Restricted and Repetitive Behaviours

What are they?

Restricted and repetitive behaviours (RRBs) are considered a core characteristic of Autism Spectrum Disorder (ASD) . For an individual to be diagnosed with ASD they must have the presence of an RRB. RRBs can encompass a variety of different behaviours from repetitive motor movements (e.g. hand-flapping, rocking), restricted patterns of interests, preoccupation with specific parts of an object rather than looking at the whole of an object (e.g. looking at the wheels of a car rather than the actual car), an insistence on sameness, inflexibility with daily routines, and engaging in nonfunctional routines. Many routines appear nonfunctional from the perspective of a neurotypical individual but are likely functional from the perspective of the individual engaging in the behaviour. These routines can look like eating the same type of foods, insisting that a single route be driven, or touching objects in a repetitive fashion.

Although the presence of an RRB is essential for a diagnosis of ASD, the severity of the symptoms of RRBs range from mild (little impact on daily functioning) to severe (significant impact on daily and independent functioning). Research shows that there is a positive correlation between the severity of RRBs exhibited from an individual and the impact that ASD has on their functioning.

What can be done about them?

Developing an effective intervention will depend on the function of the behaviour. Understanding whether the function is: socially mediated (meaning that it is maintained by attention from others), escape or avoidance from a non-preferred task, to have access or continued access to an item or activity, or automatic reinforcement (which looks like an individual engaging in the behaviour across environments with or without social attention or stimulation) will determine effective strategies. A Behaviour Consultant and Occupational Therapist can provide expertise in determining the function and implementing effective strategies.

Some evidence-based practices that are being used by professionals to target a variety of RRBs include the following:

• Differential Reinforcement of Incompatible Behaviour: This involves teaching an individual an alternative replacement behaviour, which would be incompatible with the target behaviour. It also involves prompting and reinforcing the use of the incompatible behaviour, while providing no response/no reinforcement for the target behaviour. For example, a student may be taught to squeeze their hands together instead of flapping their hands in front of their face in certain environments/contexts, such as during a conversation. They would be reinforced/praised for the squeezing and ignored when hand-flapping.
• Functional Communication Training (FCT): As problem behaviour is often communicative, FCT entails teaching an individual to engage in a more appropriate/functional behaviour that essentially gets the same message across. For example, if an individual engaged in non-contextual vocalizations to escape math class, the individual could be taught to request a break to get out of math class.
• Response Interruption and Redirection: This involves physically and/or verbally blocking an individual from engaging in an RRB and immediately prompting an alternative replacement behaviour that attempts to serve the same function or provide the same sensory input as the target behaviour. For example, a student who repetitively places his fingers in his mouth may have his hand re-directed to hold a squishy ball.

RRBs are a characteristic of ASD that require deeper understanding and further research. Therefore, there may be an element of trial-and-error when determining which strategy is the best fit for any individual child. Consultation with other professionals in the field, such as an Occupational Therapist and Behaviour Consultant, is highly recommended.