Practitioner Review: Self-injurious behaviour in children with developmental delay

Chris Oliver*, Caroline Richards

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)
1417 Downloads (Pure)


Background: Self-injurious behaviour is shown by a significant minority of children with developmental delay and has a substantial impact on child and carer wellbeing. Characteristics such as a greater degree of intellectual disability, autism spectrum disorder, some genetic syndromes and repetitive and impulsive behaviours are positively associated with self-injury. Prevalence generally increases with age into midadulthood and the behaviour is notably persistent. Scope: In this review, we discuss the dominant causal theory of self-injury which draws on the principles of operant learning. We evaluate the utility of this theory to account for all empirical observations of self-injury. Findings: A model of self-injury is presented that extends a previous model described by Guess and Carr. The new model integrates child characteristics and operant learning principles in a phenotype × environment paradigm to explain the variance in developmental trajectory of the severity of self-injury. Conclusions: Behaviour dysregulation, as evidenced by the associations between self-injury, self-restraint, repetitive and impulsive behaviours, is identified as potentially influencing the severity and persistence of self-injury. Risk markers for self-injury are identified and the extended model indicates points of intervention and highlights the possibility of risk-related, targeted early intervention. The need for increased training of practitioners in the delivery of demonstrably effective interventions for self-injury is identified.

Original languageEnglish
Pages (from-to)1042-1054
Number of pages13
JournalJournal of Child Psychology and Psychiatry
Issue number10
Early online date28 Apr 2015
Publication statusPublished - 1 Oct 2015

Bibliographical note

© 2015 Association for Child and Adolescent Mental Health.


  • applied behaviour analysis
  • autism spectrum disorder
  • behaviour dysregulation
  • behavioural phenotype
  • genetic syndrome
  • intellectual disability
  • Self-injury

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology


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