Self-harm is a complex and sensitive issue, and studies indicate that autistic adults experience self-harm more frequently than non-autistic adults. Despite this alarming statistic, there is a lack of dedicated tools for systematically assessing self-harm patterns among autistic people. A new study published in the journal Autism, 2026 Jul, presents an innovative approach and examines a visual tool that may help in understanding this phenomenon.
The study focused on two main objectives: first, to examine the accessibility and clarity of an innovative visual tool called the "Card Sort Task for Self-Harm" (CaTS) for autistic adults. Second, to experimentally apply the tool to identify proximate and distal contributing factors to self-harm, as well as to identify experiences that occur afterward.
In the first stage, five autistic adults with lived experience of self-harm reviewed the CaTS tool to ensure its clarity and accessibility. Subsequently, a pilot study was conducted with 29 participants, who were either autistic or "possibly autistic." Most participants, 82% of them, were women, and the average age was approximately 41. During the process, participants selected an average of 42 cards to describe their self-harm experience. A sequence analysis of card choices allowed researchers to identify significant transitions between factors before and after self-harm.
Among the cards most frequently chosen by participants were descriptions of restlessness (25 instances), emotional pain (22 instances), and depression (22 instances). In contrast, cards like "being part of a gang" or "talking to a teacher" were not chosen at all. The findings showed that restlessness and impulsive action preceded self-harm. After self-harm, participants reported feelings described as "better," "worse," "exhausting," and "hopeless."
The researchers indicate that the CaTS tool offers a systematic approach to investigating self-harm among autistic adults, and it has proven to be accessible and effective. Initial findings suggest that improving emotional regulation abilities and addressing unique communication needs of autistic people may reduce the transition to self-harming behaviors. However, it should be noted that this is a pilot study with a relatively small number of participants, and further larger-scale studies will be needed to confirm the findings.
A better understanding of the factors and experiences related to self-harm among autistic adults is an important step in developing more targeted and effective support strategies.