Restricted and Repetitive Behaviors (RRBs)

Restricted and repetitive behaviors (RRBs) are core features of autism and include repetitive, inflexible, sometimes inappropriate physical behaviors that lack obvious function and purpose. They become pathological when disrupting learning, working, relationships, and social adaptation. Interrupted RRBs can cause anxiety and more severe behaviors, like aggression, to return to the ritual or prevent change. A 2002 report found RRB behaviors are inversely related to intelligence — children with severe intellectual/ developmental disabilities have more extensive stereotyped behaviors. Neurobiology and developmental psychology research describes risk factors for RRB, with neural adaptation and environmental over/under stimulation among them. RRBs have potential to spontaneously reduce across time—more likely among those with increased age and cognitive/language ability. Behavioral intervention methods provide more positive outcomes than medication alone, as do early interventions targeted to improve RRBs before these behaviors become entrenched. New research has identified four distinctive RRB subtypes:

• Stereotyped behavior or repetitive, rhythmic motor movements, use of objects, or speech (echolalia), like hand flapping, tapping, rocking—or more harmful behaviors (head banging).
• Inflexible adherence to routines or ritualized patterns of verbal/non-verbal behavior, like organizing a bedroom the same way or needing to complete activities in exactly the same order each time.
• Highly restricted, fixated interests—focusing on small parts of whole items, like the wheels of a toy car—or have unusual interests, like learning the Klingon language (from Star Trek).
• Hyper-/hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment.