All individuals with autism exhibit restricted behaviors that are expressed through stereotypical movement or thought processes. Some typical examples include hand-flapping, lining up toys, an intense interest in a certain subject and resistance toward changes in plans. These behaviors are restricted in the sense that individuals with autism are limited by their preoccupations and show inflexibility in the way they act. They are often easily recognizable actions or reactions that contribute to the stigma of the disorder.
As such behaviors interfere with daily life, family functioning, communication and learning, they cause a lot of stress to parents and families. Sometimes, the behaviors are socially inappropriate, but individuals with autism often feel anxious and can be reactive if their activity is disrupted. It’s especially difficult for these individuals to gain new skills and knowledge during therapy, because it requires that they break out of their compulsions.
Leo Kanner was an Austrian psychiatrist who was the first person to document autism as a disorder, and these behaviors were an important part of his original description. Now that we know more about the characteristics of autism, these types of behavior are referred to more specifically in two ways:
- Doctors who diagnose autism use the term, “Restricted, Repetitive and Stereotyped Patterns of Behavior, Activities and Interests." This is from the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV).
- Researchers often use the phrase, “Restricted and Repetitive Behaviors (RRBs)."
The Diagnostic Definition
The DSM IV is published by the American Psychiatric Association and lists four main groups of restricted behaviors. In order for someone to be diagnosed with autism, they need to exhibit at least one of the categories:
- Show an unusual fixation or attachment toward a certain interest. For example, a child may memorize license plate numbers, play with a particular toy for hours or carry around balloons.
- Insist on established routines and become upset if there are changes. For example, a child may have a specific ritual when waking up, react negatively when furniture is moved or throw a tantrum if a different route is taken to school.
- Repetitively display certain motor actions that don’t seem to have a purpose. For example, a child may rock back and forth for an extended period of time, twist his or her fingers or even engage in self-injury, such as head banging.
- Obsess over parts of objects. For example, a child may incessantly spin the wheels of a toy car, repeatedly feel or smell the side of a table or focus on the eyes of doll.
What Research Says
Further insight into restricted and repetitive behaviors was published in a study in the “Journal of Autism and Developmental Disorders" in January 2009. It stated that:
- Each individual with autism displays RRBs differently and with different severities.
- RRBs generally decrease as a child grows older, regardless of gender, intellectual ability and medication.
- The most common expression of RRBs is having limited and specific interests.
- The least common expression of RRBs is repetitively injuring or bruising oneself.
Centers for Disease Control and Prevention: Autism Spectrum Disorders: Diagnostic Criteria
“Journal of Autism and Developmental Disorders"; Age-Related Differences in Restricted Repetitive Behaviors in Autism Spectrum Disorders"; Esbensen, et al.; January 2009
- “Diagnostic and Statistical Manual of Mental Disorders (Revised 4th ed.)"; American Psychiatric Association; 2000