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Understanding the development of repetitive behaviours in children over time and the links to thinking styles.
Chief investigators: Professor Helen McConachie, Professor Ann Le CouteurCollaborators: Professor Mark Freeston Researchers: Morag Watson; Melanie Johnson Funding: none Start and end dates: Start October 2005 End July 2006
Abstract: The aim is to follow up the development of children with autism spectrum disorder, who were previously assessed when they were aged 2-3 years old. The children are now aged 7-9 years. The three principal objectives are : 1. To assess change over time in the type, frequency and severity of children’s repetitive behaviours as reported by parents. 2. To gain qualitative information about the impact of children's repetitive behaviours on family life, and about parents’ coping strategies. 3. To explore the relationship between children’s thinking styles and current levels of repetitive behaviour. Background Children who have an autism spectrum disorder (ASD) frequently have repetitive interests, show resistance to change and/or display stereotyped movements. These behaviours can interfere with learning and cause distress to the individual and to their families and teachers. The nature, function and possible causes of repetitive behaviours in ASD are not well understood and in contrast to the range of studies on communication and social interaction difficulties in children with ASD there has been relatively little research devoted to understanding repetitive behaviours. Most work to date has been on stereotyped movements, in older individuals with learning disabilities, where lack of stimulation is a contributing factor. Therefore it is desirable to have an understanding of the underpinnings of repetitive behaviour, in children who have been studied over time. Publications associated with this study: McConachie H, Le Couteur A, Honey E. Can a Diagnosis of Asperger Syndrome be Made in Very Young Children with Suspected Autism Spectrum Disorder? Journal of Autism and Developmental Disorders, Volume 35, Number 2, April 2005, pp. 167-176(10) Honey E, McConachie H, Randle V, Shearer H and Le Couteur A. One-year change in repetitive behaviours in young children with communication disorders including autism. Journal of Autism and Developmental Disorders. 2006;
Summary of results Repetitive interests and behaviours in ASD… Repetitive interests and behaviours can be one of the most obvious and challenging aspects of Autism Spectrum Disorders, for the child and for other family members. Behaviours can be divided into “higher” and “lower” level interests and behaviours. Higher level behaviours include more complex types such as unusual interests and insistence on routines. Lower level behaviours include movements such as hand flapping, spinning and rocking. It is believed that children with ASD may find difficulty in planning and controlling their behaviour. It is also thought that they may process information by focussing more on the details than the ‘whole picture’. Some researchers think that repetitive interests and behaviours may be related to these ways of thinking. What we aimed to do… The purpose of this study was; · to assess how children’s repetitive interests and behaviours have changed over time · to find out whether the way that children with ASD think and see the world relates to repetitive behaviours. How we did it… 24 families, in total, took part in our study. All families had been involved in at least one previous study finding out about children’s early repetitive behaviours. The parents completed an interview to find out how much their child engaged in a range of repetitive behaviours. This included what types, how often and how severe the behaviours are currently and were in the past. The children carried out different games and puzzles to find out about how they process information and how they plan and control their actions. They also carried out tests of language ability. This information was then combined and analysed to consider our aims. This partly involved comparing the children’s current scores of repetitive behaviour to those gained in the previous studies when children were younger.
What we found out… The development of repetitive behaviours Across the group, between the ages of 2-3 to 7-9 years, parents reported that their children’s repetitive behaviours became less of a problem. However, there was a lot of variation between children, with some showing an increase, decrease or no change. As they got older, many children showed more higher level behaviours, for example they developed more unusual interests. Many children also showed fewer lower level behaviours over time, such as less hand flapping.
The relationship of repetitive behaviours to thinking process The children’s ability to plan and control behaviour and whether they focus on the details in a drawing task, was strongly related to their language ability. The more language ability that the child had, the more able they were to plan and control behaviour. The more language ability that the child had, the more they focussed on the ‘whole picture’ rather than the details. But, contrary to expectations, we found no relationship between the children’s repetitive behaviours and either; · their ability to plan and control behaviour, or · whether they focus on the details or on the ‘whole picture’.
What does this mean…? Repetitive behaviours are very complex. We cannot predict how they will develop for any individual child, although this study does show that repetitive behaviours reduced and changed in type for many children over a five year period. This information could be helpful for other families with children diagnosed with ASD, to understand that some types of problems are likely to reduce as children get older. The results do not support the view that repetitive behaviours are related to either children’s ability to plan and control behaviour or whether they focus on the details. Further research is needed to explore other reasons for these behaviours. We also need to focus on what consequences differences in thinking styles may have for children with ASD, for example, for how to present learning tasks.
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