# Sensory Mechanisms and Self-Injury

> **NIH NIH R01** · UNIVERSITY OF MINNESOTA · 2021 · $559,313

## Abstract

Over two decades ago, NIH estimated costs associated with self-injurious behavior (SIB) associated with
intellectual and developmental disabilities (IDD) exceeded $3 billion (US). There is little reason to think the
prevalence estimates have changed but assuredly the costs of care have. Despite progress in the behavioral
assessment and treatment of individual SIB cases, our scientific understanding of risk for the disorder remains
severely limited. One consequence of the `wait till it develops' approach is that individual SIB cases tend to be
treated long after the onset of the disorder making it a clinically difficult and expensive (and often intractable)
problem. Contrary to our own predictions, it has become clear that in very young children with developmental
delay, variables typically considered as SIB `risk factors' (e.g., poor expressive language) may have prognostic
value but do little to separate children on initial risk. Equally clear is there may be individual difference markers
which should be considered in an integrated bio-behavioral model of SIB risk to stratify vulnerable children with
more precision into `high/low' risk groups. Based on our work to date, the following framework has emerged:
(1) there is a subgroup of very young children with IDD with altered peripheral innervation and immune cell
activity; (2) this may be part of the biological substrate for the development of a phenotype characterized by
abnormal patterns of sensory responsiveness. We hypothesize that SIB is more likely to emerge in cases that
have this early phenotype.
We have already established that peripheral innervation, immune cell activity, and
abnormal sensory responsiveness can be objectively and reliably measured very early in children with
developmental delays, prior to the onset of SIB.
The overall objective of this application is to apply a
prospective developmental approach to model SIB risk. Accordingly, we hypothesize the subgroup of children
with (i) altered peripheral sensory innervation, (ii) increased inflammatory and immune activity, and (iii)
increased sensory reactivity will be at the highest etiological risk for SIB. The outcomes will have clinical impact
because (a) current methods of assessment and treatment of SIB rely on the emergence of SIB and thus likely
miss early opportunities for greater biological and behavioral plasticity, and (b) the putative risk markers being
investigated provide plausible and novel targets in a shift towards early prevention of this devastating and
costly clinical condition.

## Key facts

- **NIH application ID:** 9757797
- **Project number:** 5R01HD044763-13
- **Recipient organization:** UNIVERSITY OF MINNESOTA
- **Principal Investigator:** FRANK J SYMONS
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $559,313
- **Award type:** 5
- **Project period:** 2004-04-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9757797

## Citation

> US National Institutes of Health, RePORTER application 9757797, Sensory Mechanisms and Self-Injury (5R01HD044763-13). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/9757797. Licensed CC0.

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