Encyclopedia of Autism Spectrum Disorders

Living Edition
| Editors: Fred R. Volkmar

Treatment for Higher-Order Restricted, Repetitive Behaviors

  • Christie Enjey LinEmail author
Living reference work entry
DOI: https://doi.org/10.1007/978-1-4614-6435-8_102341-1



Treatments for higher-order restricted, repetitive behaviors (H-RRBs) aim to improve the skills of people with ASD to appropriately vary their behaviors and interests to situational demands. Specifically, to adaptively vary from following preferred idiosyncratic rituals or routines, shift one’s activities and topics of conversations from restricted interests, reasonably adjust to changes in routines and schedules, and vary from engaging in repetitive play actions. These treatments focus on addressing impairments in behavioral flexibility observed in many people with ASD. Interventions targeting H-RRBs are aimed to promote skills in flexibly adjusting to situational demands while teaching skills, either directly or indirectly, to appropriately regulate emotions and behaviors to improve the overall adaptability of people with ASD.

Higher-order restricted, repetitive behaviors are considered to be distinct from sensory motor...

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References and Reading

  1. Bishop, S. L., Hus, V., Duncan, A., Huerta, M., Gotham, K., Pickles, A., Kreiger, A., Buja, A., Lund, S., & Lord, C. (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. PubMed PMID: 23065116; PubMed Central PMCID: PMC3579001.CrossRefGoogle Scholar
  2. Boyd, B. A., Woodard, C. R., & Bodfish, J. W. (2011). Feasibility of exposure response prevention to treat repetitive behaviors of children with autism and intellectual disabilities: A brief report. Autism, 17, 196–204.CrossRefGoogle Scholar
  3. Evans, D. W., Uljarević, M., Lusk, L. G., Loth, E., & Frazier, T. (2017). Development of two dimensional measures of restricted and repetitive behavior in parents and children. Journal of the American Academy of Child Adolescent Psychiatry, 56(1), 51–58.  https://doi.org/10.1016/j.jaac.2016.10.014. Epub 2016 Nov 3. PubMed PMID: 27993229.CrossRefGoogle Scholar
  4. Harrop, C. (2015). Evidence-based, parent-mediated interventions for young children with autism spectrum disorder: The case of restricted and repetitive behaviors. Autism, 19(6), 662–672.  https://doi.org/10.1177/1362361314545685.CrossRefPubMedGoogle Scholar
  5. Kenworthy, L., Anthony, L. G., Naiman, D. Q., Cannon, L., Wills, M. C., Luong-Tran, C., Werner, M. A., Alexander, K. C., Strang, J., Bal, E., Sokoloff, J. L., & Wallace, G. L. (2014). Randomized controlled effectiveness trial of executive function intervention for children on the autism spectrum. Journal of Child Psychology and Psychiatry, 55(4), 374–383.  https://doi.org/10.1111/jcpp.12161. Epub 2013 Nov 21. PubMed PMID: 24256459; PubMed Central PMCID: PMC4532389.CrossRefGoogle Scholar
  6. Klin, A., Danovitch, J. H., Merz, A. B., & Volkmar, F. (2007). Circumscribed interests in higher functioning individuals with autism spectrum disorders: An exploratory study. Research and Practice for Persons with Severe Disabilities, 32(2), 89–100.CrossRefGoogle Scholar
  7. Lin, C. E., & Koegel, R. L. (2018). Treatment for higher-order restricted repetitive behaviors (H-RRB) in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 48(11), 3831–3845.CrossRefGoogle Scholar
  8. Richler, J., Bishop, S. L., Kleinke, J. R., & Lord, C. (2007). Restricted and repetitive behaviors in young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37(1), 73–85.CrossRefGoogle Scholar
  9. Troyb, E., Knoch, K., Herlihy, L., Stevens, M. C., Chen, C., Barton, M., et al. (2016). Restricted and repetitive behaviors as predictors of outcome in autism spectrum disorders. Journal of Autism and Developmental Disorders, 46(4), 1282–1296.  https://doi.org/10.1007/s10803-015-2668-2.CrossRefPubMedGoogle Scholar
  10. Ventola, P. E., Yang, D., Abdullahi, S. M., Paisley, C. A., Braconnier, M. L., & Sukhodolsky, D. G. (2016). Brief report: Reduced restricted and repetitive behaviors after pivotal response treatment. Journal of Autism and Developmental Disorders, 46(8), 2813–2820.  https://doi.org/10.1007/s10803-016-2813-6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  1. 1.Child and Adolescent PsychiatryUC San FranciscoSan FranciscoUSA