b. Repetitious Behavior –
Raulston & Machalicek (2017) point out that within the repetitive behavior literature, there are generally two categories described – Lower-order: involving motor stereotypy like hand flapping, rocking, lining up toys, or flipping pages of a book; usually found in those very young children. Higher order: including obsessive preoccupation with odd interests and excessive question asking; usually found in those with advanced language skills.
Also, telling us that the latest edition of the Diagnostic & Statistical Manual of Mental Disorders – DSM-5, describes four areas of Restrictive & Repetitive Behaviors (RRB) to include:
- Stereotypy – repetitively tapping or banging an object on a surface; clutching, spinning, rolling, moving, or placing objects in a stereotypical manner.
- Insistence on sameness – inflexible adherence to routines or ritualized patterns of verbal (echolalia) or non-verbal behavior.
- Perseverative interests – uncontrollable repetition of a word, phrase or gesture despite the absence or cessation of a stimulus. Insisting to continue an act or activity without purpose.
- Hyper or hypo activity to sensory input or unusual interest in sensory aspects of the environment
< My Thoughts > “…four areas of Restrictive & Repetitive Behaviors in the newer DSM-5.”
One of the reasons clinicians say this is an important part of the newer DSM-5 is because it changes how they arrive at an accurate diagnosis for persons with autism.
The Centers for Disease Control & Prevention (CDC) put it this way –
- Stereotyped or repetitive motor movements
- Insistence on sameness, inflexible patterns.
- Highly restricted & fixated interests of abnormal intensity
- HYPO (under) or HYPER (over) activity to sensory input
In an Overview of Repetitive Behaviors in Autism, expert and parent, Lisa Jo Rudy tells us that repetitive, purposeless behaviors, like lining up toys, spinning objects, or opening and closing drawers or doors can become a problem when getting in the way of ordinary daily activities.
She tells us that the DSM-5 lists abnormal, intense focus on repetitive motor movement of objects, speech and highly restricted fixated interests, or preoccupation with unusual objects. Focus on such things as – ritualized patterns of verbal or nonverbal behavior, flipping objects, echolalia, and/or idiosyncratic phrases. As well as, insistence on sameness; or, inflexible adherence to routines, and extreme distress at small changes. Above text by Lisa Jo Rudy; retrieved from: https://www.verywellhealth.com/repetitive-behaviors-in-autism-260582
< My Thoughts > “…focusing on things…”
Sonny is nonverbal, he makes sounds and laughs, but no language, so all of his repetitive behavior is nonverbal. We purposely give him ‘interactive’ toys so that he can engage in ‘purposeless behaviors’. “Wait, what?” My reasoning is that, much like the autistic child or adult who repeats video scripts as a type of communication, Sonny can use his ‘See and Say’ toy. Of course, this is where the perseverance comes in.
“Someone poisoned the waterhole!” “Someone poisoned the waterhole!” “Someone poisoned the waterhole!”… (Courtesy of Tom Hanks’ voice, Toy Story 3) Sometimes accompanied by Sonny’s laughter… and sometimes by his sounds of frustration if his juice cup is empty.
Pushing the same button, over and over and over, for no apparent reason, can make the listener crazy. But, we have taken a cue from Sonny’s playbook, and just tune out what we don’t want to hear. Or, in the case of some really irritating sounds or phrases we just make a slight adjustment to that ‘See and Say’ button. Sometimes, I laugh, move him over and start hitting the button that yells “HELP MEEEE! HELP MEEEE! Smiles.
What perseverating may look like would be for the child to continue to have an adverse reaction to a noise, an action, or some undesirable stimuli… long after that stimuli has ceased. They may be unable to bring themselves out of prolonged stimming, even though the stimming isn’t calming them.
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