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Treatment for Higher-Order Restricted Repetitive Behaviors (H-RRB) in Children with Autism Spectrum Disorder

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Abstract

Restricted repetitive behaviors (RRB) are one of the core symptoms of autism spectrum disorder (ASD). Evidence suggests that higher-order RRB (H-RRB) are particularly challenging and can negatively impact family functioning (e.g., insistence on sameness, following idiosyncratic routines). The study examined the effects of a parent-implemented behavior intervention using a multiple baseline single case experimental design in three young children with ASD. The intervention involved self-management procedures and included principles of pivotal response treatment during which parents provided bids for children to vary from H-RRB and children obtained points for engaging in these other interests and activities. Results showed improvements in child behavior, parent and child affect and interactions, children’s engagement in family activities, and overall parent ratings of RRB.

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Acknowledgments

The authors would like to thank the families who participated in the study and undergraduate assistants who aided with data management. The study was funded in part by the Ray E. Hosford Fellowship Research Grant and the Eli Broad Foundation.

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Authors and Affiliations

  1. University of California, San Francisco, 401 Parnassus Ave., LP 132, San Francisco, CA, 94143, USA

    C. Enjey Lin

  2. Stanford University School of Medicine, 1520 Page Mill Road, Palo Alto, CA, 94304, USA

    Robert Koegel

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  1. C. Enjey Lin
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  2. Robert Koegel
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Contributions

CEL conceived of the study, implemented the design of the study, collected data, conducted data analyses, interpreted the data and drafted the manuscript. RK participated in the conception of the study, design of the study, data analyses, and reviewed the manuscript.

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Correspondence to C. Enjey Lin.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Additional information

The data was collected at the University of California, Santa Barbara as part of the corresponding author’s doctoral dissertation.

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Lin, C.E., Koegel, R. Treatment for Higher-Order Restricted Repetitive Behaviors (H-RRB) in Children with Autism Spectrum Disorder. J Autism Dev Disord 48, 3831–3845 (2018). https://doi.org/10.1007/s10803-018-3637-3

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