Working with children is often challenging, but dealing with a very young child who engages in self-injurious behavior (SIB) is uniquely unsettling. When the preschool child we fostered began biting, pinching, head-banging, I found myself slipping into deep insecurity. Were we not loving him enough? Were we failing to take care of his needs? It felt like a deep, personal failing.
During this time, our counselor provided a resource that mentioned self-harm as an operant behavior. I did not take it well at all. Offering Support to Families without Judgement
Before diving into it, let’s briefly look at SIB itself. Clinical psychologist Dr. Jill Fodstad refers to these actions—like head-banging, punching, or biting—as non-suicidal self-injury. The core reason for these actions is often an inability to manage or communicate distress in an adaptive way.
Defining Self-injurious Behavior and Operant Behavior
Self-Injurious Behavior (SIB): Any behavior directed at oneself that causes bodily injury, often seen as a way to cope when adaptive strategies are unavailable.
The “Why” Behind SIB: The reasons for SIB often fall into two primary groups:
- Neurodivergent Children (Autism, intellectual disability): For this group, SIB often acts as a self-soothing mechanism. These behaviors release endorphins, which can help regulate intense emotions or cope with stress due to differences in emotional processing.
- Neurotypical Children/Teens: In this group, SIB is frequently linked to underlying anxiety, depression, feelings of isolation, or simply a poor ability to tolerate negative emotions and communicate needs effectively.
Now, let’s get back to the term that threw me for a loop: operant behavior.
When a behavior is described as operant, it means that the behavior is influenced by its consequences. The likelihood of that behavior happening again is affected by whether the outcome was positive or negative.
Essentially, it’s a voluntary behavior that is controlled by its results in the environment, allowing for learning through reinforcement or punishment.
Strategies for Addressing Self-Injurious Behaviors in Early Childhood
When supporting a family dealing with self-injurious behavior, our work is two-fold: addressing the behavior and supporting the caregiver’s emotional capacity.
Here are suggestions for how to offer support:
- Prioritize Safety First: Remind caregivers that the immediate priority is to Keep Him Safe. This may mean temporarily using padding or thick clothing to minimize physical harm while the intervention plan is developed.
- Team Approach: Coach the family to Gather a Team (pediatrician, specialists, therapists). Reassure them that this is not a sign of failure, but a necessary step to prevent caregiver burnout and ensure holistic care.
- ABCs: Suggest that the family begin to Keep a Record—tracking the Antecedent, Behavior, and Consequence. Frame this as a detective tool, not a report card.
- Offer Adaptive Strategies: Discuss strategies for meeting the child’s unmet needs, such as
- Try Sensory Soothing techniques (weighted blankets, deep pressure) if the behavior is tied to sensory and emotional regulation
- Teach ways to increase communication skills related to emotions (social-emotional learning strategies, alternate communication such sign language, picture boards for communicating emotions)
There is no one-size-fits-all solution for a child hurting himself. It’s a difficult situation but it can improve over time. Early Intervention providers working with families going through this need to remember to be supportive and encourage them to focus on one thing at a time one day at a time.
References for Self-Injurous Behavior in Early Intervention
- Operant Behavior. https://dictionary.apa.org/operant-behavior
- The Best Way To Give Advice Without Offending. https://www.familyrecoveryacademy.online/blog/the-best-way-to-give-advice-without-offending
- Understanding and addressing self-harm in kids. https://www.rileychildrens.org/connections/head-banging-punching-biting-handling-self-harm-behaviors-in-kids
- 6 Strategies for Addressing Self-Injurious Behaviors. https://www.wonderbaby.org/articles/self-injurious-behaviors
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