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 (SIB) in a 9-year-old girl with pervasive developmental disorder. The girl had 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 quantify surface tissue damage produced by SIB, the number of bodily injuries, the intensity of skin trauma, and the projected risk of further physical harm decreased dramatically following the administration of clonidine that was 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 pharmacotherapy of SIB using alpha adrenergic agonists are discussed.