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Repetitive Behaviors in Autism

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Updated May 16, 2014

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Autistic Behaviors
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When most people think of autism, they envision a child lining up toys, spinning objects, or obsessively opening and closing drawers or doors. Almost as common is the vision of a person with autism who must repeat the same behaviors, phrases, or actions over and over again in a manner reminiscent of obsessive compulsion.

This type of repetitive, sometimes apparently purposeless behavior is officially called "stereotypy" or "perseveration," and it's actually described in the diagnostic criteria for autistic disorders. This means that most people diagnosed on the autism spectrum have (or have had) "restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least two of the following:

  • encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus

  • apparently inflexible adherence to specific, nonfunctional routines or rituals

  • stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)

  • persistent preoccupation with parts of objects

Repetitive behaviors in autism can vary radically from person to person, and can range from passionate and inflexible interest in a particular subject to violent self-destructive behaviors, such as head banging. Some people on the autism spectrum engage in repetitive behaviors constantly, while others only occasionally perseverate when they're stressed, anxious or upset.

Of course, perseverative behaviors are not unique to people with autism. Most people engage in some such behaviors -- nail biting, pacing, pencil or toe tapping, compulsive cleaning, or even a "need" to watch the same TV shows or sporting events without fail are all forms of perseveration.

For some people with autism, the problem of perseveration is really no problem at all, since it only arises at the same times as it would for other people (usually under stress) and the behaviors are fairly unobtrusive. Perseveration can even be a plus for people with autism, since it may relate to a passionate interest that can lead to friendships or even careers. An individual who is perseverative in his interest in computer games, for example, can join gaming clubs -- and even create games of his own.

For many people with autism, though, perseveration or repetitive behavior is not only disturbing to others, but it's also a major roadblock to communication with others and engagement in the world. A person who compulsively flicks his hands to the exclusion of anything else is clearly unable to attend to the world around him or take part in real-world activities.

Causes of and Treatments for Repetitive Behaviors in Autism

No one really knows what causes perseveration in people with autism, though there are a variety of theories. Depending on the theory you espouse, you are likely to select a particular treatment. Some treatments have been more fully researched than others, but all have had some success with some individuals and less success with others. For example:
  • If you believe perseveration is a behavioral issue, you are likely to use behavioral techniques (rewards and, in some cases, consequences) to "extinguish" the behavior.

  • If you believe repetitive behaviors are a self-calming technique used to block out too much sensory input, you are likely to use sensory integration techniques to help the individual self-calm and regain a sense of control.

  • If you believe perseveration is a manifestation of real interests on the part of the person with autism, you are likely to use therapeutic techniques such as Floortime or SonRise to connect with the autistic individual and help him turn perseverative actions into meaningful activities. For example, a person who lines up toy engines can often turn his repetitive actions into symbolic play, and can even build on his perseverative interest to develop social skills.

  • If you believe perseverative behavior is caused by anxiety or a chemical or neurological issue, you are likely to attempt to control the behaviors through the use of pharmacotherapy.
Learn More About Autism Symptoms, Types of Autism and Autism Diagnosis

Sources:

BA Boyd et al. Sensory features and repetitive behaviors in children with autism and developmental delays. Autism Res. Apr;3(2):78-87. (2010)

LN Britton et al. The efficacy of noncontingent reinforcement as treatment for automatically reinforced stereotypy. Behavioral Interventions. 17, 93-103.(2002)

Mark Lewis et al. Repetitive behavior disorders in autism. Mental Retardation and Developmental Disabilities Research Reviews. 4:80-89 (1998)

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