Understanding and addressing self-harm in kids

Content originally published on Jan. 24, 2017 and last updated Aug. 12, 2025

What is self-harm?

When a child hurts themselves by banging their head, punching walls, biting, cutting or pinching their skin, there can be several reasons why. Self-harm describes any behavior directed at oneself that causes some form of bodily injury. Children who harm themselves are not necessarily trying to end their lives, but they can significantly injure themselves if they are self-harming often or intensively.

“We call these behaviors ‘non-suicidal self-injury,’” said Dr. Jill Fodstad, PhD, a clinical psychologist at Riley Children’s Health. "These children are not trying to die, but for a variety of reasons, they don’t have another adaptive way to manage distress or communicate what’s bothering them.”

Why do children self-harm?

Some forms of self-harm are commonly experienced by children who are neurodivergent. This may include kids with autism spectrum disorder, intellectual disability or cognitive challenges. Self-harm can also occur among very young kids. Common forms of self-harm often seen in young kids and those who are neurodivergent can include banging their heads, biting themselves, slapping or pinching themselves or banging on walls. Generally, children who are neurodivergent may have challenges regulating their emotions or coping with stress. For some, these behaviors help them calm down.

“There are children with neurodivergent needs who engage in those behaviors because they view them as self-soothing. For anyone, these behaviors release endorphins, which the child may find pleasurable or helpful to reduce their negative internal state,” Dr. Fodstad said. “There are some brain-based differences in how individuals who are neurodivergent process and respond to emotions and pain. Because of that, these kids respond in ways that may be different than how someone else would respond. But self-harm can interfere with their lives.”

For kids or teens who are not neurodiverse, self-harm may mean they are experiencing anxiety, depression or feelings that no one cares about them. For some teens, self-harm may be done to fit in with a certain group. Again, these children may not want to actually harm themselves, but they may not be able to communicate when they are experiencing negative emotions and need help.

“Because of where our brains are in adolescence, these kids may also be poor planners. They may not want to die or hurt themselves, but in that moment of distress or depression, they may have a poor ability to tolerate negative emotions, challenge their thoughts or impulses, or communicate their needs,” Dr. Fodstad said. “These children may feel too ashamed to reach out to people to ask for help, so they rely on strategies that are not very productive.”

Dr. Fodstad cautions that all self-harm has the potential to lead to dangerous and serious outcomes. Continued self-harm can lead to injuries, scarring and worsening mental health. And while most kids who self-harm do not have suicidal thoughts when they injure themselves, these behaviors can escalate into an impulsive suicidal decision.

What caregivers can do

Regardless of why your child might be harming themselves, parents and caregivers have several options to address a child’s needs. You can support your child through self-harm by:

1. Identifying triggers. If there are certain situations–such as stressful lunchrooms, math tests, a recent breakup or interactions with bullies–that could lead to self-harm behavior, talk about these with your child. “Build an emotional vocabulary that works for your child so they can easily alert others when they’re distressed,” Dr. Fodstad said. “Knowing what triggers these strong emotions can help you be proactive about reducing the likelihood that your child self-harms.”
2. Adding supports or coping mechanisms to help your child tolerate distress. Look for ways to offer additional support to your child, such as finding a peer mentor to address social issues, identifying deep breathing or other stress-relieving activities, or hiring a math tutor for academic anxiety.
3. Creating a safe space for your child to communicate. Whether it’s a parent, relative or close family friend, children need to have someone with whom they can talk openly about their concerns. By signaling to your child that you will listen to them without judgment, you can offer them a place to express their problems honestly. For younger children, it may be important to use fewer punishments and avoid giving too much attention to their behavior. Instead, it’s key to support them in calming down and then talking about their feelings.

“For a lot of teens, it’s important to know their parents will support them, no matter what. Sometimes they just need to feel heard and have their feelings validated,” Dr. Fodstad said. “Listening is a nice place to start because we also want our teens to learn how to solve their own problems, learn positive coping skills and be able to navigate life stresses without their parents’ help. That’s a difficult skill. You can do this by supporting, coaching and encouraging your child while they take the lead on solutions.”

If your child is engaging in any form of self-harm that’s interfering with their success or is difficult for you to address, it’s important to get support. Talk about your concerns with a school counselor or another adult your child is comfortable with. Your doctor may also be able to recommend therapy with a mental provider or other support to address your child’s needs.