Self-injurious behaviour in children, adolescents and young people with mental retardation

Self-infjurious behaviour (S.I.B.) is among the most serious, unmanageable and destructive behaviours exhibited by young persons with mental retardation (learning disabilities). S.I.B. has a prevalence of 10% in this population but it varies as a function of a variety of risk factors i.e. level of retardation, age, residential setting, presence of psychiatric disorder and the presence of sensory and communicative deficits. Various functions of S.I.B. have been demonstrated in studies, such as attention-seeking, communication, escape Ôr avoid social situation and self-stimulation.

For the past twenty years, there has been wide agreement that S.I.B. is multiply caused and multiply affected. Various behavioural and biological factors have been implicated as potential determinants of S.I.B. Recent research has started to examine the effect that S.I.B. and other challenging behaviours may have on the behaviours of others. It is most likely that a mutual reinforcement process exists. On the other hand, the dopamine, serotonin and especially the endogenous opiate system have been implicated as potential biological determinants of S.I.B. In addition, the role of psychiatric disorders is becoming more recognised.

Various treatment interventions have been attempted with behavioural and pharmacological being the most popular ones. Interventions through communication training may be more useful and necessary; increasing the communicative repertoire of children at risk for developing S.I.B is one of the suggested strategies. The need for prevention and early intervention is being showed as well as the need for broader interventions that might impact on the whole person.

Key-words: Self-Injurious Behaviour, Children / Adolescents / Young People, Mental Retardation (Learning Disabilities).