Restricted and Repetitive Behaviors in Autism Spectrum Disorders: A Review of Research in the Last Decade

Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, Wales, United Kingdom.
Psychological Bulletin (Impact Factor: 14.76). 05/2011; 137(4):562-93. DOI: 10.1037/a0023341
Source: PubMed


Restricted and repetitive behaviors (RRBs) are a core feature of autism spectrum disorders. They constitute a major barrier to learning and social adaptation, but research on their definition, cause, and capacity for change has been relatively neglected. The last decade of research has brought new measurement techniques that have improved the description of RRBs. Research has also identified distinctive subtypes of RRBs in autism spectrum disorders. Research on potential causal origins and immediate triggers for RRBs is still at an early stage. However, promising new ideas and evidence are emerging from neurobiology and developmental psychology that identify neural adaptation, lack of environmental stimulation, arousal, and adaptive functions as key factors for the onset and maintenance of RRBs. Further research is needed to understand how these factors interact with each other to create and sustain atypical levels of RRB. The literature indicates that RRBs have the potential to spontaneously reduce across time, and this is enhanced for those with increased age and cognitive and language ability. Research on interventions is sparse. Pharmacological treatments can be helpful in some children but have adverse side effects. Behavioral intervention methods provide the better intervention option with positive effects, but a more systematic and targeted approach is urgently needed. Evidence suggests that we will learn best from the last decade of research by taking a developmental perspective, by directing future research toward subtypes of RRBs, and by implementing early intervention targeted to improve RRBs before these behaviors become entrenched.

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    • "negatively impact on academic engagement and learning (Koegel and Covert 1972; Morrison and Rosales-Ruiz 1997), and social interactions and social inclusion (Cunningham and Schreibman 2008; Durand and Carr 1987; Loftin et al. 2008). The cause of these behaviors is as yet unestablished (for review of recent research on this topic, see: Leekam et al. 2011). However, a relationship between physiological arousal and engagement in stereotyped behavior has been proposed (e.g., Hutt et al. 1964; Hutt and Hutt 1968; Lydon et al. 2013; Sugarman et al. 2014). "
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    ABSTRACT: Previous research has suggested that a relationship may exist between physiological arousal and engagement in motor stereotypy among children and adolescents with autism. It has been speculated that levels or alterations of physiological arousal may act as antecedents or reinforcing consequences for stereotypy. The current study sought to investigate the relationship between these two variables among five children aged between four and 17 years who were diagnosed with autism spectrum disorder. The results revealed little association between physiological arousal and stereotypy among these participants. However, a consistently atypical physiological response to stress, suggestive of physiological blunting, was observed. The implications of these findings for our understanding of the function of stereotypy, and stress responsivity among persons with autism, are discussed along with suggestions for future research.
    Full-text · Article · Aug 2015 · Journal of Developmental and Physical Disabilities
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    • "This class of behaviours, driven by a desire for sameness and dislike of change (Kanner 1943), includes a wide range of motor and sensory behaviours and restricted activities that are highly frequent in their repetition and invariant in their manifestation. These behaviours are also found in neurotypical (NT) individuals and those with other developmental disorders and neuropsychological conditions (for reviews see Langen et al. 2011; Leekam et al. 2011). Caregiver interviews and questionnaires are the most frequently used measures of RRBs. "
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    ABSTRACT: In two studies we developed and tested a new self-report measure of restricted and repetitive behaviours (RRB) suitable for adults. In Study 1, The Repetitive Behaviours Questionnaire-2 for adults (RBQ-2A) was completed by a sample of 163 neurotypical adults. Principal components analysis revealed two components: Repetitive Motor Behaviours and Insistence on Sameness. In Study 2, the mean RBQ-2A scores of a group of adults with autism spectrum disorder (ASD; N = 29) were compared to an adult neurotypical group (N = 37). The ASD sample had significantly higher total and subscale scores. These results indicate that the RBQ-2A has utility as a self-report questionnaire measure of RRBs suitable for adults, with potential clinical application.
    Full-text · Article · Jul 2015 · Journal of Autism and Developmental Disorders
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    • "Identifying which, if any, auditory parameters relate to RRBs in ASD would enhance our understanding of how auditory perceptual factors may contribute to the onset and maintenance of RRBs (see also Leekam et al., 2011). This specialised knowledge could facilitate the development of new effective interventions and diagnostic tools. "
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    ABSTRACT: Current views suggest that autism spectrum disorders (ASDs) are characterised by enhanced low-level auditory discrimination abilities. Little is known, however, about whether enhanced abilities are universal in ASD and how they relate to symptomatology. We tested auditory discrimination for intensity, frequency and duration in 21 adults with ASD and 21 IQ and age-matched controls. Contrary to predictions, there were significant deficits in ASD on all acoustic parameters. The findings suggest that low-level auditory discrimination ability varies widely within ASD and this variability relates to IQ level, and influences the severity of restricted and repetitive behaviours (RRBs). We suggest that it is essential to further our understanding of the potential contributing role of sensory perception ability on the emergence of RRBs.
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