Repetitive behaviors wax and wane among autistic youth

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20 Sep 2021, 7:12 am

Spectrum

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Some types of restricted and repetitive behaviors become more prevalent among autistic children and teenagers over time, depending on their age and intellectual ability, whereas others decrease, two new studies show.

The results lend fresh support to the argument that restricted and repetitive behaviors — a core diagnostic trait that includes repetitive movements, insistence on sameness, sensory sensitivities and restricted interests — are too diverse to be lumped together.

“This is a complex behavioral domain that comprises several different subdomains that likely have different causes and might respond to different treatments,” says Mirko Uljarević, senior research fellow at the University of Melbourne in Victoria, Australia, who led one of the studies.

Uljarević and his team analyzed parent-reported data on restricted and repetitive behavior severity, language abilities and cognitive functioning for 17,581 autistic children and teenagers in a genetic registry called SPARK. (SPARK is funded by the Simons Foundation, Spectrum’s parent organization.) They categorized the various types of restricted and repetitive behaviors into five groups: repetitive motor behaviors, insistence on sameness, self-injurious behaviors, compulsions and narrow interests.

Autistic boys have more severe repetitive motor behaviors and narrow interests than autistic girls do, whereas the opposite is true for compulsions and self-injurious behaviors, the study shows. More severe repetitive motor behaviors tended to track with lower levels of cognitive and language abilities and with younger age. The work appeared in August in the Journal of the American Academy of Child & Adolescent Psychiatry.

Narrow interests are also more pronounced among participants with a low intelligence quotient (IQ), the study suggests. But the questionnaire that parents completed — called the Repetitive Behavior Scale-Revised — does not distinguish narrow interests that are unusual in their intensity from those that are unusual in terms of content, Uljarević says. “It is clear that these two different types of interests possibly have different mechanisms and might be related in different ways to factors such as IQ.”

The other study documented 15 types of restricted and repetitive behaviors in 205 autistic children at three time points, from diagnosis until age 11, using the Autism Diagnostic Interview-Revised, which relies on parent reports. Narrow interests and sensitivity to noise increased with age, whereas repetitive use of objects, unusual sensory interests, complex mannerisms and unusual preoccupations decreased, the study shows.

Some of the trajectories seem to shift with age, based on IQ. For instance, difficulties with change in routine became more prevalent with age among children with an IQ below 93 but held steady among those with an IQ of 93 and up. The work appeared in August in Molecular Autism.

Together the studies support the notion that different restricted and repetitive behaviors have dynamic relationships with one another, and so strategies to ameliorate one might amplify another, Yerys says.


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DSM 5: Autism Spectrum Disorder, DSM IV: Aspergers Moderate Severity

“My autism is not a superpower. It also isn’t some kind of god-forsaken, endless fountain of suffering inflicted on my family. It’s just part of who I am as a person”. - Sara Luterman