows he did something wrong.

With the punishing himself, we have taken to increasing his punishment (usually time off of the computer), since he obviously didn't think he was getting enough punishment. This has slowed fortunately.

The hitting himself to get out of doing things has worked in the past like a charm at Grandma's house (where they live during the week). He tried it ONCE to get out of cleaning up a mess he made with his toys in the living room. I told him "NOW you have to clean up your mess with your head hurting!" He cried while cleaning it up, and has never hit himself to get out of chores again... at my place.



jelibean
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Wed Feb 25, 2009 1:50 pm

Hiya, maybe this will help. Hope so :)

http://www.jelibean.com/ladder/index.ph ... &Itemid=28



equinn
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Wed Feb 25, 2009 7:27 pm

My son, too, (nine) ever since kindergarten. No medication. He just does this periodically when he's extremely overwhelmed. Ihas subsided for the most part.

I would ride it out. Medication will only excacerbate the issue. Self injurious behavior in kids on the spectrum is not uncommon. Risperdol is a radical treatement for this behavior, it seems. What will those powerful drugs do for him? Make him more compiant, dopy? drugged? How is this better? I think we are overusing medications on young kids.

Remove the extra stress in his life. Kids with autism need lots of modifications. Breaks from classroom, work, homework, etc.
Observe staff and how they treat him. Are they tolerant enough? Too lax? Inconsistent? All of these things will lead to self-injurious behaviors. Kids with autism need a different approach. If he's being forced to act "normal" then he could be extremely frustrated.

Again, my son doesn't do it as much now that he's older. I always discouraged it, of course. I think I even used religion (gentle of course) in order to explain that he was hurting God when he hurt himself because God created him. I don't know if you're religious, but this might help. they are not in control, but you need something to get him to stop and think about what he's doing.



LarissaM
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Thu Feb 26, 2009 8:44 am

Thanks everyone for the replies.

lelia, I haven't been to that site before but I found one book that seemed related - is this the one you meant? http://www.jkp.com/catalogue/book.php/i ... 1843107651

Artemisia, My son only does this behavior at home, never at school. I don't tolerate the behavior either, but other than restraining him which only escalates it, there is no way for me to stop him once he starts. Secluding him in his room to do it in private sometimes makes it end sooner.

Jimbeaux, I'm glad your girlfriend's son has stopped this behavior. His reasons for doing it seem a little different from my son's. Punishment never really worked with my son, and he doesn't ever really learn from his past experiences or mistakes. :(

jelibean, Thanks for your link. I learned something new there and will talk about some of those ideas with his psychologist today.

equinn, It's hard to ride this out because my son is feeling really badly about himself and saying a lot of horrible things about his life (when engaged in this behavior). This is part of the reason for the med recommendation from the doctor. She has followed him for several years and has also dx'ed him with a mood disorder. She feels he needs a mood stabilizer. We've tried many other ways to help him. No one wants to dope him up - we want to help him be stable. My younger NT son is very frightened by the behavior and is regularly driven to tears of worry over what's going to happen to his big brother.

All of this self-injurious behavior happens at home. He is under pressure at school because he is a perfectionist and has several academic & some social weakesses, but he never acts out there. He brings it all home.



jelibean
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Thu Feb 26, 2009 11:04 am

LarissaM lovely reply, thanks.

Often these kids will present with problems in one arena or another but rarely both unless Oppostional Defiance and Conduct Disorder are well entrenched. If your son is presenting at home, my suggestion would be that you are totally right to think he is under huge amounts of pressure at school. School is like a swimming pool. How hard is he struggling to stay afloat? How many sharks swim under the radar and bite his legs when no one else is looking? How many lifeguards actually spring into action to help him if he needs it? How many other fish that he is swimming with are actually NICE to him? All these problems get overwhelming and build up in the limbic system (amigdyla) and build up like volcanic layers until.............they errupt.

Many children that exhibit tics hold them in until the get home and then they all come out, my guess is bless his heart, he is simply unwinding in the only way he knows possible. It is incredibly stressful for these kids at school. How many times are they got at or upset but only to forget what happened. Like layers they just grow and grow.

Try a shortcut in communication when he comes home from school. I know we all want to know what kind of day they have had, but it is hard for children to know what to say except kick off or shrug their shoulders and stare at you as if you were off another planet. If they can identify Red as AWFUL, Orange as so so and GREEN for GREAT, you will get an idea. Frustration plays a huge part, he is a perfectionist so if he can't rule a margin straight that will get him upset. Embarrasement too, hilighted in class, pointed at, shouted at etc. All sorts could be happening under the water where you can't see.

So if they say Red, leave him and let him chill down. Obviously something has happened but he is not ready or able to communicate. Tender loving care in bucket loads is my advice, steer away from punishments they don't help. He possibly only kicks off where he feels safe which is why he is waiting till he gets home.

A fluffy warm towel is always welcomed when you have only just escaped drowning! When he is able to communicate with you, listen to him and help him. You are his lifeline between school and home. All too often we look at the Behaviour and the Consequences rarely the Antecedent. So what is kicking him off, a teacher maybe? Find someone at school that YOU like and trust, speak to them and explain what is happening. Find out the reason and they you can solve it. :D

Good luck though :D



CelticGoddess
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Thu Feb 26, 2009 12:56 pm

^ I absolutely agree with jelibean. My son has a tendency to self abuse. Before we started homeschooling, when he would come home from school, he coul immediately do an activity of his choice. Whatever he needed to unwind was fine. It wasn't up to me to choose because I don't know how his body is feeling that day. We usually don't speak much until dinner because I knew he had spent his entire day being overstimulated. That's when it started to dissipate. I also find that it's incredibly difficult for kids to have feelings that they can't control or can't put words too. Sometimes the feelings of frustration and disappoint build and build until it explodes. But it gets it out.

I work with him all the time to give him other options for release and after a few years, it sunk in and his brain was in a place where it could receive the information and put it into practice effectively with little to no reminders.

The one part in this thread that bothers me though is the notion of "not tolerating this behaviour." That makes it sound like he's wilfully choosing to act this way. That's really not the case. If these kids could CHOOSE not to self abuse, you can bet they would because it just don't feel good. He's reached his max and he doesn't feel like he has any other options. It's good to remind yourself of that from time to time :)



LarissaM
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Thu Feb 26, 2009 2:12 pm

jelibean, Thank you for more helpful suggestions. I think we are looking at this in a very similar way. I do try to follow his lead and not pester him about his day and wait for him to open up to me. I am trying to work with the school but it's an evolving process and not a lot of information is flowing between home and school right now.

CelticGoddess, My son gets unwind time after school too. Many days he can decide what time he will snack and do homework, so I try not to press him before he is ready.

If you could give me some ideas that were helpful for release that worked for your son I might try them with my son if he's open to them.

I understand that when my son is harming himself, he is out of control and is not making a conscious choice. When I say that I'm not tolerating it, I do not mean to imply a lack of understanding of or compassion for his difficulties. What I do mean is that I cannot let him run around my house for hours, smashing his head into things, screaming about how his life is horrible and that he wants to kill himself with a sledgehammer. As his mother, I know that this behavior requires intervention, as opposed to just accepting that this is part of who he is (especially since this is a new behavior for him). I hope that explains where I'm coming from a bit better.



CelticGoddess
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Thu Feb 26, 2009 2:21 pm

Gotcha.That makes total sense. I'm on my way out the door, but I'll come back on tonight to give you some ideas of what worked for us. Hang in there. :)



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Fri Feb 27, 2009 11:56 am

I do this when I've been overstimulated. Usually happens at night when I'm in bed, winding down from a hard day/week. I have to be restrained or I will injure myself quite badly - I'm not usually aware of it at the time, I just want to feel something. One reason why I only usually do it at home/in bed might be because I'm safe there, which might be the reason your son also does it. Outside I put my mask on, and cope the best I can. But those stressful and stimulated situations in life are hard to mask for a long amount of time.

I am very sensitive to my surroundings, so constant noise, constant ppl around me, cold temperatures, harsh light will all contribute to the meltdown I might have at the end of the day.

It could be that he has to bottle everything up inside when he's out there in the big bad world, that he just lets loose when he gets home, because that's his sanctuary.


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jelibean
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Fri Feb 27, 2009 12:21 pm

Hiya LarissaM, yes we are singing from the same hymn sheet :D

I do powerpoints and use email to communicate with school. Much easier as I am on the spectrum too. Writing an email means I can delete, add and communicate whereas you can't delete what you have said on the phone!! Sometimes it comes out all wrong.

I designed a powerpoint presentation for school, written by both my children. Anyone now that wants to find out about my son can just access the powerpoint. If anyone would like to see what I am on about do pm me with your email addie and I will send it across.

Self Stimulation aka stims.............harmful ones as you may have read on our site must be got rid of! But what are the harmful stims.......umm yea banging your head on a wall is for sure. I tend to scab pick, not for days but for months until my skin now is totally unseeable in summer clothes. Biting nails, cutting with knives or scissors, headbanging are all signs of frustration and stress. The stress loads in this kids is huge and yet they don't have the equipment in their brains to be able to deal with it. Bit like baking without an oven! Distractions work well but actually finding out what is causing the anxiety and stress will help reduce them.

Sensory Issues are mighty complex and can have dangerous consequences. I tell my kids the body is like a factory................Mouth = Door, Stomach = Canteen, Bladder/Kidneys = Water filtration system, Digestive System = Waste Disposal, Brain = Central Administration, Eyes = Windows, Bones = structure, Muscles = Plaster, Skin = Paint................and so on. Once they understand HOW the body works they can slowly start to understand that it is not just a skinbag but actually it is very important IT IS REAL. And it's theirs!! So we have to look after it!

Stims can sometimes relieve the zoning out that so many kids do. It 'wakes' them up, keeps them alert, almost like pinching yourself to stay awake.

Have you seen any of the 'stimming aids' that are available on the market. I don't mean the squishy stress balls that pop their gunge in 5minutes flat..............you end up more stressed than you were before you got hold of it! I mean the strong sturdy ones that are spectrum friendly?

Some of these kids need a hand/mouth stim. Strangely enough out of all my 5 children, the 3 with the strong hand mouth stim and needed a dummy in their mouth constantly..............are the smokers!! Stims change just as the children grow and develop so be careful that headbanging is not replaced with biting!!

Hope that helps just a bit, awful situation but he sounds as though he has the perfect mum so good luck.
x :D



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Fri Feb 27, 2009 1:53 pm

LarissaM wrote:
My 9 year old son with AS was doing pretty well at the beginning of this school year. He had made some new friends and was enjoying his activities. School was going OK.

In the late fall, he started banging his head on a regular basis when he became frustrated. Anything can set him off - being surprised, disappointed, frustrated, disciplined for something, bumping his own toe. He would then repeatedly bang his head on the floor, table, wall, headboard, etc. He has now expanded this to punching himself in the head with a closed fist and also trying to pull out his hair. These episodes happen several times weekly, and can go on for hours.

The doctor has made adjustments to his ADHD medication while this was ongoing and he has been off of stimulants for a couple of months. Unfortunately this only reduced the problem slightly. The next medical recommendation is risperdal, which my husband and I are not comfortable with.

The psychologist has given suggestions, but when flooded with anger and frustration, my son cannot access any of them.

Has anyone had any success addressing their child's self-injuring behavior?


you are going to feel terrible for your child, but children like us suffer and you as a parent can only do so much. you cannot change genetics. one thing you can TRY to do is set clear LIMITS for the child. some people do not see the line between setting limits and being abusive/controlling but these are two different things. try setting limits and sticking to them. this is an upheal battle, so take it one small step at a time.



LarissaM
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Sat Feb 28, 2009 10:11 am

Update:

We have worked on a new, streamlined plan with the psychologist to encourage our son to use replacement behaviors instead of the head-banging when he's intensely frustrated. He has bought into the plan and feels highly invested in it. We should know if it's working within a few days, though things may get worse before they get better. This morning, he even used one of the terms from the plan appropriately.

The sensory piece is huge with him because he often starts running around and crashing into furniture when he gets agitated and needs physical outlets for the energy and stress. Our house has had lots of sensory equipment come in and out over the years but since he's been better lately, we don't have lots of stimming aids that can handle 55 pounds of punch. I guess I need to dig out my catalogs or go on line for some new stuff.

I agree on the need for limit-setting. It is important to not let his self-injurious behavior spiral out of control.



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