Journal of Autism and Developmental Disorders

, Volume 38, Issue 8, pp 1439–1450 | Cite as

One-year Change in Repetitive Behaviours in Young Children with Communication Disorders Including Autism

  • Emma Honey
  • Helen McConachie
  • Val Randle
  • Heather Shearer
  • Ann S. Le Couteur
Original Paper


Repetitive behaviours are a relatively neglected area of study in autism. Previous research has concluded that repetitive behaviour is inversely related to ability and that it tends to increase over the preschool years. One-hundred and four children ages 24–48 months, with autism, autism spectrum disorder (ASD) or other disorders, were followed for 13 months. Twelve items from the Autism Diagnostic Interview (ADI-R) were analysed, as well as diagnostic algorithm scores. Ability was related to degree of repetitive behaviours, except for one cluster of relatively able children. ADI-R repetitive behaviour algorithm scores increased over time; however, when all 12 behaviours were considered, there was a general decrease in impact upon the child’s and family’s activities. Reasons for this decrease are discussed.


Longitudinal Repetitive behaviour Autism spectrum disorder Ability Early identification ADI-R 



We are very grateful to the parents and children who took part in the studies and shared their experiences with us. We are also grateful to the clinicians in the North East of England who approached families about the research. Study 1 formed a doctoral dissertation of Heather Shearer. Study 2 was funded by the Community Fund (National Lottery Charities Board) with a grant to Children North East in collaboration with the University of Newcastle.


  1. Abelson, A. (1983). Infantile autism: An over-view. Journal of Psychiatric Treatment and Evaluation, 5, 31–35.Google Scholar
  2. Bailey, A., Philips, W., & Rutter, M. (1996). Autism: Towards an integration of clinical, genetic, neuropsychological and neurological perspectives. Journal of Child Psychology and Psychiatry, 37, 89–126.PubMedCrossRefGoogle Scholar
  3. Baird, G., Charman, T., Baron-Cohen, S., Cox, A., Swettenham, J., Wheelwright, S., & Drew, A. (2000). A screening instrument for autism at 18 months of age: A 6 year follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 694–702.PubMedCrossRefGoogle Scholar
  4. Baird, G., Charman, T., Baron-Cohen, S., Cox, A., Swettenham, J., Wheelwright, S., & Drew, A. (2001). Screening and surveillance for autism and pervasive developmental disorders. Archives of Disease in Childhood, 84, 468–475.PubMedCrossRefGoogle Scholar
  5. Baranek, G. (1999). Autism during infancy: A retrospective video analysis of sensory-motor and social behaviours at 9–12 months of age. Journal of Autism and Developmental Disorders, 29, 213–224.PubMedCrossRefGoogle Scholar
  6. Baron-Cohen, S., Allen, J., & Gillberg, C. (1992). Can autism be detected at 18 months? the needle, the haystack, and the CHAT. British Journal of Psychiatry, 161, 839–843.PubMedCrossRefGoogle Scholar
  7. Bartak, L., Rutter, M., & Cox, A. (1975). A comparative study of infantile autism and specific developmental receptive language disorders. I. The children. Journal of Autism and Childhood Schizophrenia, 7, 383–396.CrossRefGoogle Scholar
  8. Berkson, B., & Tupa M. (2000). Early development of stereotyped and self-injurious behaviours. Journal of Early Intervention, 23, 1–19.CrossRefGoogle Scholar
  9. Bishop, D. (2000). Pragmatic language impairment: A correlate of SLI, a distinct subgroup, or part of the autistic continuum? In: D. V. M. Bishop & L. B. Leonard (eds). Speech and language impairments in children: Causes, characteristics, intervention and outcome. Hove: Psychology Press.Google Scholar
  10. Bodfish, J. W., Symons, F. J., Parker, D. E., & Lewis, M. H. (2000). Varieties of repetitive behaviour in autism: Comparisons to mental retardation. Journal of Autism and Developmental Disorders, 30, 237–243.PubMedCrossRefGoogle Scholar
  11. Charman, T. (2000). Theory of mind and the early diagnosis of autism. In: S. Baron-Cohen, H. Tager-Flusberg & D. Cohen (eds) Understanding other minds (2nd ed). Oxford: Oxford University Press.Google Scholar
  12. Charman, T., & Baird, G. (2002). Practitioner review: Diagnosis of autism spectrum disorder in 2- and 3-year-old children. Journal of Child Psychology and Psychiatry, 43, 289–305.PubMedCrossRefGoogle Scholar
  13. Charman, T., Taylor, E., Drew, A., Cockerill, H., Brown, J., & Baird, G. (2005). Outcome at 7 years of children diagnosed with autism at age 2: Predictive validity of assessments conducted at 2 and 3 years of age and pattern of symptom change over time. Journal of Child Psychology and Psychiatry, 46, 500–513.PubMedCrossRefGoogle Scholar
  14. Cox, A., Klein, K., Charman, T., Baird, G., Baron-Cohen, S., Swettenham, J., Drew, A., & Wheelwright, S. (1999). Autism spectrum disorders at 20 and 42 months of age: Stability of clinical and ADI-R diagnosis. Journal of Child Psychology and Psychiatry, 40, 719–732.PubMedCrossRefGoogle Scholar
  15. Evans, D., Leckman, J., Carter, A., Reznick, J., Henshaw, D., King, R., & Pauls, D. (1997). Ritual, habit and perfectionsim: The prevalence and development of compulsive behaviour in normal children. Child Development, 71, 58–58.CrossRefGoogle Scholar
  16. Filipek, P. A., Accardo, P. J., Baranek, G. T., Cook, E. H., Dawson, G., Gordon, B., Gravel, J. S., Johnson, C. P., Kallen, R. J., Levy, S. E., Minshew, N. J., Prizant, M. B., Rapin, I., Rogers, S. J., Stone, W. L., Teplin, S., Tuchman, R. F., & Volkmar, F. R. (1999). The screening and diagnosis of autistic spectrum disorders. Journal of Autism and Developmental Disorders, 29, 439–484.PubMedCrossRefGoogle Scholar
  17. Frith, U. (1999). Autism: Explaining the enigma. Oxford: Blackwell.Google Scholar
  18. Gray, K. M., & Tonge, B. J. (2001). Are there early features of autism in infants and preschool children? Journal of Paediatrics and Child Health, 37, 221–226.PubMedCrossRefGoogle Scholar
  19. Hall, S., Thorns, T., & Oliver, C. (2003). Structural and environmental characteristics of stereotyped behaviours. American Journal on Mental Retardation, 108, 391–402.PubMedCrossRefGoogle Scholar
  20. Honey, E., McConachie, H., & Le Couteur, A. (2005). ‘Will it ever stop?’ How parents deal with children’s repetitive behaviours. Communication (National Autistic Society, UK), summer, 45–47.Google Scholar
  21. Howlin, P., & Asgharian, A. (1999). The diagnosis of autism and Asperger syndrome: Findings from a systematic survey. Developmental Medicine and Child Neurology, 41, 834–839.PubMedCrossRefGoogle Scholar
  22. Howlin, P., Mawhood, L., & Rutter, M. (2000). Autism and developmental receptive language disorder – a follow-up comparison in early adult life. II: Social, behavioural and psychiatric outcomes. Journal of Child Psychology and Psychiatry, 41, 561–578.PubMedCrossRefGoogle Scholar
  23. Howlin, P., & Moore, A. (1997). Diagnosis of autism: A survey of over 1200 patients in the UK. Autism, 1, 135–162.CrossRefGoogle Scholar
  24. Le Couteur, A. (2003). National Autism Plan for Children. London: National Autistic Society, Royal College of Psychiatrists, Royal College of Paediatrics and Child Health, and the All Party Parliamentary Group on Autism.Google Scholar
  25. Le Couteur, A., Rutter, M., & Lord, C. (2003). The Autism Diagnostic Interview, Revised. Los Angeles: Western Psychological Services.Google Scholar
  26. Lewis, M. H., & Bodfish, J. W. (1998). Repetitive behaviour disorders in autism. Mental Retardation and Developmental Disabilities, 4, 80–89.CrossRefGoogle Scholar
  27. Lord, C. (1995.) Follow-up of two-year-olds referred for possible autism. Journal of Child Psychology and Psychiatry, 36, 1365–1382.PubMedCrossRefGoogle Scholar
  28. Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., Pickles, A., & Rutter, M. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–223.PubMedCrossRefGoogle Scholar
  29. Lord, C., Rutter, M., & Le Couteur, A. S. (1994). Autism diagnostic interview-revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685.PubMedCrossRefGoogle Scholar
  30. Lord, C., Shulman, C., & DiLavore, P. (2004). Regression and word loss in autistic spectrum disorders. Journal of Child Psychology and Psychiatry, 45, 936–955.PubMedCrossRefGoogle Scholar
  31. McConachie, H., Randle, V., Hammal, D., & Le Couteur, A. (2005). A controlled trial of a training course for parents of children with suspected autism spectrum disorder. Journal of Pediatrics, 147, 335–340.PubMedCrossRefGoogle Scholar
  32. McGovern, C. W., & Sigman, M. (2005). Continuity and change from early childhood to adolescence in autism. Journal of Child Psychology and Psychiatry, 46, 401–408.PubMedCrossRefGoogle Scholar
  33. Michelotti, J., Slonims, V., Baird, G., & Charman, T. (2002). Follow-up of children with language delay and features of autism from preschool years to middle childhood. Developmental Medicine and Child Neurology, 44, 812–819.PubMedCrossRefGoogle Scholar
  34. Moore, V., & Goodson, S. (2003). How well does early diagnosis of autism stand the test of time? follow-up study of children assessed for autism at age 2 and development of an early diagnostic service. Autism, 7, 47–63.PubMedGoogle Scholar
  35. Mullen, E. (1995). Mullen Scales of Early Learning. Circle Pines, MN: American Guidance Service Inc.Google Scholar
  36. Paul, R., & Cohen, D. (1984). Outcome of severe disorders of language acquisition. Journal of Autism and Developmental Disorders, 14, 405–422.PubMedCrossRefGoogle Scholar
  37. Piven, J., Harper, J., Palmer, P., & Arndt, S. (1996). Course of behavioral change in autism: A retrospective study of high-IQ adolescents and adults. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 523–529.PubMedCrossRefGoogle Scholar
  38. Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The Modified Checklist for Autism in Toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of Autism and Developmental Disorders, 31, 131–144.PubMedCrossRefGoogle Scholar
  39. Shearer, H. (2001). Executive function and autistic symptomatology in very young children. Unpublished PhD, Department of Psychology, University of Durham.Google Scholar
  40. South, M., Ozonoff, S., & McMahon, W. M. (2005). Repetitive behaviour profiles in Asperger syndrome and high-functioning autism. Journal of Autism and Developmental Disorders, 35, 145–158.PubMedCrossRefGoogle Scholar
  41. Sparrow, S. A., Balla, D. A., & Cicchetti, D. V. (1984). Vineland Adaptive Behavior Scales. Circle Pines, MN: American Guidance Services.Google Scholar
  42. Sperry, L. A., & Symons, F. J. (2003). Maternal judgements of intentionality in young children with autism: The effects of diagnostic information and stereotyped behaviour. Journal of Autism and Developmental Disorders, 33, 281–287.PubMedCrossRefGoogle Scholar
  43. Stone, W. L., Lee, E. B., Ashford, L., Brissie, J., Hepburn, S. L., Coonrod, E. E., & Weiss, B. H. (1999.) Can autism be diagnosed accurately in children under 3 years? Journal of Child Psychology and Psychiatry, 40, 219–226.PubMedCrossRefGoogle Scholar
  44. Szatmari, P., Bryson, S. E., Streiner, D. L., Wilson, F. J., Archer, L., & Ryerse, C. (2000). Two-year outcome of preschool children with autism or Asperger’s syndrome. American Journal of Psychiatry, 1576, 1980–1987.CrossRefGoogle Scholar
  45. Thelan, E. (1979). Rhythmical stereotypies in normal infants. Animal Behaviours, 27, 699–715.CrossRefGoogle Scholar
  46. Turner, M. (1996). Repetitive behaviour and cognitive functioning in autism. Unpublished PhD thesis, University of Cambridge.Google Scholar
  47. Turner, M. (1999). Annotation: Repetitive behaviour in autism: A review of psychological research. Journal of Child Psychology and Psychiatry, 40, 839–849.PubMedCrossRefGoogle Scholar
  48. Wing, L. (1996). The Autistic Spectrum: A guide for parents and professionals. London: Constable.Google Scholar
  49. Wing, L., & Gould, J. (1979). Severe impairments of social interaction and associated abnormalities in children: Epidemiology and classification. Journal of Autism and Developmental Disorders, 9, 11–30.PubMedCrossRefGoogle Scholar
  50. Young, R. L., Brewer, N., & Pattison, C. (2003). Parental identification of early behavioural abnormalities in children with autistic disorder. Autism, 7, 125–143.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Emma Honey
    • 1
  • Helen McConachie
    • 2
  • Val Randle
    • 2
  • Heather Shearer
    • 1
  • Ann S. Le Couteur
    • 2
  1. 1.Department of PsychologyUniversity of DurhamDurhamUK
  2. 2.School of Clinical Medical SciencesUniversity of Newcastle, Sir James Spence Institute, Royal Victoria InfirmaryNewcastleUK

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