Beneficial effects of clonidine on severe self-injurious behavior in a 9-year-old girl with pervasive developmental disorder

We report the successful treatment of persistent self-injurious behavior (S IB) in a 9-year-old girl with pervasive developmental disorder. The girl ha d inflicted severe tissue damage to her face, neck, and inner thighs due to pinching, scratching, and rubbing of her skin. Using a rating scale to qua ntify surface tissue damage produced by SIB, the number of bodily injuries, the intensity of skin trauma, and the projected risk of further physical h arm decreased dramatically following the administration of clonidine that w as titrated to a maximum dose of 0.4 mg daily. The girl's SIB showed marked improvement over a 24-month period of observation. Issues related to pharm acotherapy of SIB using alpha adrenergic agonists are discussed.