Repetitive Behaviors and Autism

So I’ve talked about the first two areas of concern in autism, which are social interactions and communication.  The last area is repetitive behaviors.

As a recap, according to the DSM IV these are the requirements for a diagnosis of autism.

  • At least two symptoms from the area of Social Interaction are present
  • At least one symptom from the area of Communication is present
  • At least one symptom from the area of Repetitive Behaviors is present
  • A total of 6 (or more) items are present from the 3 areas listed above
  • Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:
    • Social interaction
    • Language as used in social communication
    • Symbolic or imaginative play
  • The disturbance is not better accounted for by Rett’s Disorder or Childhood Disintegrative Disorder.
Ok, let’s talk about Repetitive Behaviors.  Like I said above, at least one of the following is present.
  • Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
  • Apparently inflexible adherence to specific, nonfunctional routines or rituals
  • Stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole body movements)
  • Persistent preoccupation with parts of objects
What does this look like?
Restricted patterns of interest.  The key to this area is the intensity and focus.  We all have interests, but it is the intensity and focus on that interest that can become disruptive to every day life.  For some it may be a subject like trains, dinosaurs, trucks, star wars, etc.  It may become the only thing the individual will talk about and can have an effect on relationships and school depending on how focused they are on that subject.  For others it may be in lining things up, or matching objects.  This can affect ones life when the intensity is so strong that they have a meltdown every time things are not how they would like them to be lined up.  
Specific, nonfunctional routines or rituals.  Just like we have our own rules for things, and I’m sure that some individuals with autism don’t understand our rules…some individuals with autism have their own rules and we just don’t get it.  I had a student and his “rule” was that he had to enter the building through a certain door.  I didn’t know about this “rule” and it took a while before I figured it out, but if he went through the right door instead of the left door (even if we already made it halfway down the hallway) he would have to turn around go back outside and come in through the left door.  This was a behavior that was specific, nonfunctional and turned into a ritual.
Repetitive motor mannerisms.  Many of us have little movements that we do when we are in stressful moments, or when we are trying to pay attention.  For example, when we are sitting in a meeting all day, we tend to get restless.  We start to bounce our leg, or tap our pencil on the desk.  Once again what this is looking at is the intensity and focus.  Many individuals with autism have repetitive behaviors that may begin as a coping mechanism for them but can easily turn into habit.  Some of these repetitive behaviors may be hand flapping, walking on tip toes, spinning, darting across the room, flicking their fingers in front of their eyes, etc.
Preoccupation with parts of objects.  Sometimes you will find that individuals with autism focus on parts of objects rather than looking at the object as a whole.  For example rather than playing with a toy car, the child may be overly focused on the tires.  Instead of using the toy functionally, they may only spin the tires.
Repetitive behaviors can be all consuming and may affect an individuals ability to function fully in their environment, however that information can be very useful as we learn to interact with each individual. 
If you have any concerns about your child’s development, please contact your doctor.

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