The Association Between Repetitive, Self-Injurious and Aggressive Behavior in Children With Severe Intellectual Disability

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Colleges, School and Institutes


We evaluated the independent association between adaptive behavior, communication and repetitive or ritualistic behaviors and self-injury, aggression and destructive behavior to identify potential early risk markers for challenging behaviors. Data were collected for 943 children (4-18 years, M = 10.88) with severe intellectual disabilities. Odds ratio analyses revealed that these characteristics generated risk indices ranging from 2 to 31 for the presence and severity of challenging behaviors. Logistic regressions revealed that high frequency repetitive or ritualistic behavior was associated with a 16 times greater risk of severe self-injury and a 12 times greater risk of showing two or more severe challenging behaviors. High frequency repetitive or ritualistic behaviors independently predict challenging behavior and have the potential to be early risk markers for self-injury and aggression of clinical significance.


Original languageEnglish
Pages (from-to)910-919
Number of pages10
JournalJournal of Autism and Developmental Disorders
Issue number6
Early online date1 Jul 2011
Publication statusPublished - Jun 2012


  • Aggression, Autism spectrum disorder, Intellectual disability, Prevalence, Repetitive behavior, Self-injury, Stereotyped behavior, adaptive behavior, adolescent, adult, aggression, article, automutilation, child, child behavior, disease association, disease severity, human, intellectual impairment, major clinical study, preschool child, priority journal, school child, Adolescent, Child, Child, Preschool, Female, Humans, Intellectual Disability, Male, Self-Injurious Behavior, Stereotyped Behavior