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Presence of Restrictive or Repetitive Behaviors and Interests

Author: Capella Partnered with CARD

what's covered
This lesson will explore ASD-related restrictive or repetitive behaviors and interests by defining and discussing the following:
  1. Stereotyped or Repetitive Motor Movements, Use of Objects, or Speech
  2. Insistence on Sameness, Inflexible Adherence to Routines, or Ritualized Patterns of Verbal or Nonverbal Behavior
  3. Highly Restricted, Fixated Interests (Abnormal in Intensity or Focus)
  4. Hyper- or Hyporeactivity to Sensory Input or Unusual Interest in Sensory Aspects of the Environment

1. Stereotyped or Repetitive Motor Movements, Use of Objects, or Speech

before you start
Keep in mind that in addition to Criterion A (social communication and social interaction deficits), an individual must meet the criteria for at least two of the following four symptom areas related to restricted and repetitive behaviors and interests to qualify for an ASD diagnosis.

Examples of behaviors involving stereotyped or repetitive motor movements, use of objects, or speech include repeating sounds, words, or phrases out of context (ranging from single words or sounds to entire scripts of movies) and repeated movements, such as hand flapping, flipping a light switch on and off, twirling objects, lining up toys, and so on.

Individuals displaying these behaviors may:

  1. repeat sounds, words, or phrases out of context
  2. perform repeated movements, such as tensing, looking, touching, or vocalizations with no observable purpose

EXAMPLE

Terry will often repeat words and phrases to herself from her favorite movie when sitting at the lunch table with classmates.

EXAMPLE

When asked, “Do you want to paint with red or green?” Iman replies, “Red or green."

EXAMPLE

Jarrel repeatedly waves his fingers in front of his eyes and pulls grass from the yard to rub between his fingers and wave in the air.

Video Transcript


2. Insistence on Sameness, Inflexible Adherence to Routines, or Ritualized Patterns of Verbal or Nonverbal Behavior

Individuals with these symptoms may display extreme distress at small changes in schedules or routines (e.g., becoming upset when classroom schedule changes), inflexibility with changes to the organization or placement of objects, difficulty with transitions, or rigid thinking patterns.

Individual exhibiting these symptoms may be:

  1. inflexible with changes to schedules and routines.
  2. inflexible with changes to the organization or placement of objects.
  3. insistent on doing things exactly as they previously did them.

EXAMPLE

Ben has a tantrum when his caregiver takes an alternate route home because of road construction blocking the normal route.

EXAMPLE

Shantal insists on following the same route to the cafeteria every day, even when she is in a different location and another route would be shorter.

EXAMPLE

Yasmine insists her family members sit in the same exact places at the dinner table.

3. Highly Restricted, Fixated Interests (Abnormal in Intensity or Focus)

Individuals may display unreasonably strong attachment to or preoccupation with unusual objects, carry or hoard particular objects, or have excessively circumscribed or perseverative interests.

Some individuals perseverate on specific topics (e.g., an individual may turn every conversation into a discussion about mathematics).

Behaviors of these individuals may include:

  1. obsessive carrying or hoarding
  2. specific topics

EXAMPLE

Mario will repeatedly open and close the doors on toy houses and cars.

EXAMPLE

Arin will gather all of the catalogs that come in the mail and hide them behind her bed so that she can look at the credit card logos.

EXAMPLE

Preston spends many hours studying and memorizing all the train lines, times, and stops for the local transit system.

EXAMPLE

Gabriela tries to turn every conversation that she has with others into a discussion about ocean animals.

Video Transcript


4. Hyper- or Hyporeactivity to Sensory Input or Unusual Interest in Sensory Aspects of the Environment

Individuals with these symptoms may display apparent indifference to pain or extreme temperatures or may overreact to differences in temperature. They may have unreasonably adverse responses to specific sounds or textures, such as throwing a tantrum whenever a family member uses the kitchen blender or crying in terror upon handling sand or uncooked rice.

Behaviors of these individuals may include:

  1. constant manipulating or gazing at items
  2. intolerance or avoidance of particular environmental sounds

EXAMPLE

Alessander throws a tantrum whenever a family member vacuums or uses the blender.

EXAMPLE

In the housekeeping center, Margo closes her eyes and rubs the smooth pretend apple on her cheek repeatedly.

EXAMPLE

Yusef will constantly spin the wheels of cars and will approach cars in parking lots to examine their wheels.

Video Transcript

hint
Remember, the individual must have at least two of these restricted, repetitive patterns of behavior, interests, or activities (in addition to all three social communication and social interaction deficits outlined in Criterion A) to qualify for an ASD (299.00) diagnosis.

summary
In this lesson, you learned that in order for an individual to qualify for an ASD (299.00) diagnosis, they must meet the criteria for at least two of the four outlined symptom areas related to restricted and repetitive behaviors and interests: stereotyped or repetitive motor movements, use of objects, or speech, such as repeating sounds, words, phrases, or movements; insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior, such as inflexibility to changes in routines or object placement; highly restricted, fixated interests (abnormal in intensity or focus), referring to an unreasonable fixation on objects or topics; and hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment, marked by apparent indifference to pain or extreme temperatures or unreasonably adverse responses to specific sounds or textures.