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Increased Exposure to Rigid Routines can Lead to Increased Challenging Behavior Following Changes to Those Routines

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Abstract

Several neurodevelopmental disorders are associated with preference for routine and challenging behavior following changes to routines. We examine individuals with Prader–Willi syndrome, who show elevated levels of this behavior, to better understand how previous experience of a routine can affect challenging behavior elicited by disruption to that routine. Play based challenges exposed 16 participants to routines, which were either adhered to or changed. Temper outburst behaviors, heart rate and movement were measured. As participants were exposed to routines for longer before a change (between 10 and 80 min; within participants), more temper outburst behaviors were elicited by changes. Increased emotional arousal was also elicited, which was indexed by heart rate increases not driven by movement. Further study will be important to understand whether current intervention approaches that limit exposure to changes, may benefit from the structured integration of flexibility to ensure that the opportunity for routine establishment is also limited.

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Acknowledgments

This work was supported by a project grant from the Jérôme Lejeune Foundation to KAW and CO, and Cerebra who provide core funding to the Cerebra Centre for Neurodevelopmental Disorders (to director CO). Special thanks to the Prader–Will Syndrome Association, UK and Gretton Homes for their assistance in recruitment; Emma Cross, Laura Heath-Jones Campbell, Victoria Johnson, Jessica Penhallow, Amy Perry and Helena Todd, for assistance with data collection and processing; and Prof. Tony Holland for advice on project design and assistance with recruitment. Finally, we are extremely grateful for the support of the participants, their families and caregivers, without whom the work would not have been possible.

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  1. Kate A. Woodcock

    Present address: School of Psychology, Queen’s University Belfast, University Road, Belfast, BT7 1NN, UK

Authors and Affiliations

  1. Cerebra Centre for Neurodevelopmental Disorders, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK

    Leah E. Bull, Chris Oliver, Eleanor Callaghan & Kate A. Woodcock

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  1. Leah E. Bull
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Correspondence to Kate A. Woodcock.

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Bull, L.E., Oliver, C., Callaghan, E. et al. Increased Exposure to Rigid Routines can Lead to Increased Challenging Behavior Following Changes to Those Routines. J Autism Dev Disord 45, 1569–1578 (2015). https://doi.org/10.1007/s10803-014-2308-2

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