Effective Interventions in the Treatment of Self-Harming Behavior in Children and Adolescents with Autism Spectrum Disorder: A Review
Abstract
1. Introduction
1.1. Self-Injurious Behaviors in Children and Adolescents with ASD
1.2. Prevalence and Relevance of the Problem
1.3. Treatment
1.4. Review of the State of the Art
1.5. Limitations and Gaps
1.6. The Current Study
2. Materials and Methods
2.1. Selection of Studies
2.2. Extraction of Studies
2.3. Risk of Bias
3. Results
3.1. Study and Sample Characteristics
3.2. Overview of Interventions
Effectiveness of Interventions
4. Discussion
Author Contributions
Funding
Conflicts of Interest
References
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Study topic | Narrative review of effective interventions for treatment of self-injurious behaviors in children and adolescents with ASD |
Population | Children and adolescents with ASD |
Intervention | Interventions for self-injurious behaviors in ASD (behavioral therapy, occupational therapy-based interventions, ABBA method, etc.) |
Comparison | Comparison of different types of interventions considering their effectiveness |
Outcome | Results of interventions will be evaluated in terms of reduction or decrease in self-harming behaviors, improvements in quality of life, or adaptive behavior |
Study design | Controlled clinical trials, cohort studies, and case–control studies. Longitudinal studies and intervention studies with control groups are the most appropriate for evaluating long-term effectiveness of interventions |
Pattern | WoS | Scopus | PubMed |
---|---|---|---|
(“adolescents”) AND (“children”) AND (“autism spectrum disorder”) AND (“self-injurious behaviors”) AND (“Intervention” OR “Psychological Interventions” OR “cognitive behavioral therapy” OR “TCC” OR “Psychotherapy” OR “Clinical Psychology” OR “Intervention program*” OR “intervention*” OR “treatment program*” OR “therapeutic program*” OR “therapy program*” OR “clinical intervention*” OR “clinical treatment*” OR “psychological treatment*” OR “cognitive behavioral therapy*” OR “ABA therapy” OR “behavioral therap*” OR “ABA” OR “occupational therapy” OR “sensory therapy” OR “sensory integration” OR “effective interventions” OR “ABA behavioral therapy” OR “Family based therapy” OR “asperger” OR “self-harm” OR “self-injurious behavior” OR “interpersonal therapy” OR “Cognitive therapy” OR “behavioral therapy). | 143 | 236 | 98 |
Inclusion Criteria | Exclusion Criteria |
---|---|
Children and adolescents (up to 18 years old) diagnosed with autism spectrum disorder. Publication must be dated no more than 10 years ago to ensure the relevance and timeliness of the approaches. Studies evaluating interventions designed to reduce or manage self-injurious behaviors. Includes different types of interventions, such as behavioral, cognitive, sensory integration, and educational therapies, among others. Articles presenting quantitative and qualitative results on the effectiveness of interventions. Research directly addressing interventions to treat self-injurious behaviors in children and adolescents with ASD. Studies that clearly describe the methodology used in the intervention (behavioral, pharmacological, sensory, etc.). Articles that include data on the effectiveness of the intervention. No language restrictions. | Studies that focus exclusively on adults with ASD or populations not diagnosed with ASD. Studies that primarily investigate medical or psychological conditions other than ASD, unless they include a significant subgroup of participants with ASD. Studies that do not specifically evaluate interventions targeting self-injurious behaviors in children and adolescents with ASD. Articles not directly related to self-injurious behaviors in ASD. Studies of other disorders or interventions not applicable to ASD. Research without empirical evidence or studies that have not been peer-reviewed. |
Author(s), Year, Country | Type of Study | Intervention/Therapy | Key Findings |
---|---|---|---|
Weiss et al. [26], (2018) Canada | Randomized controlled | Cognitive behavioral therapy | Improvement in emotional regulation and reduction in self-harming behaviors. |
Peterson et al. [27], (2024) USA | Experimental | Applied behavior analysis and other behavioral interventions | Reduction in self-harming behaviors and other problematic behaviors. |
Alakhzami & Chitiyo [6], (2022) USA | Experimental | Functional communication training | Reduction in self-harming behaviors. |
Robinson et al. [28],(2019) USA | Case | Behavioral interventions | Reduction in self-harming behaviors. |
Sabus et al. [29], (2019) USA | Review | Pharmacotherapy | Pharmacological strategies; effectiveness of risperidone; pharmacotherapy should be combined with behavioral therapy. |
Wood et al. [30], (2019) USA | Randomized controlled | Cognitive behavioral therapy | Significant decrease in both anxiety and self-injury behaviors. |
Morano et al. [18], (2017) USA | Meta-analysis | Behavioral treatments | Reduction in self-harming behaviors. |
Boesch et al. [16], (2015) USA | Case | Behavioral approach | 50% reduction in self-injurious behaviors and effectiveness in severe cases. |
Minshawi et al. [31], (2014) USA | Observational | Association analysis | Relationship between self-harm and clinical features; key functional assessment for intervention. |
Schaaf et al. [9], (2013) USA | Randomized controlled | Sensory integration therapy | 40% reduction in self-injurious behaviors; improvement in self-regulation. |
Izurieta Cossio [32], (2023) Peru | Case | Behavioral intervention | Reduction in self-injurious behaviors; effective individualized intervention. |
Ghaleiha et al. [33],(2013) Iran | Randomized controlled | Pharmacotherapy | Improvement in irritability and indirect reduction in self-harm. |
Oshima et al. [34], (2023) Japan | Randomized controlled | Cognitive behavioral therapy | Improvements in emotional self-regulation and reduction in self-harm. |
Type of Therapy | Overall Effectiveness |
---|---|
Behavioral Therapies | Behavioral therapy is highly effective in reducing self-injurious behaviors, especially with applied behavioral intervention (ABA). The best results are seen in young children, although it is also useful in adolescents with moderate self-injurious behaviors. It is especially effective for higher-functioning individuals who can learn new behavioral skills quickly. |
Cognitive Behavioral Therapies | Cognitive behavioral therapies show positive effectiveness in terms of emotional regulation, with significant reductions in self-injurious behaviors, particularly in managing frustration and anxiety. They are especially effective in children and adolescents with greater functional and verbal ability who can benefit from problem-solving and the development of emotional coping skills. |
Occupational Therapy/Sensory Integration | These therapies are moderately effective, and they are especially useful for people with sensory overreactions. These therapies help reduce self-injurious behaviors related to sensory overload. They are most useful for children and adolescents with sensory difficulties and can also be applied to people with a wider range of functional abilities. |
Combined Interventions with Medication | These interventions are effective for severe cases of ASD, especially those with emotional or neuropsychiatric comorbidities. Pharmacological interventions may be necessary in combination with other therapies to manage severe or neurochemical symptoms and are more common in adolescents with severe self-injurious behaviors. |
Combined Interventions (ABA + CBT, SI) | These interventions are highly effective in the combined management of behaviors and emotions, offering integrated improvements that address multiple factors. These interventions are ideal for children and adolescents with ASD, especially those with emotional difficulties and severe self-injurious behaviors, who require a comprehensive approach that addresses both behavioral and emotional aspects. |
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Labarca, P.; Oyanadel, C.; González-Loyola, M.; Peñate, W. Effective Interventions in the Treatment of Self-Harming Behavior in Children and Adolescents with Autism Spectrum Disorder: A Review. Children 2025, 12, 1184. https://doi.org/10.3390/children12091184
Labarca P, Oyanadel C, González-Loyola M, Peñate W. Effective Interventions in the Treatment of Self-Harming Behavior in Children and Adolescents with Autism Spectrum Disorder: A Review. Children. 2025; 12(9):1184. https://doi.org/10.3390/children12091184
Chicago/Turabian StyleLabarca, Pamela, Cristian Oyanadel, Melissa González-Loyola, and Wenceslao Peñate. 2025. "Effective Interventions in the Treatment of Self-Harming Behavior in Children and Adolescents with Autism Spectrum Disorder: A Review" Children 12, no. 9: 1184. https://doi.org/10.3390/children12091184
APA StyleLabarca, P., Oyanadel, C., González-Loyola, M., & Peñate, W. (2025). Effective Interventions in the Treatment of Self-Harming Behavior in Children and Adolescents with Autism Spectrum Disorder: A Review. Children, 12(9), 1184. https://doi.org/10.3390/children12091184