Journal of the Korean Academy of Child and Adolescent Psychiatry

Korean Academy of Child and Adolescent Psychiatry (대한소아청소년정신의학회)
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Patterns of Restricted and Repetitive Behaviors in Toddlers and Young Children with Autism Spectrum Disorder

  • Song, Da-Yea (Department of Psychiatry, Seoul National University College of Medicine) ;
  • Kim, Dabin (Department of Psychiatry, Seoul National University Bundang Hospital) ;
  • Lee, Hannah J. (Department of Psychiatry, Seoul National University Bundang Hospital) ;
  • Bong, Guiyoung (Department of Psychiatry, Seoul National University Bundang Hospital) ;
  • Han, Jae Hyun (Department of Psychiatry, Seoul National University Bundang Hospital) ;
  • Yoo, Hee Jeong (Department of Psychiatry, Seoul National University College of Medicine)
  • Received : 2022.02.28
  • Accepted : 2022.03.14
  • Published : 2022.04.01
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Abstract

Objectives: Restricted and repetitive behaviors (RRBs) are a core symptom in the diagnosis of autism spectrum disorder (ASD). The complexity of behavioral patterns has called for the creation of phenotypically homogeneous subgroups among individuals with ASD. The purpose of this study was 1) to investigate the different types of RRBs and 2) to explore whether subgroups created by RRBs would show unique levels of functioning in toddlers and young children with ASD. Methods: A total of 313 children with ASD, aged 12-42 months were included in the analysis. The Autism Diagnostic Interview-Revised was used to obtain information on the different types of RRBs by grouping 15 items into six categories. The Vineland Adaptive Behaviors Scale, a parent-reported questionnaire, was used to measure adaptive functioning. A portion of the children were analyzed separately for verbal-related RRBs based on their expressive language level. Two-step cluster analysis using RRB groups as features was used to create subgroups. Analysis of covariance while covarying for age and language was performed to explore the clinical characteristics of each cluster group. Results: Sensory-related RRBs were the most prevalent, followed by circumscribed interests, interest in objects, resistance to change, and repetitive body movements. A subset of the children was analyzed separately to explore verbal-related RRBs. Four cluster groups were created based on reported RRBs, with multiple RRBs demonstrating significant delays in adaptive functioning. Conclusion: Heterogeneity of RRBs emerges at a young age. The different patterns of RRBs can be used as valuable information to determine developmental trajectories with better implications for treatment approaches.

Keywords

Acknowledgement

This work was supported by an Institute for Information & Communications Technology Promotion (ITTP) grant funded by the Korean government (MSIT) (No.2019-0-00330, Development of AI Technology for Early Screening of Infant/Child Autism Spectrum Disorders based on Cognition of the Psychological Behavior and Response).

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