Subcategories of Restricted and Repetitive Behaviors in Children with Autism Spectrum Disorders

Abstract

Research suggests that restricted and repetitive behaviors (RRBs) can be subdivided into repetitive sensory motor (RSM) and insistence on Sameness (IS) behaviors. However, because the majority of previous studies have used the Autism Diagnostic Interview-Revised (ADI-R), it is not clear whether these subcategories reflect the actual organization of RRBs in ASD. Using data from the Simons Simplex Collection (n=1825), we examined the association between scores on the ADI-R and the Repetitive Behavior Scale-Revised (RBS-R). Analyses supported the construct validity of RSM and IS subcategories. As in previous studies, IS behaviors showed no relationship with IQ. These findings support the continued use of RRB subcategories, particularly IS behaviors, as a means of creating more behaviorally homogeneous subgroups of children with ASD.

ASD Validity

“…The RRBs include stereotyped movements, repetitive manipulation of objects, repetitive self-injurious behavior, specific object attachments, compulsions, rituals and routines, an insistence on sameness in the environment, repetitive use of language, as well as narrow and circumscribed interests (Bishop et al 2013;Leekam et al 2011). Given this wide range of RRB behaviors, it is possible that, in part, different forms of RRBs may be caused by different brain dysfunctions.…”

“…Leekam et al (2011) noted an age stratification in the RRBs where, Blower level RRBs are more apparent in younger and more developmentally delayed cases, and preoccupations, special interests, and obsessions more often found in older and more able cases^(p. 564). This developmental split in the RRBs has appeared as two clusters: a younger motor cluster with stereotyped movements and repetitive manipulation of objects; and an older cognitive cluster with compulsions, rituals, insistence on sameness, and circumscribed interests (Bishop et al 2013;Georgiades et al 2010;Leekam et al 2011). …”

Psychometric properties of the Repetitive Behavior Scale-Revised for individuals with autism spectrum disorder in Japan

“…Finally, in this study, we focused on the RBS-R-J total score to examine validity but did not consider factor structuring. To date, although several researchers have suggested multidimensional structuring models of the RBS-R (Bishop et al, 2012;Lam & Aman, 2007;Mirenda et al, 2010;Szatmari et al, 2006), the structuring models were inconsistent. One explanation appears to be that principal component analysis has difficulty with localized solutions.…”

“…One explanation appears to be that principal component analysis has difficulty with localized solutions. In fact, Bishop et al (2012) and Lam and Aman (2007) proposed a five-factor model of the RBS-R items, but each model had different items. Studies using a more appropriate analysis technique are needed to examine multidimensional structuring of RRBs for ASD.…”

“…Dimensional evaluation can be a more successful approach to encompass the features of RRBs than using diagnostic categories in research and clinical settings. In fact, various studies have used the RBS-R as a simple, useful instrument for evaluating RRBs in clinical trials on ASD treatment efficacy (Anagnostou et al, 2012;Dawson et al, 2010;Hardan et al, 2012), examinations of RRB subcategories (Bishop et al, 2012;Lam & Aman, 2007;Lam, Bodfish, & Piven, 2008), and research on the relationship between RRBs and associated ASD clinical features (Gabriels, Cuccaro, Hill, & Ivers, 2005).…”