The reasons behind the higher prevalence of SIB in individuals with ASD versus

The reasons behind the higher prevalence of sib in

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The reasons behind the higher prevalence of SIB in individuals with ASD versus DD is not completely understood and need to be explored. In this study, we adjusted for multiple child and maternal characteristics. Low IQ is a known risk factor for SIB (McClintock et al. 2003), and we similarly found that lower IQ scores were associated with more SIB. We also found that IQ scores were lower in children with ASD versus DD, but the difference in SIB prevalence between the two groups persisted after adjustment for IQ. Thus, our data suggest that IQ scores alone cannot explain the difference in SIB prevalence between the two groups. Therefore, other unaccounted factors in our study, such as deficits in executive functions (EF) and adaptive behaviors skills, or their interactions may be involved in SIB occurrence (Gilotty et al. 2002; McClintock et al. 2003; Oliver and Richards 2015; Richards et al. 2012; Turner 1999). EF are a collection of cognitive abilities required for executing and controlling goal-directed behaviors in a constantly changing environment (Jurado and Rosselli 2007). Deficits in EF (i.e., inability to generate, plan, shift and inhibit behavior) may compromise the ability to control repetitive behaviors (Lopez et al. 2005; Turner 1999). Oliver and Richards (2015) proposed a model that elucidated a potential role of deficits in EF in SIB based on the co-occurrence of SIB, impulsivity, and repetitive behaviors. These authors suggested that all these three behaviors could have the same etiology linked to difficulties in regulating behaviors due to deficits in EF. Differences in the types of deficits in EF have been documented between children with ASD and DD. For example, a recent review by Craig et al. (2016) on deficits in EF in those with ASD and ADHD indicated both similarities and differences. One important difference was the documentation of abnormalities in the area of cognitive flexibility/perseveration that affected mostly those with ASD and may result in inability to shift or disengage from an activity and occurrence of persistent repetitive behaviors, including SIB. Further, Lopez et al. (2005) reported associations between deficits in specific types of EF (cognitive flexibility, working memory, and response inhibition) and the occurrence of restricted, repetitive behaviors in those with ASD. It is possible that the same mechanism that leads to restricted, repetitive behaviors is also involved in the occurrence of SIB as suggested by Oliver and Richards (2015). Thus, there is a need to evaluate the association between deficits in EF and SIB in large samples of children with ASD. Soke et al. Page 6 J Autism Dev Disord . Author manuscript; available in PMC 2019 July 01. Author Manuscript Author Manuscript Author Manuscript Author Manuscript
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Adaptive behavior skills are age-appropriate skills, such as self-care, expressive and receptive language, toileting, that allow individuals to function independently in a society (Kanne et al. 2011).
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