1. Continuity and Change in Children’s Restricted and Repetitive Behaviour Susan Leekam*, Helen McConachie**, Bronia Arnott +, Elizabeth Meins +, Charles Fernyhough +, Kathryn Parkinson**, Michelle Turner +, Lucia Vittorini +, Charlotte Wright #, Ann Le Couteur** Cardiff University, + University of Durham, **University of Newcastle, # University of Glasgow Background Restricted and repetitive behaviours (RRBs) form an essential part of the diagnosis of autism spectrum disorders (ASD). They are also extremely common in typically developing children. However we know very little about the change and continuity of these behaviours across early childhood. The purpose of this longitudinal research was to identify whether restricted and repetitive behaviours and subtypes of these behaviours change with age between 15 months, 2 years and 6 years, using factor analysis and frequency comparisons. Factor analysis: Subtypes of RRBs Does your child: 1= never/rarely,2= occasional, 3= marked Repetitive motor movements - Arrange toys or other item in rows or patterns? - Spin him/herself around and around? - Rock backwards and forwards? - Pace/move around repetitively? - Make repetitive hand/finger movements? Unusual sensory interest - Look at objects from unusual angles?* - Have a special interest in the smell of people or objects? - Have a special interest in the feel of different surfaces?* - Insist on wearing the same clothes/ refuse new clothes?* Rigidity/Adherence to routine - Insist on things remaining the same? - Get upset about minor changes to objects? - Insist on aspects of routine remaining the same? - Insist on doing or re-doing things in a certain way? - Play the same music etc repeatedly?* - Insist on wearing the same clothes/refuse new clothes?* - Insist on eating the same/small range of foods? Preoccupation with restricted patterns of interest - Arrange toys/items in rows or patterns? - Have a fascination with specific objects? - Look at objects from particular or unusual angles?* - Have a special interest in the feel of different surfaces?* - Have special objects he/she carries around? - Collects or hoards item of any sort? - Plays the same music etc. repeatedly?* * these items are associated with two factors at 2yrs and with one factor at 6 yrs Acknowledgements: Research funded by ESRC. Contact: Sue Leekam, School of Psychology, Cardiff University, UK, CF10 38T. LeekamSR@cardiff.ac.uk. Reference: Leekam et al. (2007). Repetitive behaviours in typically developing 2-year olds. Journal of Child Psychology & Psychiatry, 48 (11), 1131-1138. LeekamSR@cardiff.ac.uk Repetitive Behaviour Questionnaire-2 (RBQ-2) The RBQ-2 (Leekam et al. 2007) is a 20-item postal questionnaire for parents Unlike other measures that focus on specific aspects of behaviour, e.g. compulsive behaviour, or stereotypy, the RBQ-2 measures a wide range of repetitive behaviours and is suitable for both non-clinical and clinical populations. 19-items measure frequency and/or severity of repetitiveness (1=never/rarely, 2= occasional, 3 = marked). Item 20 measures the range of self-chosen activities (1=flexible, 2= some variation 3=restricted range). Participants 1237 parents in North-East England were recruited when their children were aged 2 years. 679 parents (55%) completed the RBQ-2 (343 boys and 336 girls). 590 of the same parents (289 boys, 301girls) also completed the RBQ-2 when their child was 6 years. In addition, a small subset of the same parents (139; 74 boys, 65 girls) also completed the RBQ-2 when their child was 15 months. This was a mixed SES community sample, predominantly White-British. Conclusion Restricted and repetitive behaviours reduce steadily between 15 months and 6 years. The most striking changes in structure and frequency occur between 15 months and 2 years. Between 2 and 6 years, the structure remains stable and the frequency continues to reduce, but RRBs do not disappear. Individual continuity between RRBs is also indicated by significant correlations in RRBs between 15m and 2yrs (r=.66) and between 2yrs and 6yrs (r=.63). Taken together, these results indicate that clinicians aiming to discriminate atypical patterns of RRB should focus less on the presence of RRBs and more on their changing nature. RBQ-2: Subtypes of RRBs Results Continuity and change in RRB frequencies RRBs reduced with age. Boys had higher Total Repetitive Behaviour scores overall than girls (p<. 04, all ages together) but this gender difference was not found independently at 15mths. Preoccupation with Restricted Interest was significantly higher than every other subtype at age 2 and 6yrs (p <.01 for all). In contrast, at 15mths the highest score was for Motor Movements (significantly higher than every other subtype, p<.001) Continuity and change in factor structure A 4-factor model provided the best fit for the data at 2 yrs (51% variance). The same 4-factor structure fitted well at 6 yrs (50% variance), with all items fitting well with one of the 4 factors. The weighting of factors changed, with motor subtype accounting for most variance at 2 (28%) and rigidity at 6 (26%). In contrast, at 15mths, a 2-factor, not a 4-factor structure best fitted the data (motor-sensory/ rigidity/interests) RBQ-2: Total RRB