5 November 2026
Self injury changed considerably over time in young autistic children
Primary source: Boyle J, Dakopolos A, Surgent O, et al. Autism Research (2026)
What happened?
Researchers examined self-injurious behaviours in autistic children, including head-banging, self-biting and skin-picking. They compared measures collected at ages 2–5 and 4–9 years, looking at whether self-injury was associated with sensory responses, emotional and behavioural regulation, and cognitive ability.
What did researchers discover?
Self-injury was common but did not follow one fixed course. Severity changed substantially between assessments. At both time points, more severe self-injury was associated with greater dysregulation and more sensory differences. Among children followed over time, improvements in sensory measures and higher later cognitive scores were associated with reduced self-injury severity.
How strong is the evidence?
The initial assessment included 325 autistic children; 161 were assessed later, and 122 had data at both time points. This longitudinal element is valuable, but attrition reduced the follow-up sample. The study was observational, so it cannot show that sensory changes caused self-injury to decrease. Broad severity categories may also conceal differences in the form, frequency and function of individual behaviours.
What does it mean for autistic children and families?
Self-injury in early childhood may persist, improve or become more severe, and should not be assumed to have a uniform developmental course. The findings support considering sensory distress and regulation alongside communication, health, pain and environmental factors. They do not provide a tool for predicting an individual child’s trajectory.
Does it change clinical practice?
When self-injury occurs, clinicians should document its form, frequency, context and possible communicative function, while involving medical and multidisciplinary colleagues where appropriate. Reviewing sensory demands and regulation supports may be useful, but these should form part of an individual assessment rather than being treated as a stand-alone solution.
What don't we know yet?
Further research must clarify why self-injury changes, whether directly addressing sensory or regulation needs reduces it, and how pain, communication access, sleep, physical health and environmental demands affect individual trajectories.