The Prevalence of Self-injurious Behaviour in Autism: A Meta-analytic Study

J Autism Dev Disord. 2020 Nov;50(11):3857-3873. doi: 10.1007/s10803-020-04443-1.


Self-injurious behaviour is purportedly common in autism, but prevalence rates have not yet been synthesised meta-analytically. In the present study, data from 14,379 participants in thirty-seven papers were analysed to generate a pooled prevalence estimate of self-injury in autism of 42% (confidence intervals 0.38-0.47). Hand-hitting topography was the most common form of self-injury (23%), self-cutting topography the least common (3%). Sub-group analyses revealed no association between study quality, participant intellectual disability or age and overall prevalence rate of self-injury. However, females obtained higher prevalence rates than males (p = .013) and hair pulling and self-scratching were associated with intellectual disability (p = .008 and p = .002, respectively). The results confirm very high rates of self-injury in autism and highlight within group risk-markers.

Keywords: Autism; Intellectual disability; Prevalence; Self-harm; Self-injurious behaviour.

Publication types

  • Meta-Analysis

MeSH terms

  • Adolescent
  • Autistic Disorder / diagnosis
  • Autistic Disorder / epidemiology*
  • Autistic Disorder / psychology
  • Female
  • Humans
  • Intellectual Disability / diagnosis
  • Intellectual Disability / epidemiology*
  • Intellectual Disability / psychology
  • Male
  • Prevalence
  • Self-Injurious Behavior / diagnosis
  • Self-Injurious Behavior / epidemiology*
  • Self-Injurious Behavior / psychology