June 22, 2020

Restricted and Repetitive Behaviours in Autism

Restricted and repetitive behaviors are one of the hallmark symptoms of autism spectrum disorder.

These mean the repetitive movements, ritualistic behavior such as rocking back and forth. In addition, sensory sensitivities are included in the repetitive and restricted behaviors.

Since studies in the 20th century mainly focused more on the social and communication delays and deficits of autism spectrum disorder, the knowledge about restricted and repetitive behaviors was lacking.

However, recent studies show that these are used to relieve anxiety in individuals with autism.

What Do Stereotyped Repetitive Behaviors Look Like?

Stereotyped behaviors or stereotypy is defined as repetitive body movements that are thought to serve no social function.

Stereotypic behaviors could be exhibited as verbal or nonverbal, fine or gross motor oriented. They could be simple or complex in nature.

Stereotyped (repetitive) behaviors could vary drastically from one person to another. While some repeat words over and over again, others could be exhibiting physical actions such as flicking or pacing.

Stereotypy is repetitive movements. They can be simple behaviors such as rocking the body back and forth, or complex behaviors like marching in place.

They may occur with or without objects. Children with autism usually engage in repetitive, restricted and stereotyped behavioral patterns.

These can be many forms. The child could mouth the objects, they can flap their hands or exhibit repetitive finger movements.

Children with autism can also utter non-contextual repeated words and phrases.

Some other examples to stereotypy include:

  • Spinning objects
  • Strict adherence to order
  • Predictable routines
  • Delayed or immediate echolalia

Stereotypic behaviors do not only occur with individuals with autism. They are common with individuals that may have other sensory or developmental disabilities.

Problems Caused by Restricted and Repetitive Behaviors (RRBs)

Restricted and repetitive behaviors could have an impact on the individual with autism’s life, varying from mild to severe.

These generally occur under stress. They may not be that obtrusive.

Many people with autism struggle in their daily lives due to the restricted and repetitive behaviors being so disturbing.

Those around them also have a difficult time engaging with these individuals.

RRBs can negatively impact communication and engagement with the individuals’ environment. This could obstruct their education or skill development.

However, restricted and repetitive behaviors may not be that bad for some individuals.

Their limited and passionate interest in certain topics and activities could help them build relationships or even careers.

At the end of the day, restricted and repetitive behaviors are not wrong in their nature. Sometimes they may help the individual overcome stressful situations.

But they could also be roadblocks to an individual’s daily life.

Children Asking Repetitive Questions

Children with autism go through stages where they ask a lot of questions. They may ask these questions over and over again.

This could be frustrating for parents and caregivers, and especially for those that they interact with.

There are various reasons that children with autism ask a lot of questions. The child could have a different reason for asking the same question.

This could be related to their emotions, environment, and many other aspects of their lives.

It is important to try and see what causes this behavior and understand what prompts the child to ask repetitive questions.

Repetitive behaviors or echolalia are one of the hallmark symptoms of autism spectrum disorder. Repetitive questions are a part of this.

Repetitive behaviors and echolalia generally occur when the child is stressed or trying to convey something, be it a thought or emotion.

When a child has trouble expressing themselves, they may ask a familiar question instead.

In addition, when they don’t know how to start a conversation, and would like to communicate, they could resort to asking questions.

Therefore, it is important to look for the underlying matter that you think is causing the repetitive questions.

Repetitive Behaviors in Adults

Adults are also affected by repetitive behaviors. It wasn’t until recently that adults got the chance to test their restricted and repetitive behaviors.

Some of the repetitive behaviors exhibited by adults include strict routines, lining up objects, insistence on sameness, fidgeting with objects and more.

Since most tests for assessing repetitive behaviors are designed for children, adults were kind of left in the dark.

The questions in the tests designed for children are mostly directed towards parents and caregivers.

There are also references in those questions that don’t really apply to adults.

Psychologists from Cardiff University have developed the first self-assessment test in the hopes of helping clinicians diagnose autism in adults.

Through this test, it is assessed to what extent the adults are affected by one of the hallmark criteria used to diagnose autism, meaning repetitive behaviors.

Although not designed to diagnose autism, this test could help determine whether the adult has repetitive behaviors.

Many of the measures used for autism research and diagnosis depend on the feedback from parents, caregivers, teachers, and individuals in contact with the child with autism. However, this test can be self-implemented by adults.

For example, in the questionnaire Repetitive Behaviors Questionnaire-2 (RBQ-2), there is a question like “Does your child have any special objects he/she likes to carry around?”. This may not apply to the adult.

In the new test, a part of the study published in the Journal of Autism and Developmental Disorders, psychologists rephrase the question as “Do you have any special objects you like to carry around?”.

In this question, one of twenty in the Repetitive Behavior Questionnaire-2 for adults (RBQ-2A), does not refer to play time or toys, and adults with autism can complete the questions by themselves.

Routines and Resistance to Change

Individuals with autism love routine. Any disruption to their routines could bring tantrums. However, there is another side to this.

Children with autism have a very different understanding of the world. Life is very unpredictable and confusing for them.

They often would like to know what is going to happen next, or even every day. That is why they prefer to have a daily routine.

They like taking the same route to school, eating the same food, dressing up in the same order. Rules are important to them. It may be difficult to change the way they do things.

Change is really stressful for all these reasons. Even the minor changes like moving from one activity to another could cause distress.

Daily schedules help them know what is going to happen next in a given day, giving them some comfort. Sometimes this strict adherence to routine and sameness could even go beyond.

They could be upset when their physical environment changes, like the place of the chair in a room. They may prefer to eat certain types of food in certain colors. Here are some more:

  • Restricted and limited preference for fabrics of their clothes or everyday items
  • Need for daily activities bound with routine, like meal times
  • Following a strict schedule every day while conducting daily tasks
  • Attention to tiniest details of their routines

The dependence on routines could vary depending on the stress levels, illnesses, etc. People with autism have an especially difficult time dealing with the unexpected changes.

Although change is not a comfortable idea for them, autistic individuals can manage to cope with the situation better if they are prepared in advance.

Sometimes, these routines and repetitive and restricted behaviors can negatively affect the individual’s life. They cause distress and discomfort.

While learning or developing a skill, they could be a roadblock. At these times, intervention could be necessary.

How Can Parents Help the Repetitive Behaviour?

There are a couple of things that can be done to help the individual.

  • Get to the root of it: Understanding the function of the behavior could be a great way to reduce anxiety caused by it.
  • Set structure: People with autism love structure. It helps them understand how things work in the world. Use visual supports or social stories. Plan your day beforehand. This will alleviate the stress that comes with changing activities.
  • Adjust the environment: Restricted and repetitive behaviors could be a way of autistic child to state that there are some sensory stimuli they are not comfortable with in the environment they are in. Maybe the classroom is too bright, or the chair is uncomfortable.
  • Early intervention: Behaviors would be harder to change the longer they continue. Set limits from an early age for some behaviors that might be appropriate for a child but not for an adult.
  • Encourage skill development: Social and self-regulation skills can help manage the stress or the discomfort that can come with uncertainty, which may lead to repetitive behaviors.
  • Make use of their interests: If your child is obsessively into a certain activity or topic, make use of it. Utilize this obsession and interest to increase their skills. You can also promote self-esteem and boost socializing.

Why Do Autistic Kids Do That?

It is still not certain why children with autism exhibit restricted and repetitive behavior. There are various theories.

One of the theories is that restricted and repetitive behaviors are a result of attention deficits.

In addition, recent advancements in technology lead scientists to think that these behaviors could also be a way to relieve stress for the individual.

Depending on the severity of the repetitive behaviors, certain interventions could be tried.

If the behavior is dangerous and hurting the child, for instance if they are banging their head on the wall, this behavior should be altered.

One way to go about altering the behaviour could be using behavioral techniques like rewarding to “extinguish” the behavior.

However, before going about this way, the parents and caregivers should really understand the purpose of the behavior. If it is helping the child, “extinguishing” might not be such a great idea.

If these are helping the child to calm down or manage some sensory challenges, the child should be supported while they modify their routines.

Parents should also work with a therapist to find the best approach to handle the behavior, making life less stressful and difficult for them.

If you feel like these behaviors are caused as the child is trying to self-calm themselves to block out sensory overload, you can utilize sensory integration techniques to help them regain a sense of control.

When the repetitive behavior is caused by anxiety or some chemical imbalance or a neurological issue, you could attempt to control such through pharmacotherapy under the guidance of your child’s doctor.

Treatments of Repetitive Behaviour

As mentioned before, repetitive behaviors don’t always need “fixing”. However, some severe forms could lead to greater problems if left untreated.

Echolalia, repeating of words and phrases, for instance, could hinder the development of communication skills and socializing.

Some of the interventions and therapy methods are mentioned above. But there are other methods used in reducing the repetitive behaviors if need be.

Positive behavior could help improve the situation of the children with autism through eliminating the problem behaviors.

First, the underlying reasons behind these repetitive behaviors should be investigated. Sometimes autistic children exhibit these behaviors to attract attention, while other times they are a way of self-calming.

If you feel like the repetitive behaviors are caused by attracting attention, being ignorant to these could allow them to abandon the behaviors after a while.

Instead of showing too much interest in the act, the child’s attention could be attracted through alternative games and activities, helping them to quit the action.

Children with autism have unique and special abilities. Discovering and improving them could be effective in reducing the harmful repetitive behaviors.

Behavioral treatments, special therapies, parental attention and various combinations of these can also be used to treat the repetitive behaviors. Usually stereotyped behaviors disappear in time.

They can appear when the individual is distressed or trying to relax.

In these times, the caregivers could shift the attention of the autistic child to something they enjoy or are interested in.

Technology could come really handy while modifying the behavior of the child. Some mobile device applications can attract the attention of children for long stretches of time, distracting them from the repetitive behavior.

Selecting an application that is also educational could really improve the skills of the child.

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How to Stop Repetitive Behaviors

The real question here is whether the repetitive and restricted behaviors should actually be stopped?

Recent studies showed that stimming is actually a way for the individual with autism to calm themselves when they are overwhelmed with certain emotions.

Autistic individuals are sensitive to some sensory stimuli. They can feel discomfort if the light is too bright or the fabric of the couch is too scratchy.

Sometimes they express their emotions through using repetitive behaviors.

There used to be a section in repetitive behaviors’ definition that stated “non meaningful acts”. However, there is some evidence indicating that this might not be the case.

If the act is not hurting the individual or way too disruptive, the behaviors could be helping the individual in some manner.

However, if the repetitive behaviors are hurting the individual, then there are some interventions that can be tried to modify the behavior in a positive manner. We have discussed some of them above.

How Can Parents Help This Behavior?

The first thing to do is understand the function of repetitive behavior. It will be easier to adjust to intervention or support to give to the child.

Another thing that can be done is to modify the environment and remove or adjust things that are causing the child anxiety.

In addition, autistic individuals respond very well to structures.

They like knowing what will happen next. This could help reduce the occurrence of repetitive behaviors that stem from anxiety of moving from one activity to another.

You can also contact an expert autism counsellor to manage the anxiety levels of your child.

Early intervention would be a great way to get ahead of the situation as it becomes difficult in time to modify the behavior. Here are some other practices you can try to take repetitive behaviors under control in a positive manner:

Boundaries: Determine clear and consistent boundaries. You can limit the time that the child could talk about a subject, for instance. Start with small limitations and increase them gradually. Set realistic goals that you can plan together and try to achieve them. Again, start slow to build on success and increase the confidence of the child.

Self-Regulation Skills: These are activities that help the individual manage their behavior and emotions. If a person can identify when they are feeling anxious and you equip them with alternative ways to use, the repetitive behaviors could decrease in time. These alternative ways could include relaxation techniques, squeezing a stress ball, or developing a communication system to indicate when one is anxious.

Perseverative Behavior in Autism

Perseveration is when the child gets stuck on a topic or an idea. Although it is seen in all children, you can also observe this behavior in children with autism.

Children with autism who perseverate often repeat the same thing or fall into repetitive behaviors.

They look like they are stuck on the same topic, unable to break it off. They might not know how to.

They may be feeling stressed and behave in this way to manage that stress.

It is also important to know perseverance is different from obsession. Obsession could be more severe.

Autistic children with perseveration are not just fixated on a topic. They are usually unable to convey their emotions and thoughts, too.

They may have trouble overcoming their anger or being scared. It may be usual for them to ask the same question over and over again.

Or they may give the same answer to different questions, regardless of it being relevant or meaningful.

Perseveration could be a coping mechanism for some of the children with autism. They may fall into repetitive behaviors when they feel overwhelmed with emotions.

Which Behavior Would Be an Example of a Restricted and Repetitive Pattern of Behavior?

Simple motor activities performed over and over could be an example of restricted and repetitive behaviors. These include rocking back and forth, flapping hands, hitting head on objects, etc. Children could line up their toys in certain patterns.

Echolalia is also common with children with autism, where they repeat phrases, words or paragraphs without the intention to interact or communicate.

What is Restricted Interest in Autism?

Many individuals with autism have restricted interests. Restricted interests are the intense interest by people with autism in specific topics or certain objects.

An autistic individual could be really interested in a TV show, or a subject such as maths or arts.

They have deep knowledge on these areas of interest as they enjoy being involved with them. They may talk about their interests and go into monologue about the topic they like to talk about.

Restrictive interests could be repetitive.). A child with autism could spin a wheel on their toy car, for instance.

Restricted interests can be interruptive on daily life, causing tantrums and anxiety.

However, the child could be really good with their skills in this restricted area as well.

What is Self Stimming in Autism?

Self stimming is the self stimulating behaviors done by individuals with autism. It usually involves repetitive movements and sounds, and everybody has different ways of doing it.

Not just autistic people, everyone engages in some sort of self-stimulating behaviors, be it biting your nails or leg shaking.

Stimming is part of the diagnostic criteria for autism as they may get out of control, causing problems.

However, this does not mean that stimming is always a bad thing. It should be handled when it is disruptive.

But it can be helpful in managing stress and anxiety.

For most, it is a harmless act that might not even be noticed. Self stimming is a little bit more noticeable in people with autism.

They may rock back and forth, flap their hands, or twirl. However, as long as it does not cause any interference or danger, the behavior is mostly harmless.

Here are some of the common self stimming behaviors for people with autism:

  • Rocking back and forth
  • Flapping hands
  • Flicking hands
  • Snapping fingers
  • Walking on toes
  • Repeating words
  • Repetitive blinking

There are some that may cause harm to the individual with autism, such as banging their head, punching, biting, swallowing dangerous items, etc.

How Do You Control Stimming in Autism?

As is the case with repetitive behaviors, the question here is whether or not stimming needs to be controlled.

If the act is not causing major problems, it doesn’t necessarily need to be taken under control.

Parents and caregivers should investigate whether self stimming is causing social isolation, or disruptions? Is it leading to your child harming themselves?

If your answers are yes, please contact the child’s doctor to figure out a plan.

If self-stimming is just a way for them to be comfortable when they are anxious, it would not be a good idea to eliminate the action altogether.

The goal should always be to support and encourage the child to express themselves safely.

In the event that self-stimming behavior is not harmful, you should look into the root cause of the act. If you can find the reason behind it, it becomes easier to manage.

  • Observe the child and see what happens before or triggers the stimming. You can then eliminate or reduce this trigger, lowering the anxiety level of the child.
  • Encouraging positive and acceptable behaviors and self-control will also help the child understand the concept and adapt to that behavior, leaving out the stimming.
  • Daily routines and tasks also help individuals with autism be structured, feeling safer.
  • Don’t punish. It is not helpful. Without getting to the root of the behavior, the one you thought you stopped will be replaced with another.
  • If you have the chance, get professional help from specialists. They will be able to evaluate your child to identify the root cause of the stimming and recommend how to approach it.

Stimming could be permanent or it could go away. It may get better as the child grows up. But it can also get worse if the person is under a lot of stress.

Learning self-control skills could really improve the negative impacts of stimming in every aspect of the autistic individual’s life.

Do my Child’s Restricted Interests Need to be Fixed?

The short answer is no.

People with autism spectrum disorder are unique with their restricted interests.

These interests could be encouraged and developed to a point that they can make a career out of it.

Restricted interests do not need to be fixed. Trying to fix them or ignoring what the person is interested in could be stressful to them.

This may isolate them, make them feel depressed and lonely. Instead of eliminating them, you can foster these special interests.

If your child is really into math, they can meet new people if they join a math club.

Your child could be interested in playing video games. Today, we have the ability and infrastructure to turn this passion into a career, where they can socialize and be entertained, while also earning their life.

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This post does not provide medical advice. See Additional Information.

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