Subdomains of restricted and repetitive behaviors within autism: Exploratory structural equation modeling using the diagnostic interview for social and communication disorders.
Mirko Uljarević, Sarah J Carrington, Antonio Y Hardan and 1 others
PMID 35178885WHAT IT FOUND
Restricted and repetitive behaviors in autism split into six distinct domains, not just motor and sameness.
Sensory interests, sensory sensitivity, and stereotyped language emerged as separate factors. These patterns vary by age and intellectual ability, suggesting clinicians should assess these subdomains individually rather than as one block.
Key findings
01Analysis identified six distinct factors for restricted and repetitive behaviors: repetitive motor behaviors, unusual sensory and object focused interests, sensory sensitivity, insistence on sameness, circumscribed interests, and stereotyped language.
02Individuals with autism and intellectual disability showed higher scores for repetitive motor behaviors, unusual sensory and object focused interests, sensory sensitivity, and stereotyped language, while those without intellectual disability showed higher scores for insistence on sameness and circumscribed interests.
03Age was negatively associated with repetitive motor behaviors, unusual sensory and object focused interests, and stereotyped language, but not with sensory sensitivity, insistence on sameness, or circumscribed interests.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study used data collected in the 1990s, and participants were diagnosed using older criteria (DSM-IV or ICD-10), which may not fully reflect current diagnostic understandings. The sample size of 226 is modest for factor analysis, and the authors note that a larger sample might have revealed even finer distinctions. The number of female participants was low (37), limiting the ability to assess sex differences robustly. The sample was predominantly children, so the findings may not fully apply to older adolescents or adults. The study could not test whether the factor structure remained stable across different ages, sexes, or ability levels. Some items, particularly those related to the 'unusual sensory and object focused interests' factor, showed cross-loading or ambiguous definitions, requiring further research to clarify.
Declared interests
The authors report no conflicts of interest. The study was funded by the National Institute of Mental Health.
The easy way to misread this
Do not treat the six-factor structure as a definitive diagnostic tool. The study is exploratory, used older diagnostic criteria, and had a small sample size with few females. The 'stereotyped language' and 'unusual sensory and object focused interests' factors are preliminary and need replication before being used to guide specific clinical interventions.