What are repetitive and restrictive behaviors?

Restrictive and repetitive behaviors are common in individuals who experience autism spectrum disorder (ASD). Many children with ASD present with some restrictive and repetitive behaviors throughout their development. 

Repetitive and restrictive behaviors can present in different forms, and some of the most common categories of these behaviors include:

Restrictive interests: 

Restrictive interests refers to when a child becomes hyper-focused on a single topic or aspect of a topic to the point of obsession. For example, a child may have an unusual and extensive knowledge of tigers and show little interest in discussing other topics. Restrictive interests can make it difficult for a child to add to their knowledge of other subjects, and can be especially difficult for children in a classroom setting, who may not be able to move on from one preferred activity to another. Toddlers and babies can present with restrictive interest by demonstrating a clear and unwavering preference for one toy or specific piece of a toy (e.g., the wheel of a truck). For example, if a baby only wants to play with one specific toy truck or continuously turns back and forth between the same two pages of a book over and over. 

Strict adherence to routine: 

Children with ASD may find it difficult to stray from familiar routines to the point of it inhibiting their ability to adapt to change. For example, a child may not want to leave school early to go to a doctor’s appointment (which strays from their daily routine) or may insist on walking the exact same route to the park every time. Young children and toddlers may demonstrate strict adherence to routine by reacting strongly to any deviations from their usual feeding or sleeping schedules, for example. 

Echolalia:

Echolalia refers to frequently repeated phrases by those other than the original speaker. Children with ASD may repeat or “echo” the words of others, such as parents of other children in the immediate vicinity. It is also common for children who present with echolalia to repeat favorite phrases from TV shows, movies, or books. The repeated phrases often do not relate what a child may be doing or who they are speaking to, and occasionally can just sound like noises or parts of utterances other than sentences. 

Repetitive motor behaviors: 

Sometimes known as stereotypy, repetitive motor behaviors refer to movements that a child performs over and over again often as a reaction to various stimuli. One of the most common examples of stereotypy in young children is hand-flapping, but it can also look like jumping, spinning, or head shaking. Repetitive motor behaviors can often be jarring or disruptive in classroom environments and social interactions with other children. In some cases, these behaviors can result in self-injury. For children with consistent and/or excessive stereotypy, therapists can work with them to find appropriate replacement behaviors that they can use instead to express their emotions or process the sensory stimuli in their environment. 

These behaviors can make it difficult for children to learn how to adapt to changes in their environment or maintain social relationships. Clinicians who work with children with ASD often recommend therapeutic services, such as applied behavior analysis (ABA), that work with children to reduce these behaviors or find healthy replacement behavior options.

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References:

Kim, So Hyun, and Catherine Lord. “Restricted and repetitive behaviors in toddlers and preschoolers with autism spectrum disorders based on the Autism Diagnostic Observation Schedule (ADOS).” Autism research : official journal of the International Society for Autism Research vol. 3,4 (2010): 162-73. doi:10.1002/aur.142

“Restrictive and Repetitive Behavior.” Kennedy Krieger Institute, kennedykrieger.org, 2020, https://www.kennedykrieger.org/patient-care/conditions/restrictive-and-repetitive-behavior.  

“Echolalia and Its Role in Gestalt Language Acquisition.” Clinical Topics, ASHA, 2020, https://www.asha.org/practice-portal/clinical-topics/autism/echolalia-and-its-role-in-gestalt-language-acquisition/