Using the big data approach to clarify the structure of restricted and repetitive behaviors across the most commonly used autism spectrum disorder measures.

The measures were not designed to assess distinct restricted and repetitive behavior domains, so the factors may miss subtle symptoms or sensory interests. The ADOS analysis used only modules 3 and 4, and modules 1 and 2 were excluded because one item mixed several restricted behavior domains. Validation against the RBS-R, IQ and anxiety data was available only for part of each sample. Several factors had very few items, including a 2-item repetitive motor behavior factor on the SRS-2 and SCQ. The study used existing cross-sectional data, so it cannot show that anxiety causes insistence on sameness or that any therapy changes these behaviors. Possible participant overlap across databases was not fully resolved, although the authors said it was unlikely to affect results.

The paper states that the work was supported by the National Institutes of Health. The supplied text does not report any other conflict of interest or industry funding.

Do not conclude that these autism measures are interchangeable for assessing restricted and repetitive behaviors. The SRS-2, SCQ and ADI-R supported different interest factors and had uneven item coverage, and the ADOS did not support a fine-grained restricted behavior factor model.