Restricted, Repetitive Patterns of Behaviour, Interests, or Activities and Autism

Adolescent on the autism spectrum watching tv Autistic people vary enormously from each other but they all have restricted, repetitive patterns of behaviour, interests, or activities of one kind or another.

For example, they may

- have an overwhelming interest in something, such as transport systems or Dr. Who

- stick to specific routines or rituals, such as always going to the shops the same way

- repeat the same movements, such as flapping their hands over and over again

- be hypersensitive to certain sounds, such as telephones

It is worth noting that some autistic people like their repetitive behaviours and consider them useful ways to deal with stressful events.

Personal Accounts

Luke Jackson

" I can only speak for myself when I say that if one subject is on my mind or I am fascinated by something, then literally everything else is insignificant. I suppose this can be seen as selfishness and I do try to think of others; sometimes it is very hard. If I am focussed on my fascination - I feel an overwhelming excitement in me that I cannot describe. I just have to talk about it and the irritation at being stopped can easily develop into raging fury."

Adult with Autism

"I quickly become overwhelmed [in social situations]. Is it surprising that I then feel like blocking the world out and literally putting my thoughts back in order? That I start to rock to tell myself which feelings are mine? That I start speaking to myself or groaning to block out other sounds and so that I know which thoughts are mine? I think anyone experiencing life this way would do the same."

Theres Joliffe

"Reality to an autistic person is a confusing, interacting mass of events, people, places, sounds and sights. There seem to be no clear boundaries, order or meaning to anything. A large part of my life is spent trying to work out the pattern behind everything. Set routines, times, particular routes and rituals all help to get order into an unbearably chaotic life. Trying to keep everything the same reduces some of the terrible fear."

Statistics

Restricted and repetitive behaviours occur in most people with most forms of autism. However not everyone with a diagnosis of an autism will have the same restricted and repetitive behaviours.

Other Conditions

Obsessive Compulsive Disorders

It should be noted that Obsessive Compulsive Disorder is not the same as the restricted and repetitive behaviours seen in many autistic people and that care should be taken to avoid confusion.

Baron-Cohen (1989) suggests that the terms obsession and compulsion should be used with considerable caution to describe autistic behaviours and that the more descriptive term ‘repetitive activities’ should be used.

That said,

some people with autism suffer from both problems (Bejerot, 2000; Gross-Isseroff, 2001; Leyfer, 2006).
some researchers believe there are similarities in underlying pathologies and outcomes (Delorme, 2007;Kanno, 2004; Volkmar, 2005).

Causes

There are various theories as to why autistic people have restricted and repetitive behaviours including:

Abnormalities in the brain anatomy and sensorimotor gating of autistic individuals
An attempt to increase sensory input. For example, rocking may be an attempt to stimulate the vestibular (balance) system. Hand flapping or finger flicking may be an attempt to stimulate the visual system.
An attempt to reduce sensory input and environmental stimulation. For example, focusing on a particular sound may reduce the impact of a loud and distressing environment.
A coping strategy for dealing with uncertainty and confusion. Particular subjects or objects may provide structure, order and predictability.
A coping strategy for dealing with stress, anxiety and possibly Obsessive Compulsive Disorder
The individual’s enjoyment of learning about a particular subject or gathering together items of interest.
A source of pleasure for individuals who have limited access to other sources of enjoyment
Medical conditions, including streptococcal infections
A self reinforcing strategy for dealing with some of the above, which becomes worse over time

Effects

Restricted and repetitive behaviours affect each autistic person (and their family and careers) in different ways. For example some autistic people

may miss out on other activities because they are restricted to following their obsessions
may upset other members of their family by insisting that things are done they want them to be done – such as where each member of the family can sit at mealtimes
may be bullied or ostracised by their peers because their behaviours are seen to be odd or weird
may become anxious, aggressive or violent if they are not allowed to follow their repetitive behaviour
may become trapped by the behaviours, if they become self-reinforcing. The longer the behaviours persist, the more ingrained they are likely to become

However some autistic people may be able to utilise their obsessions and interests. For example, Temple Grandin was able to utilise her obsession with animals and machinery to become a professor of animal welfare.

Studies and Reviews

This page provides details of some of the most significant scientific studies and reviews on restricted, repetitive patterns of behaviour, interests, or activities in autistic people.

You can find more studies and reviews on this topic in our publications database.

If you know of any other publications we should list on this page please email info@informationautism.org

Please note that we are unable to supply publications unless we are listed as the publisher. However, if you are a UK resident you may be able to obtain them from your local public library, your college library or direct from the publisher.

Related Studies and Reviews

Baron-Cohen S. (1989) Do autistic children have obsessions and compulsions? British Journal of Clinical Psychology. 28(99), Read Abstract (New Window)
Boyd B. A., McDonough S. G., Bodfish J. W. (2012) Evidence-based behavioral interventions for repetitive behaviors in autism. Journal of Autism and Developmental Disorders. 42(6), Read Abstract (New Window)
Carrasco M., Volkmar F. R., Bloch M. H. (2012) Pharmacologic treatment of repetitive behaviors in autism spectrum disorders: Evidence of publication bias. Pediatrics. 129(5), Read Abstract (New Window) Read Full (New Window)
Geurts H. M., Corbett B. A., Solomon M. (2009) The paradox of cognitive flexibility in autism. Trends in Cognitive Sciences. 13(2), Read Abstract (New Window)
Gunn K. C. M., Delafield-Butt J. T. (2016) Teaching children with autism spectrum disorder with restricted interests: A review of evidence for best practice. Review of Educational Research. 86(2), Read Abstract (New Window)
Harrop C. (2015) Evidence-based, parent-mediated interventions for young children with autism spectrum disorder: The case of restricted and repetitive behaviors. Autism. 19(6), Read Abstract (New Window)
Lanovaz M. J., Sladeczek I. (2012) Vocal stereotypy in individuals with autism spectrum disorders: A review of behavioral interventions. Behavior Modification. 36(2), Read Abstract (New Window)
Leekam S., Prior M. R., Uljarevic M. (2011) Restricted and repetitive behaviors in autism spectrum disorders: A review of research in the last decade. Psychological Bulletin. Read Abstract (New Window)
Mandy W. P. L., Skuse D. H. (2008) Research review: What is the association between the social-communication element of autism and repetitive interests, behaviours and activities? Journal of Child Psychology and Psychiatry. 49(8), Read Abstract (New Window)
McDougle C. J., Kresch L. E., Posey D. J. (2000) Repetitive thoughts and behavior in pervasive developmental disorders: treatment with serotonin reuptake inhibitors. Journal of Autism and Developmental Disorders. 30(5), Read Abstract (New Window)
Patterson S. Y., Smith V., Jelen M. (2010) Behavioural intervention practices for stereotypic and repetitive behaviour in individuals with autism spectrum disorder: a systematic review. Developmental Medicine and Child Neurology. 52(4), Read Abstract (New Window)
Petrus C. et al. (2008) Effects of exercise interventions on stereotypic behaviours in children with autism spectrum disorder. Canadian Physiotherapy Association. 60(2), Read Abstract (New Window) Read Extract (New Window)
Rajapakse T., Pringsheim T. (2010) Pharmacotherapeutics of tourette syndrome and stereotypies in autism. Seminars in Pediatric Neurology. 17(4), Read Abstract (New Window)
Rapp J. T., Vollmer T. R. (2005) Stereotypy II: a review of neurobiological interpretations and suggestions for an integration with behavioral methods. Research in Developmental Disabilities. 26(6), Read Abstract (New Window)
Reed F. D. D., Hirst J. M., Hyman S. R. (2012) Assessment and treatment of stereotypic behavior in children with autism and other developmental disabilities: A thirty year review. Research in Autism Spectrum Disorders. 6(1), Read Abstract (New Window)
Soorya L., Hollander E., Kiarashi J. (2008) Psychopharmacologic interventions for repetitive behaviors in autism spectrum disorders. Child and Adolescent Psychiatric Clinics of North America. 17(4), Read Abstract (New Window)
Turner M. (1999) Annotation: Repetitive behaviour in autism: a review of psychological research. Journal of Child Psychology and Psychiatry and Allied Disciplines. 40(6), Read Abstract (New Window)
Zarafshan H. et al. (2017) Effectiveness of non-pharmacological interventions on stereotyped and repetitive behaviors of preschool children with autism: a systematic review. Basic and Clinical Neuroscience. 8(2), Read Abstract (New Window) Read Full (New Window)