Exploring the Relationship Between Restricted and Repetitive Behaviors, Anxiety, and Aggression in Children with Autism Spectrum Disorder


Book Description

Previous research has demonstrated associations between restricted and repetitive behaviors (RRBs) and anxiety, RRBs and aggression, and anxiety in aggression in youth with autism spectrum disorder (ASD), yet no study has investigated the nature of the relationship between all three constructs. As such, the goal of the present study was to test the hypothesis that anxiety mediates the relationship between RRBs and aggression. Participants consisted of 115 parent(s)/guardian(s) of children with ASD who completed parent/caregiver-report questionnaires on the frequency and severity of their child's RRBs, anxiety symptoms, and aggressive behaviors. The present study is the first to use construct-specific measures of anxiety and aggression that were normed on and developed for youth with ASD, as well as the first to use Bishop and colleagues' (2013) five-factor RRB structure (which divides RRBs into sensory-motor, self-injurious, compulsive, restricted interests, and ritualistic/sameness behaviors) to test this association. Results of this study suggest that anxiety significantly mediated the relationship between overall RRBs (as a unitary construct) and aggression. At a more granular level, anxiety significantly mediated the relationship between four out of five RRB subcategories (self-injury, compulsive, restricted interests, and ritualistic behaviors/sameness) and aggression. These findings contribute to the limited literature on the relationship between RRBs, anxiety, and aggression in youth with ASD and have important implications for treatment and clinical practice.




Repetitive and Restricted Behaviors and Interests in Autism Spectrum Disorders


Book Description

This volume examines repetitive and restrictive behaviors and interests (RRBIs) affecting individuals with autism spectrum disorder (ASD). The various aspects of RRBIs, an umbrella term for a broad class of behaviors linked by repetition, rigidity, invariance, and inappropriateness to place and context are reviewed by an international team of expert leaders in the field. Key topics of coverage include: Neurological Mechanisms Underlying Repetitive: Animal and human models Underlying mechanisms of RRBs across typical and atypical development The relationship between RRBI and other characteristics of ASD (communication, social, sensory aspects) RRBIs and adults with ASD Diagnosing RRBIs An RRBI intervention model The book bridges the gap between the neurobiological and neurocognitive bodies of knowledge in relation to RRBIs and their behavioral aspects and examines associations with other domains of ASD. In addition, the volume addresses related assessment and treatment of RRBI in ASD. This is an essential resource for researchers, graduate students, clinicians and related therapists and professionals in developmental psychology, behavioral therapy/rehabilitation, social work, clinical child and school psychology, child and adolescent psychiatry, pediatrics, occupational therapy and special education.




Phenomenology of Restricted Repetitive Behavior in Children with Autism Spectrum Disorders


Book Description

The DSM-5 diagnostic criteria for Autism Spectrum Disorder (ASD) placed a new emphasis on the clinical presence of restricted and repetitive behaviors (RRB). There is little research exploring the relationship between RRB and other patient characteristics in large well-characterized samples. This study used a comprehensive measure of RRB to determine how RRB relate to key demographic and clinical features such as gender, age, IQ, adaptive behavior, and problem behaviors. In addition, it examined the relationship between different RRB measures, and how these RRB measures relate to the severity of social communication (SC) symptoms. Data from the Simons Simplex Collection (SSC) were used to address these research aims. Correlations, ANCOVA, and logistical regressions were conducted using a sample of 2,759 children with ASD. Analyses revealed varying relationships between RRB and gender, IQ, and problem behaviors. Males were more likely to obtain higher scores on subscales measuring stereotypy and restricted interests. Across full-scale, nonverbal, and verbal IQ, individuals with lower IQ scores were more likely to be reported to have higher rates of all RRBS with the exception of ritualistic/sameness behaviors. Most problem behavior subscales were significantly related to all RRB measures except for the ADOS RRB scores. Results from the regression analyses suggest that overall RRB symptom measures differ in their ability to predict SC criteria. Implications for the current literature, understanding and diagnosis of ASD are discussed and directions for future research suggested.




Repetitive Behaviors and Anxiety in Children with Autism Spectrum Disorder


Book Description

There has been limited research on repetitive behaviors in autism spectrum disorder (ASD) with little information about how repetitive behaviors in ASD differ from repetitive behaviors in other disorders, particularly obsessive-compulsive disorder (OCD). Further, there has been little research examining how repetitive behaviors are related to the social impairments characterizing ASD. This study examined the relation between repetitive behaviors, anxiety, and social problems in ASD, as well as symptoms that differentiate ASD and OCD. Parents of 49 children with ASD and 12 children with OCD completed interviews and surveys regarding their children's repetitive behaviors (Children's Yale-Brown Obsessive Compulsive Scale; Repetitive Behaviors Scale - Revised), anxiety (Spence Children's Anxiety Scale for Parents), and social impairment (Social Responsiveness Scale). Within the ASD group, approximately half of participants were reported to have clinically significant levels of anxiety. Mediation analyses provided some support for Baron-Cohen's (1989) model suggesting that social difficulties lead to anxiety, producing repetitive behaviors in individuals with ASD. However, there was more support for an alternate mediation model suggesting that anxiety leads to repetitive behaviors, creating social problems. Both models support theories suggesting that anxiety leads to repetitive behaviors in children with ASD. The current study provides converging evidence that anxiety is a significant clinical issue for many children with ASD and is related to core social symptoms. Multivariate analysis of variance and qualitative descriptions were used to compare children with ASD and children with OCD. Results indicated that the severity and frequency of most types of repetitive behaviors are comparable in children with ASD and children with OCD. However, differences were evident between groups on the number of obsessions (more in OCD) and on stereotyped and restricted behavior (greater frequency and severity in ASD). The distinction between groups on these symptoms suggests that they may be useful in differentiating ASD from other disorders. A significant number (74%) of children with ASD met criteria for OCD, suggesting that it may be appropriate to use both diagnoses in the same individual. This research has implications for our conceptualization of repetitive behaviors in ASD and our assessment and treatment of children with this disorder.




The Relationship Between Restricted and Repetitive Behaviors and Psychiatric Symptoms in Children and Adolescents with Autism Spectrum Disorders


Book Description

Approximately 1150 flyers were distributed to potentially eligible families via local school districts and other support services. A total of 88 parents completed study materials; 71 participants met eligibility criteria and had usable data on all rating scales. On average, children were 11 years old, and 87% were male; 80% of the respondents were the children's biological mothers. Results from hierarchical multiple regression analyses indicated that ritualistic and sameness behaviors positively predicted anxiety ([beta] = 0.649, p




The Relationship Between Anxiety and Repetitive and Restrictive Behavior in Children and Adolescents with Down Syndrome


Book Description

Children with Intellectual and Developmental Disabilities (IDD) have a high prevalence of repetitive and restricted behaviors (RRB) and anxiety disorders. Most of the knowledge about the relationship between RRB and anxiety in the field of developmental disabilities (DD) has been gained through studies of higher functioning individuals with autism spectrum disorder (ASD). There is little information available about the relationship between RRB and anxiety in children with Down syndrome (DS), despite common comorbidities and the potential association. This study examined the relationship between RRB and anxiety in children who have DS by recruiting the parents of 76 children and examining scores on measures of anxiety and RRB. This study found a strong relationship (r = .69) between anxiety and RRB in children with DS, but did not find level of functioning to moderate this relationship. A better understanding of the relationship between RRB and anxiety in children with DS can lead to more accurate understanding of behavioral phenotypes in DS, more accurate diagnoses, and better treatment for individuals with DS.




Self-Injurious Behavior in Individuals with Neurodevelopmental Conditions


Book Description

This book addresses self-injurious behavior (SIB) in individuals with various neurodevelopmental conditions (NDCs). It takes a cross-NDC perspective that synthesizes recent research on variability in incidence and presentation across NDCs and the natural history and neurobiology of SIB. Chapters examine implications for biobehavioral definitions of subtypes of SIB and provide a detailed guide to assessment and intervention using an integrated research-based model for individualized treatment. In addition, chapters present a practice-focused structure using case studies to illustrate clinical implications of research findings. The book concludes with a discussion of current directions in research and their potential to guide innovation in prevention and treatment of SIB. Topics featured in this handbook include: · Self-restraint among individuals who self-injure. · Self-injurious behavior in individuals with autism spectrum conditions. · Assessing and managing short-term effects of SIB. · Reducing risk of, and responding to, relapse following successful intervention with SIB. · Ethical issues associated with working with people who engage in self-injurious behaviors. Self-Injurious Behavior in Individuals with Neurodevelopmental Conditions is a must-have resource for researchers, clinicians and practitioners as well as graduate students in the fields of clinical child and school psychology, applied behavior analysis, pediatrics, social work, developmental psychology, behavioral therapy/rehabilitation, child and adolescent psychiatry, clinical psychology and psychiatry of adult intellectual disability, and special education.




Handbook of Autism and Anxiety


Book Description

The diagnosis of autism spectrum disorder (ASD) has evolved greatly since Asperger's day. And as our clinical understanding of this spectrum of disorders has grown, so has recognition of the connections between anxiety disorders and ASD—a welcome development, but also a source of confusion for many in the field. The Handbook of Autism and Anxiety brings together leading experts to explain this comorbidity, the diagnostic similarities and differences between the two disorders and the extent to which treatment for each can be coordinated for optimum results. Focusing on repetitive behaviors, social difficulties and fears as core components of anxiety disorders as well as ASD, contributors discuss specific symptoms in depth to aid in diagnosis. Assessment and treatment issues relevant to the autism-anxiety connection are considered in clinical and school contexts. And an especially timely conclusion details how key changes in the DSM-5 affect the diagnosis and conceptualization of each disorder. Key topics addressed in the Handbook include: Phenotypic variability in ASD: clinical considerations. Etiologic factors and transdiagnostic processes. Social worries and difficulties: autism and/or social anxiety disorder? Implementing group CBT interventions for youth with ASD and anxiety in clinical practice. Autism and anxiety in school settings. DSM-5 and autism spectrum disorder. The Handbook of Autism and Anxiety is an essential resource for researchers, clinicians/professionals and graduate students in child and school psychology, psychiatry, social work, education, clinical counseling and behavioral therapy.







Exploring the Relationship Between Anxiety and Social Functioning in Youth with Autism Spectrum Disorder


Book Description

Recent systematic reviews and meta-analyses reveal that psychiatric comorbidities are highly prevalent in youth with Autism Spectrum Disorder (ASD), particularly anxiety disorders. Given the high prevalence of anxiety among this population, recent research has focused on investigating potential mechanisms underpinning anxiety. The purpose of the current study was to examine the relationship between anxiety and social functioning in youth with ASD as well as the moderating influence of sex, age, and IQ. The current study involved secondary data analysis, using data from the Simons Simplex Collection (SSC) dataset of the Simons Foundation for Autism Research Initiative (SFARI). The sample included 2,856 individuals aged 4 to 18. Overall, anxiety rates were around 38% in this population and similar across parent and teacher reports. Based on both parent and teacher data, social functioning accounted for a substantial portion of the variance in anxiety, controlling for age, sex, and IQ (17% for parent report and 15% for teacher report). The addition of social functioning domains (social awareness, social cognition, social communication, social motivation, and restricted interests and repetitive behaviours) to the hierarchical regression models accounted for more of the variance in anxiety, controlling for age, sex, and IQ (24% for parent report and 27% for teacher report). All five social functioning domains were significant predictors of anxiety. For parent data, IQ was found to moderate the relationship between anxiety and social functioning, suggesting that when social functioning is low, youth without Intellectual Disability (ID) show higher anxiety than youth with ID. Limitations and future directions for the research are discussed. It is hoped that these results will assist in identifying at-risk youth and developing preventive therapeutic and school- based interventions.