The Relationship Between Repetitive and Stereotyped Behavior and Social-Communicative Skills in Young Children with ASD

Background: Repetitive and stereotypes behaviors (RSB) have received far less attention in autism research compared to deficits in the social-communicative domain (Richler, Huerta, Bishop & Lord, 2010; Lewis & Bodfish, 1998). Moreover, not much research has been done on the relationship between RSB and social communication skills (Ray-Subramanian & Weismer, 2012). Nevertheless, understanding of RSB is important, because of its interference with different aspects of functioning in children with ASD, especially with the possibilities to learn from and attend to the world around them (Richler et al., 2010). Therefore, research should focus on examining possible relationships between RSB and symptoms in social and communication domains (Richler et al., 2010; Watt, Wetherby, Barber & Morgan, 2008).

Objectives: The present study aimed (1) To examine the relationships between RSB and social communicative skills in children with ASD. It is hypothesized that a higher frequency and/or duration of RSB is negatively related to social-communication skills. (2) To examine the relationships between RSB and the severity of ASD symptoms in young children. It is predicted that a higher frequency and/or duration of RSB is positively correlated to severity of ASD symptoms in young children.

Methods: Fifty-five young children with ASD were included in this study. RSB was assessed by coding the frequency and duration of RSB on videotaped observations of the ADOS (33.05 ± 9.83 months). The level of social-communicative skills was measured using the subscale interpersonal relationships of the Vineland SEEC (46.34 ± 6.55) and the subscales language and communication and reciprocal social interaction of the ADI-R (30.29 ± 7.48 months). Severity of ASD was assessed using the total scores of the ADOS and the ADI-R and interpreting them as spectrum scores. A series of stepwise multiple regressions were conducted to evaluate whether RSB are related to social-communicative skills and severity of ASD.

Results: As hypothesized a negative relationship with a medium effect size was found between the duration of RSB and social-communicative skills. Secondly, as hypothesized a positive relationship with a medium effect size was found between the duration of RSB and severity of ASD.

Conclusions: The findings of this study indicate that a prolonged engagement in RSB is negatively related to social-communicative skills and positively related to severity of ASD. These findings are in line with other studies, which show that RSB can negatively influence the development of social and communication skills and overall development, because of its interference with learning opportunities (Bruckner & Yoder, 2007; Ray-Subramanian & Weismer, 2012; Watt et al. 2008). This study adds to the limited research between RSB and social-communication skills and may enhance the understanding of developmental trajectories of ASD, including cascades across domains.