Sapir Soker Elimaliah

City University of New York,

College of Staten Island
elm.sapir@gmail.com

  • Twitter Social Icon

By Sapir Soker Elimaliah

What is Autism¹?

A neurodevelopmental disorder that is manifested by two main areas of difficulty:

  • Social communication and interactions.

  • Restricted and repetitive behaviors (RRB) and areas of interest, insistence on sameness and sensory sensitivity.

 

Restricted and Repetitive Behaviors (RRB) in Autism

Restricted and repetitive behaviors are a diverse group of behaviors. Restricted and repetitive behaviors could be manifested in various ways and could vary between individuals and across ages². These behaviors could interfere with learning and social interactions opportunities.

There are four main types of restricted and repetitive behaviors¹

Insistence on sameness

Motor movements

Sensory sensitivity

Narrow scope of areas of interest

 
 

The Function of Restricted and Repetitive Behaviors

Among the many possible functions, the primary function of restricted and repetitive behaviors is self-regulation.

 

 

Self-regulation is an acquired skill that refers to one’s ability to adapt his or her behaviors and thoughts to the situation in order to be a part of it, despite internal conflicts and impulses. Self-regulation also refers to the ability to utilize one’s adaptive behaviors in order to achieve short and long term goals.

What is self-regulation?

Causes of Restricted and Repetitive Behaviors

Overwhelming sensory input

External and internal causes such as confusion, uncertainty and an  environment with too many stimuli at once such as loud noises and bright lights (sensory overload)   

Distracting and excessive thoughts

One's own thoughts that are too distracting, intense or dysregulated such as painful memories (but not exclusively)

The intensity of a specific emotion

An emotion experienced in a way that is uncontainable for the individual. They could be positive or negative emotions. 

 

Accepting Restricted and Repetitive behaviors in different contexts

 The presence of restricted and repetitive behaviors could be disruptive to both the person who is experiencing them and to his or her surroundings. The negative responses from the environment to harmless behaviors causes great embarrassment to the individuals and their caregivers, which leads them to avoid public places. These behaviors have an essential role in the regulation of either an over or under stimulated system. Knowing their function and causes could lead to an increase in the acceptance of restricted and repetitive behaviors, which will support the integration of neurodiverse individuals.

 

Restricted and repetitive behaviors are more “tolerable” when appearing in early childhood compare with adulthood, in special education classes and in contained environments (like therapy offices, schools...).

 

When stressed (though not exclusively), individuals with autism rely on restricted and repetitive behaviors to regulate themselves. Preventing these behaviors could lead to greater stress that could, in turn, lead to an increase in the intensity of these behaviors. It is a vicious cycle.  

Increased intensity of RRB (more self regulation needed)

Trigger of restricted and repetitive behaviors

Distracting thoughts

Sensory load and stress

Intensive emotions

Greater stress

Negative reactions from the environment

RRB appear as a strategy of self regulation 

Therefore, whenever possible, restricted and repetitive behaviors should be accepted and allowed, because they serve an important, though sometimes invisible, function.

In the same way teachers expected their students to adapt and follow the class rules, so does they should adapt themselves to their students’ needs as well.

Different Restricted and Repetitive Behaviors (RRB) Across Development

In infancy³ and early childhood, the presence of RRB or other self soothing behaviors (such as thumb sucking) are more acceptable and even seen as age appropriate.  

In school-aged children, RRB may be tolerated, but they could also lead to several negative outcomes such as:

  • Social isolation- peers would prefer to stay away

  • Bullying

  • Removing from public areas (cinemas, classes)

Adults who engage in RRB may have the most trouble and receive the most judgement. 

More About Restricted and Repetitive Behaviors

Citations

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

  2. Esbensen, A. J., Seltzer, M. M., Lam, K. S., & Bodfish, J. W. (2009). Age-related differences in restricted repetitive behaviors in autism spectrum disorders. Journal of autism and developmental disorders, 39(1), 57-66.

  3. Thelen, E. (1979). Rhythmical stereotypies in normal human infants. Animal behaviour, 27, 699-715.

  4. Kapp, S. K., Steward, R., Crane, L., Elliott, D., Elphick, C., Pellicano, E., & Russell, G. (2019). ‘People should be allowed to do what they like’: Autistic adults’ views and experiences of stimming. Autism, 1362361319829628.

  5. Watt, N., Wetherby, A. M., Barber, A., & Morgan, L. (2008). Repetitive and stereotyped behaviors in children with autism spectrum disorders in the second year of life. Journal of autism and developmental disorders, 38(8), 1518-1533.