Skip to main content

Advertisement

Log in

Factor Structure of Repetitive Behaviors Across Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder

  • Original Paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

Restricted interests and repetitive behaviors (RRBs) are core symptoms of autism spectrum disorder (ASD), and commonly occur in attention-deficit/hyperactivity disorder (ADHD). Little is known about how RRBs manifest in ADHD. We quantified and compared factor structures of RRBs in children with ASD (n = 634) or ADHD (n = 448), and related factors to sex and IQ. A four-factor solution emerged, including Stereotypy, Self-Injury, Compulsions, and Ritualistic/Sameness. Factor structures were equivalent across diagnoses, though symptoms were more severe in ASD. IQ negatively correlated with Stereotypy, Self-Injury, and Compulsions in ASD, and negatively correlated with Compulsions and Ritualistic/Sameness behaviors in ADHD. In ASD only, females exhibited higher Self-Injury. Thus, patterns of RRBs are preserved across ASD and ADHD, but severity and relationship with IQ differed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

Abbreviations

ASD:

Autism spectrum disorder

ADHD:

Attention deficit/hyperactivity disorder

EFA:

Exploratory factor analysis

RRBs:

Restricted and repetitive behaviors

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.

    Book  Google Scholar 

  • Antezana, L., Factor, R. S., Condy, E. E., Strege, M. V., Scarpa, A., & Richey, J. A. (2018). Gender differences in restricted and repetitive behaviors and interests in youth with autism. Autism Research. https://doi.org/10.1002/aur.2049.

    Article  PubMed  Google Scholar 

  • Bishop, S. L., Hus, V., Duncan, A., Huerta, M., Gotham, K., Pickles, A., et al. (2013). Subcategories of restricted and repetitive behaviors in children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(6), 1287–1297. https://doi.org/10.1007/s10803-012-1671-0.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bishop, S. L., Richler, J., & Lord, C. (2006). Association between restricted and repetitive behaviors and nonverbal IQ in children with autism spectrum disorders. Child Neuropsychology, 12(4–5), 247–267. https://doi.org/10.1080/09297040600630288.

    Article  PubMed  Google Scholar 

  • Bodfish, J. W., & Lewis, M. H. (2002). Repetitive behavior in autism. Paper presented at the International Meeting for Autism Research. (IMFAR), Orlando, FL.

  • Bodfish, J. W., Symons, F. J., Parker, D. E., & Lewis, M. H. (2000). Varieties of repetitive behavior in autism: Comparisons to mental retardation. Journal of Autism and Developmental Disorders, 30(3), 237–243. https://doi.org/10.1023/A:1005596502855.

    Article  PubMed  Google Scholar 

  • Burbidge, C., Oliver, C., Moss, J., Arron, K., Berg, K., Furniss, F., et al. (2010). The association between repetitive behaviours, impulsivity and hyperactivity in people with intellectual disability. Journal of Intellectual Disability Research, 54(12), 1078–1092. https://doi.org/10.1111/j.1365-2788.2010.01338.x.

    Article  PubMed  Google Scholar 

  • Chen, F. F. (2007). Sensitivity of goodness of fit indexes to lack of measurement invariance. Structural Equation Modeling, 14(3), 464–504. https://doi.org/10.1080/10705510701301834.

    Article  Google Scholar 

  • Clark, L. A., & Watson, D. (2019). Constructing validity: New developments in creating objective measuring instruments. Psychological Assessment, 31(12), 1412.

  • Cooper, M., Martin, J., Langley, K., Hamshere, M., & Thapar, A. (2014). Autistic traits in children with ADHD index clinical and cognitive problems. European Child & Adolescent Psychiatry, 23(1), 23–34. https://doi.org/10.1007/s00787-013-0398-6.

    Article  Google Scholar 

  • Cuccaro, M. L., Shao, Y., Grubber, J., Slifer, M., Wolpert, C. M., Donnelly, S. L., et al. (2003). Factor analysis of restricted and repetitive behaviors in autism using the autism diagnostic interview-R. Child Psychiatry and Human Development, 34(1), 3–17. https://doi.org/10.1023/A:1025321707947.

    Article  PubMed  Google Scholar 

  • Dworzynski, K., Ronald, A., Bolton, P., & Happé, F. (2012). How different are girls and boys above and below the diagnostic threshold for autism spectrum disorders? Journal of the American Academy of Child and Adolescent Psychiatry, 51(8), 788–797. https://doi.org/10.1016/j.jaac.2012.05.018.

    Article  PubMed  Google Scholar 

  • Esbensen, A. J., Seltzer, M. M., Lam, K. S. L., & Bodfish, J. W. (2009). Age-related differences in restricted repetitive behaviors in autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(1), 57–66. https://doi.org/10.1007/s10803-008-0599-x.

    Article  Google Scholar 

  • Faraone, S. V., Perlis, R. H., Doyle, A. E., Smoller, J. W., Goralnick, J. J., Holmgren, M. A., et al. (2005). Molecular genetics of attention-deficit/hyperactivity disorder. Biological Psychiatry, 57(11), 1313–1323. https://doi.org/10.1016/j.biopsych.2004.11.024.

    Article  PubMed  Google Scholar 

  • Grzadzinski, R., Di Martino, A., Brady, E., Mairena, M. A., O’Neale, M., Petkova, E., et al. (2011). Examining autistic traits in children with ADHD: Does the autism spectrum extend to ADHD? Journal of Autism and Developmental Disorders, 41(9), 1178–1191. https://doi.org/10.1007/s10803-010-1135-3.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hattori, J., Ogino, T., Abiru, K., Nakano, K., Oka, M., & Ohtsuka, Y. (2006). Are pervasive developmental disorders and attention-deficit/hyperactivity disorder distinct disorders? Brain & Development, 28(6), 371–374. https://doi.org/10.1016/j.braindev.2005.11.009.

    Article  Google Scholar 

  • Hayden, E., & Durbin, C. (2018). Development and psychopathology. In T. H. Ollendick, S. W. White, & B. A. White (Eds.), The Oxford handbook of clinical child and adolescent psychology (pp. 31–41). New York: Oxford University Press.

    Google Scholar 

  • Hooker, J. L., Dow, D., Morgan, L., Schatschneider, C., & Wetherby, A. M. (2019). Psychometric analysis of the repetitive behavior scale-revised using confirmatory factor analysis in children with autism. Autism Research: Official Journal of the International Society for Autism Research, 12(9), 1399–1410.

    Article  Google Scholar 

  • Hopwood, C. J., & Donnellan, M. B. (2010). How should the internal structure of personality inventories be evaluated? Personality and Social Psychology Review, 14(3), 332–346.

  • Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55. https://doi.org/10.1080/10705519909540118.

    Article  Google Scholar 

  • Ickowicz, A., Schachar, R. J., Sugarman, R., Chen, S. X., Millette, C., & Cook, L. (2006). The parent interview for child symptoms: A situation-specific clinical research interview for attention-deficit hyperactivity and related disorders. The Canadian Journal of Psychiatry, 51(5), 325–328.

    Article  Google Scholar 

  • Kotelnikova, Y., Olino, T. M., Klein, D. N., Mackrell, S., & Hayden, E. P. (2017). Higher and lower order factor analyses of the temperament in Middle Childhood Questionnaire. Assessment, 24(8), 1050–1061. https://doi.org/10.1177/1073191116639376.

    Article  PubMed  Google Scholar 

  • Lam, K. S. L., & Aman, M. G. (2007). The repetitive behavior scale-revised: Independent validation in individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37(5), 855–866. https://doi.org/10.1007/s10803-006-0213-z.

    Article  PubMed  Google Scholar 

  • Lichtenstein, P., Carlström, E., Råstam, M., Gillberg, C., & Anckarsäter, H. (2010). The genetics of autism spectrum disorders and related neuropsychiatric disorders in childhood. The American Journal of Psychiatry, 167(11), 1357–1363. https://doi.org/10.1176/appi.ajp.2010.10020223.

    Article  PubMed  Google Scholar 

  • Loomes, R., Hull, L., & Mandy, W. P. L. (2017). What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 56(6), 466–474. https://doi.org/10.1016/j.jaac.2017.03.013.

    Article  Google Scholar 

  • Lord, C. (1994). Autism diagnostic interview-revised. Western Psychological Services. https://doi.org/10.1037/t18128-000.

    Article  Google Scholar 

  • Lord, C., Rutter, M., Goode, S., & Heemsbergen, J. (1989). Autism diagnostic observation schedule: A standardized observation of communicative and social behavior. Journal of Autism and Developmental Disorders, 19(2), 185–212.

    Article  Google Scholar 

  • Marsh, H. W., Hau, K.-T., & Wen, Z. (2004). In search of golden rules: comment on hypothesis-testing approaches to setting cutoff values for fit indexes and dangers in overgeneralizing Hu and Bentler’s (1999) findings. Structural Equation Modeling: A Multidisciplinary Journal, 11(3), 320–341. https://doi.org/10.1207/s15328007sem1103_2.

    Article  Google Scholar 

  • Martin, J., Hamshere, M. L., O’Donovan, M. C., Rutter, M., & Thapar, A. (2014). Factor structure of autistic traits in children with ADHD. Journal of Autism and Developmental Disorders, 44(1), 204–215. https://doi.org/10.1007/s10803-013-1865-0.

    Article  PubMed  Google Scholar 

  • McFayden, T. C., Albright, J., Muskett, A. E., & Scarpa, A. (2018). Brief report: Sex differences in ASD diagnosis—A brief report on restricted interests and repetitive behaviors. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-018-3838-9.

    Article  Google Scholar 

  • Mirenda, P., Smith, I. M., Vaillancourt, T., Georgiades, S., Duku, E., Szatmari, P., et al. (2010). Validating the repetitive behavior scale-revised in young children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 40(12), 1521–1530. https://doi.org/10.1007/s10803-010-1012-0.

    Article  PubMed  Google Scholar 

  • Mullen, E. M. (1995). Mullen Scales of Early Learning (AGS). Circle Pines, MN: American Guidance Service Inc.

    Google Scholar 

  • Putnick, D. L., & Bornstein, M. H. (2016). Measurement invariance conventions and reporting: The state of the art and future directions for psychological research. Developmental Review, 41, 71–90. https://doi.org/10.1016/j.dr.2016.06.004.

    Article  PubMed  Google Scholar 

  • Ramtekkar, U. P., Reiersen, A. M., Todorov, A. A., & Todd, R. D. (2010). Sex and age differences in attention-deficit/hyperactivity disorder symptoms and diagnoses: Implications for DSM-V and ICD-11. Journal of the American Academy of Child and Adolescent Psychiatry, 49(3), 217–28.e283.

    PubMed  PubMed Central  Google Scholar 

  • Reiersen, A. M., Constantino, J. N., Volk, H. E., & Todd, R. D. (2007). Autistic traits in a population-based ADHD twin sample. Journal of Child Psychology and Psychiatry, 48(5), 464–472. https://doi.org/10.1111/j.1469-7610.2006.01720.x.

    Article  PubMed  Google Scholar 

  • Reinhardt, V. P., Wetherby, A. M., Schatschneider, C., & Lord, C. (2014). Examination of sex differences in a large sample of young children with autism spectrum disorder and typical development. Journal of Autism and Developmental Disorders, 45(3), 697–706. https://doi.org/10.1007/s10803-014-2223-6.

    Article  Google Scholar 

  • Rimmer, C., Dahary, H., Quintin, E. M. (2019). The impact of restricted and repetitive behaviors on social emotional learning and executive functioning in adolescents with autism spectrum disorder. Presented at International Society for Autism Research, Montreal, Québec.

  • Rodgers, J., Glod, M., Connolly, B., & McConachie, H. (2012). The relationship between anxiety and repetitive behaviours in autism spectrum disorder. Journal of Autism and Developmental Disorders, 42(11), 2404–2409. https://doi.org/10.1007/s10803-012-1531-y.

    Article  PubMed  Google Scholar 

  • Roid, G. H., & Pomplun, M. (2012). The Stanford-Binet Intelligence Scales, fifth edition. In D. P. Flanagan & P. L. Harrison (Eds.), Contemporary intellectual assessment: Theories, tests, and issues (pp. 249–268). New York: The Guilford Press.

    Google Scholar 

  • Ronald, A., Simonoff, E., Kuntsi, J., Asherson, P., & Plomin, R. (2008). Evidence for overlapping genetic influences on autistic and ADHD behaviours in a community twin sample. Journal of Child Psychology and Psychiatry, 49(5), 535–542. https://doi.org/10.1111/j.1469-7610.2007.01857.x.

    Article  PubMed  Google Scholar 

  • Sandin, S., Lichtenstein, P., Kuja-Halkola, R., Hultman, C., Larsson, H., & Reichenberg, A. (2017). The heritability of autism spectrum disorder. Journal of the American Medical Association, 318(12), 1182–1184. https://doi.org/10.1001/jama.2017.12141.

    Article  PubMed  Google Scholar 

  • Skogli, E. W., Teicher, M. H., Andersen, P. N., Hovik, K. T., & Øie, M. (2013). ADHD in girls and boys—Gender differences in co-existing symptoms and executive function measures. BMC Psychiatry, 13, 12. https://doi.org/10.1186/1471-244X-13-298.

    Article  Google Scholar 

  • Supekar, K., & Menon, V. (2015). Sex differences in structural organization of motor systems and their dissociable links with repetitive/restricted behaviors in children with autism. Molecular Autism, 6, 50. https://doi.org/10.1186/s13229-015-0042-z.

    Article  PubMed  PubMed Central  Google Scholar 

  • Szatmari, P., Georgiades, S., Bryson, S., Zwaigenbaum, L., Roberts, W., Mahoney, W., et al. (2006). Investigating the structure of the restricted, repetitive behaviours and interests domain of autism. Journal of Child Psychology and Psychiatry, 47(6), 582–590. https://doi.org/10.1111/j.1469-7610.2005.01537.x.

    Article  PubMed  Google Scholar 

  • Szatmari, P., Liu, X., Goldberg, J., Zwaigenbaum, L., Paterson, A. D., Woodbury-Smith, M., et al. (2012). Sex differences in repetitive stereotyped behaviors in autism: Implications for genetic liability. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 159b(1), 5–12. https://doi.org/10.1002/ajmg.b.31238.

    Article  PubMed  Google Scholar 

  • Wechsler, D. (2003). Wechsler Intelligence Scale for Children (4th ed.). San Antonio: Pearson. https://doi.org/10.1037/t15174-000.

    Book  Google Scholar 

  • Wechsler, D. (2011). Wechsler Abbreviated Scale of Intelligence (2nd ed.). San Antonio: Pearson. https://doi.org/10.1037/t15171-000.

    Book  Google Scholar 

  • Wechsler, D. (2012). Wechsler Preschool and Primary Scale of Intelligence (4th ed.). San Antonio, TX: The Psychological Corporation.

    Google Scholar 

  • Wechsler, D. (2014). Wechsler Intelligence Scale for Children (5th ed.). Bloomington, MN: Pearson.

    Google Scholar 

Download references

Acknowledgments

RS is funded by an NSERC Discovery Grant (RGPIN-2017-04656), a SSHRC Insight Grant (435-2017-0936), the University of Western Ontario Faculty Development Research Fund, the province of Ontario Early Researcher Award, and a Canadian Foundation for Innovation John R. Evans Leaders Fund (37497).

Author information

Authors and Affiliations

Authors

Contributions

Authors NB, CM, and RS conceived of and designed the analysis. Authors EK, EA, RN, SG, JC, RS, and XL collected the data. Authors NB, CM, and RS contributed data or analysis tools. Authors NB and CM performed the analysis. Author NB wrote the first draft, all authors edited.

Corresponding author

Correspondence to Noah J. Brierley.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Brierley, N.J., McDonnell, C.G., Parks, K.M.A. et al. Factor Structure of Repetitive Behaviors Across Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. J Autism Dev Disord 51, 3391–3400 (2021). https://doi.org/10.1007/s10803-020-04800-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-020-04800-0

Keywords

Navigation