The Repetitive Behavior Spectrum: From Harmful to Helpful

Robert H. Rice


Systematic study comparing repetitive behaviors in autism with those observed in obsessive compulsive disorder (OCD) and other Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition-Text Revision (DSM-IV-TR) diagnoses is lacking despite its diagnostic and treatment significance.  This research examines repetitive behaviors in a sample of children and adults diagnosed with an autism spectrum disorder (ASD), (OCD), or both. Data were collected from three participant pools; clinic clients, parents/caregivers, and therapists; in order to test the psychometric properties of questions for assessing the functional characteristics of repetitive thoughts and behavior (i.e., stereotypy, compulsion, obsession, perseveration, preoccupation). Exploratory factor analyses revealed four factors that demonstrated reasonable consistency across the three types of informants. These four assessed factors included: 1) intrusive effects; 2) soothing effects; 3) level of distress, and; 4) pleasure-seeking qualities.  Reliability for the new scales was calculated separately for subjects, correspondents, and therapists revealing high internal consistency. Validity analyses were completed, first by examining bivariate correlations among the new scales and then by examining correlations between the new scales and established measures of functioning (i.e., Gilliam Autism Rating Scale-Second Edition; GARS-2, Yale-Brown Obsessive Compulsive Scale; Y-BOCS, and Adaptive Behavior Assessment System-Second Edition; ABAS-II).  As hypothesized, the new scales measuring soothing and pleasure-seeking qualities of repetitive behavior had higher correlations with measures of ASD than OCD and the new scales measuring level of distress and intrusiveness in repetitive behavior had higher correlations with measures of OCD than ASD.  The results of this study take a step toward better distinguishing what motivates repetitive behaviors and, thus, how to best think about them in the context of intervention strategies.


repetitive behavior; autism; obsessive compulsive disorder


Asperger, H. (1944/1991). “Autistic psychopathy” in childhood. Translated and annotated by U. Frith. In U. Frith (Ed.), Autism and Asperger syndrome (pp. 37-92). New York: Cambridge University Press.

Baron-Cohen, S. (1989). Do autistic children have obsessions and compulsions. British Journal of Clinical Psychology, 28, 193-200.

Bodfish, J., Symons, F., Parker, D., and Lewis, M. (2000). Varieties of repetitive behavior in autism: Comparisons to mental retardation. Journal of Autism and Developmental Disorders, 30(3), 237-243.

Gabriels, R., Cuccaro, M., Hill, D., Ivers, B., Goldson, E. (2004). Repetitive behaviors in autism: relationships with associated clinical features. Research in Developmental Disabilities, 26, 169-181.

Gilliam, J. E. (1995). Gilliam Autism Rating Scale. Austin, TX: Pro-Ed.

Goodman, W., Price, L., Rasmussen, S., and Mazure, C. (1989). The Yale-Brown Obsessive Compulsive Scale: I. Development, use, and reliability. Archives of General Psychiatry, 46(11), 1006-1011.

Goodman, W., Price, L., Rasmussen, S., and Mazure, C. (1989). The Yale-Brown Obsessive Compulsive Scale: II. Validity. Archives of General Psychiatry, 46(11), 1012-1016.

Hollander, E., King, A., Delaney, K., Smith, C.J., Silverman, J.M. (2003). Obsessive-compulsive behaviors in parents of multiplex autism families. Psychiatry Research, 117(1), 11-16.

Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217-250.

Kanner, L. (1949). Problems of nosology and psychodynamics in early infantile autism. American Journal of Orthopsychiatry, 19, 416-426.

Kanner, L. (1951). The conception of wholes and parts in early infantile autism. American Journal of Psychiatry, 108, 23-26.

Lam, K. and Aman, M. (2007). The Repetitive Behavior Scale-Revised: Independent Validation in Individuals with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 37-5, 855-866.

Lewis, M. and Bodfish, B. (1998). Repetitive behavior disorders in autism. Mental Retardation and Developmental Disabilities Research Reviews, 4, 80-89.

McDougle, C.J., Kresch, L.E., Goodman, W.K., Naylor, S.T., Volkmar, F.R., Cohen, D.J., and Price, L.H. (1995). A case-controlled study of repetitive thoughts and behavior in adults with autistic disorder and obsessive-compulsive disorder. American Journal of Psychiatry, 152(5), pp.772-777.

Richardson, R., Burns, M. (2005). Adaptive Behavior Assessment System (2nd Edition). Assessment for Effective Intervention, 30(4), 51-54.

Russell, A.J., Mataix-Cols, D., Anson, M., & Murphy, D. (2005). Obsessions and compulsions in Asperger syndrome and high-functioning autism. British Journal of Psychiatry, 186, 525-528.

Scahill, L., McDougle, C., Williams, S., Dimitropoulos, A., Aman, M., McCracken, J., Tierney, E., Arnold, L., Cronin, P., Grados, M., Ghuman, J., Koenig, K., Iam, K., McGough, J., Posey, D., Ritz, L., Swiezy, N., and Vitiello, B. (2006). Children’s Yale-Brown Obsessive Compulsive Scale modified for pervasive developmental disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 45(9), 1114-1122.

South, M., Ozonoff, S., and McMahon, W. (2005). Repetitive behavior in Asperger syndrome and high-functioning autism. Journal of Autism and Developmental Disorders, 35(2), 145-158.

Turner, M. (1997). Towards an executive dysfunction account of repetitive behavior in autism. In J. Russell (Ed.). Autism as an executive disorder. Oxford: Oxford University Press.

Turner, M. (1999). Annotation: Repetitive behavior in autism: A review of psychological research. Journal of Child Psychology and Psychiatry, 40, 839-849.

Full Text: HTML PDF


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.