Self-harm practices such as cutting and hitting can begin in children as young as age 7, according to a study published Monday in the journal Pediatrics, reported to be the first to look at self-injury in children younger than age 11.
Research suggests that many adolescents and adults engage in self-injury as a means to self-medicate for stress and depression.
But findings from this study now warn to look out for these behaviors as early as elementary school.
"For a parent, for a teacher and for a medical professional, part of the message is to recognize that kids at younger ages are harming themselves," said Benjamin Hankin, associate professor of psychology at University of Denver in Colorado.
"There's this view that only older kids do this, but parents should pay attention to the emotion and behavior problems earlier."
Hankin and his colleagues interviewed 665 children in third, sixth, and ninth grades. Nearly 8 percent of the children reported at least one attempt to harm themselves, the study found.
Nearly 8 percent of the third graders interviewed reported at least one attempt at self-harm.
Some of the signs to look for in younger children include extreme frustration that can lead to incidents such as hitting their heads against the wall, Hankin said.
"The signs and what you're looking for can change based on age and gender of the kid," he said.
Girls were three times more likely to self-injure than boys once they reach the ninth grade, the study found.
Girls reported more cutting and carving of skin, while boys were more likely to report hitting themselves, the study found. Hankin warned parents to be aware of the risks of self-injury in earlier childhood.
"An important thing for parents is to follow their gut instinct," he said. "If you think your child is experiencing emotional pain, then ask."
"Sometimes they may deny it, but parents shouldn't shrug it off," said Hankin.