A Stimulating Play Situation Designed to Observe Restricted Interests and Repetitive Behaviors in Young Autistic Children

Background: Restricted interests and repetitive behaviors (RIRBs) in young autistic children have largely been documented through questionnaires and parental reports, a indirect method which limits the scope and usefulness of the results. Although some direct-observation measures of RIRBs have been recently attempted (Baranek & al. 2007; Barrett & al. 2004; Bruckner & Yoder, 2007; Goldman & al. 2008; MacDonald & al, 2007; Ozonoff & al. 2008) their role in standard diagnostic instruments remains limited, with only recent inclusion in the ADOS algorithm and with doubts remain as to their specificity and measurability.

Objectives: a) To develop a stimulation play situation (SPS) which triggers RIRBs in 2 to 5 years old autistic and non-autistic children by exposing children to objects of interest. b) to compare RIRB produced in the ADOS-G  and in the proposed SPS.

Methods: The SPS is composed of 35 objects providing specific presses for RIRBs. Children are exposed to items in three different formats: free play, semi-free play and semi-structured play.  Frequency and duration of thirty-one behaviours, chosen based on information acquired (questionnaire) from a previous study with 100 autistics experts, are coded: hand flapping, lining-up objects, visual explorations, rotating objects, hopping, searching for the same object, tiptoe-walking, shaking objects, pacing and running, holding objects in hand, talking about the same subject, repeating a sequence of actions, tapping objects, putting fingers or hands in ears, rocking, putting objects in mouth, touching objects, repeating sounds, pressing objects, fingers in mouth, sticking objects on cheeks, hand or finger posturing, smelling objects, placing objects on ears, rubbing hands, fingers in ears, putting part of other’s people body in mouth, squinting of eyes, hands on eyes, fingers in nose, put object in movement.  Each behavior relies on a reliability superior to 80% between scorers. The frequency, duration, and contextual releasers of these behaviors will be compared in the SPS and in the ADOS-G, (module 1), in a group of 40 typical children and 40 autistics children. The order of passation will be balanced across groups.

Results: Preliminary analyses (6 subjects) in the autism subgroup indicate that the SPS produces more RIRBs (6,17; SD 2,9) than the ADOS-G (2,88; SD 1,3).

Conclusions: These preliminary findings suggest that the SPS is potentially useful to reveal RIRBs in young autistic children. The specificity of these repetitive behaviors to the autism category will be examined through their aggregation with ADOS-G diagnoses.