Cognition and behavior: Context affects repetitive behavior
Repetitive behaviors are often motivated by anxiety when children with autism and intellectual disability transition from one task to the next, but they are linked to a desire for attention when the children have free time, according to a study published in May in the Journal of Applied Research in Intellectual Disabilities1.
This suggests that treatments for repetitive behaviors should take into account the underlying motivations.
Repetitive behaviors, one of the three core symptoms of autism, include hand flapping, rocking and repeating sounds. Some behaviors, such as head banging or slapping, can be harmful, and some treatments for autism are aimed at preventing them.
However, studies and anecdotal accounts suggest that repetitive behaviors may help individuals calm themselves, and that treatments that inhibit them can do more harm than good.
In the new study, researchers looked at the context surrounding repetitive behaviors in 37 children with autism who have both intellectual disability and autism, and 37 children with intellectual disability alone, all 5 to 18 years of age. Caregivers for each of the children filled out the Motivation Assessment Scale Revised, which indicates whether a repetitive behavior is an attempt to alleviate sensory sensitivity or anxiety, a way to seek attention or objects, or an attempt to escape from a situation2.
For example, the questions include “Does the behavior occur when the person is expected to do something new?” and “Does the behavior occur when you take away a favorite toy, food or activity?” The caregivers filled out 279 questionnaires, one for each behavior exhibited over a six-week period and in different contexts, such as in a playground or sitting at a table.
The questions also took into account whether the children were performing a task suggested by a caregiver, were amusing themselves during free time or were transitioning from one structured activity to another.
In both groups of children, repetitive behaviors are most likely to be associated with a desire for attention or a certain object when children have free time. In contrast, repetitive behaviors during transitions are most likely to be associated with anxiety, the study found. That suggests that behavioral interventions should be specific to the context, such as teaching a child how to get what he or she needs during playtime, the researchers say.
Individuals with autism and intellectual disability are more likely than those with intellectual disability alone to show repetitive behaviors associated with the desire to escape during transitions. This suggests that transitional periods are particularly stressful for children with autism, the researchers say.
1: Joosten A.V. et al. J. Appl. Res. Intellect. Disabil. 25, 262-270 (2012) PubMed
2: Joosten A.V. et al. J. Autism Dev. Disord. 39, 521-531 (2009) PubMed