Severe self-injurious behaviors in an autistic child with sensory seeking, depressive disorder and anxiety disorder: A focus on the therapeutic interventions

We report the case of a 12-year-old boy with nonverbal autism, intellectual disability, and hypermobility spectrum disorder. The patient was hospitalized in a French multidisciplinary neurobehavioral inpatient unit due to extreme self-harming behaviors. This major self-aggression led to a multi-fractured nose and to a growing risk of life-threatening traumatic injuries (risk of cervical fracture and spinal cord injury caused by forceful headbanging). These challenging behaviors required for a time the day-to-day skills of at least four caregivers and resulted in a rare escalation of restraint measures and in exceptional adaptations by our psychoeducational team. Clinical improvement was obtained after managing all causes of somatic pain and discomfort, as well as stabilizing the patient's mood and anxiety. We offered both sensorimotor developmental approaches with proprioceptive compressive garment and therapeutic body wrap, as well as protective equipment and specific psychoeducational interventions adapted to his severe self-injurious behaviors and to his developmental abilities.