ECT for self-injury in an autistic boy

Area of Science:

• Neuroscience
• Developmental Psychology
• Psychiatry

Background:

• Self-injurious behavior (SIB) is a significant challenge in autism spectrum disorder (ASD).
• Standard treatments, including psychopharmacological and behavioral interventions, often have limited efficacy for severe SIB in ASD.
• Refractory SIB in ASD poses risks of serious head trauma and profoundly impacts daily functioning.

Observation:

• A case study of an 8-year-old boy with ASD, mental retardation, and severe SIB (averaging 109 attempts/hour) is presented.
• The patient exhibited extreme self-injury towards his head, necessitating bilateral arm restraints and protective equipment.
• His daily functioning was severely impaired by the dangerous self-injurious behavior.

Findings:

• Fifteen bilateral electroconvulsive therapy (ECT) treatments led to significant mood stabilization.
• ECT reduced the patient's self-injurious attempts from 109 to 19 per hour.
• Maintenance ECT was initiated, and the patient could resume age-appropriate educational and social activities.

Implications:

• Electroconvulsive therapy (ECT) should be considered as a treatment option for severe, refractory self-injurious behavior in autism spectrum disorder (ASD).
• ECT may offer a viable therapeutic pathway for individuals with ASD and intractable SIB who do not respond to conventional interventions.
• This case highlights the potential of ECT in managing severe SIB, improving quality of life, and enabling functional recovery in specific ASD populations.