Repetitive Behavior in Autism

Sensory integration can decrease repetitive movements.

If your child's autism includes repetitive rituals, you will want to learn as much as possible about repetitive behavior in autism. The common symptom of autism includes a range of unusual behaviors that may be upsetting to parents. Learning about repetitive behavior can help you better understand your child and learn possible ways to lessen the intensity of the behaviors.

Repetitive Behavior in Autism Overview

Repetitive behavior is the term to describe specific types of unusual voluntary behaviors commonly found in autism. Repetitive behavior is also sometimes referred to as self-stimulating behavior or stimming. Each case of autism is unique and not everyone experiences repetitive behavior.

People affected with autism can engage in different levels of repetitive behavior. Some people may only exhibit repetitive behavior when upset or excited. Yet others may have rigid repetitive rituals that limit their ability to participate in other activities that are not a part of their routine.

The repetitive behavior typically begins at two or three years of age and can sometimes be extreme during the preschool years. As affected children grow older, the behaviors may be less prevalent, especially with therapy.

Types of Repetitive Behavior

Patterns of repetitive behavior can manifest in a number of ways ranging from a simple hand movement to a complex physical ritual. Common repetitive behavior includes:

  • Hand or arm flapping
  • Twirling
  • Clenching muscles
  • Repeating a noise or phrase in a pattern (echolalia)
  • Rocking back and forth
  • Flicking fingers
  • Head banging

Repetitive behavior can sometimes include self-injury. Some people with autism engage in self-harming rituals such as head banging, skin scratching or excessively grinding teeth.

What is the Meaning of Repetitive Behavior?

It is unknown exactly why a person with autism engages in repetitive behavior. However, some theories suggest that the behavior is a type of response to a sensation or experience. For instance, a person with autism may rock back and forth when distressed in order to calm himself. Another affected person might flap his hands when he is excited about a favorite subject such as sports trivia.

Other theories propose that repetitive behaviors may be related to how a person with autism processes information. For example, a person with autism might flip her fingers repetitively in front of her eyes as she listens to music.

These theories lead to the question of whether or not the repetitive behavior is a form of communication. The repetitive gestures could be viewed as messages. For one person with autism, arm flapping means, "I don't like that." Yet twirling for another person with autism translates to, "This makes me happy."

Causes of Repetitive Behavior

While the cause of repetitive behavior is unknown, recent studies suggest that people with autism may have certain brain abnormalities. Some studies have noted irregularities in the brain structure of some people with autism that could result in autism symptoms such as repetitive behavior. Scientists have also identified impairments in the brain of some autistic individuals that affect cognitive skills and neurotransmitter imbalances that could produce unusual behavior.

Studies on Repetitive Behavior

Two recent studies have shed light on possible causes of repetitive behavior.

2008 Hofstra University Study

In May 2008, Hofstra University announced the results of an autism study that linked repetitive behavior to impairments in certain parts of the brain. The study involved 18 people with autism and 15 people with average brain development. Scientists used functional magnetic resonance imaging (fMRI) to figure out how the different regions of the brain responded to cognitive activities. The fMRI showed that the people with autism had less activity in the prefrontal cortex, parietal cortex and basal ganglia than the people with average brain development.

2009 Brain Abnormalities Study

A 2009 study published in the Journal of Autism and Development Disorders found that corpus callosum abnormalities in the brain might lead to autism symptoms such as repetitive behavior. The 32 study participants all had similar degrees of autism and IQs. Each participant was given a group of neurocognitive tests and MRI brain scans, which revealed that they all had a smaller corpus callosum than the average person.

Treatments for Repetitive Behavior

Behavioral therapy techniques and medications can help lessen the intensity of repetitive behavior.

Therapy

Behavioral and sensory therapy can be effective treatments for repetitive behavior in autism. Therapy techniques include:

  • Applied Behavioral Analysis: Applied behavioral analysis involves a reward system for positive behavior and ignoring repetitive behavior. A therapist conducts the therapy in a structured environment and discourages the repetitive behavior by only rewarding appropriate behavior.
  • Sensory Integration Therapy: Sensory integration therapy can help a child with autism that has trouble processing sensory information in addition to repetitive behavior. Some of the behaviors may be the result of anxiety over sensory processing issues. A therapist can help you develop a personalized plan for your child that can help address sensory issues and lessen the repetitive behavior.

Medication

Certain medications are sometimes recommended to help reduce repetitive behavior. The following four medications are sometimes prescribed for repetitive behavior:

  • Risperidone: Risperidone (Risperdal) is an antipsychotic medication. Risperdal is currently the only U.S. Federal Food and Drug Administration (FDA) approved medication to treat autism. Risperidone is generally only recommended for people over 18 years old.
  • Fluxetine: Prozac is the trade name for fluxetine, an antidepressant and antianxiety drug. This drug is sometimes recommended for autism yet a recent study showed that it may be an ineffective treatment for repetitive behavior. Fluxetine is usually only recommended for people over 18 years old.
  • Fluvoxamine: Fluvoxamine (Luvox) is an antidepressant that can be used by children over eight years old.
  • Valproate: Children over two years old can use valproate. Valproate (Depakote) is a mood stabilizing medication.

You can get the right help for your loved one. Early intervention can make a significant difference in reducing repetitive behavior in autism. Ongoing research also provides hope for better future treatments.

Repetitive Behavior in Autism