Comparing response blocking and response interruption/redirection on levels of motor stereotypy: Effects of data analysis procedures

Motor stereotypies in autism spectrum disorder: Clinical randomized study and classification proposal

LAY ABSTRACT

Motor stereotypies are one of the most frequent features in children with a diagnosis of autism spectrum disorder. They may disrupt children's functioning and development and be a potential source of stress for families. Several factors, including sex, age, cognitive ability, and severity of autism spectrum disorder, may influence the presence and intensity of stereotypies. The present study aimed to identify the prevalence of motor stereotypies in a group of children with autism spectrum disorder. In addition, it sought to investigate whether sex, age, cognitive ability, verbal language, neurological comorbidities, and severity of autism spectrum disorder were associated with an increased probability and higher number, duration, and variability of stereotypies. A total of 134 participants aged 2.3-17.6 years underwent a clinical protocol with standardized video-recorded sessions. Stereotypies were identified and classified by two independent evaluators. The prevalence of stereotypies was 56.7%, and a total of 1198 motor stereotypies were captured. Children who were younger, nonverbal, and had higher severity of autism spectrum disorder had an increased probability of presenting stereotypies. Being nonverbal or having higher severity of autism spectrum disorder was also associated with presenting a higher number of stereotypies. Children with developmental delay, intellectual disability, or epilepsy displayed longer stereotypies, and children with developmental delay or intellectual disability additionally presented more diverse stereotypies. As part of the study, the authors present a clinical classification model, a glossary, and video samples of motor stereotypies. The findings of this study suggest that children who are younger, nonverbal, have lower cognitive ability, and have higher severity of autism spectrum disorder may have a higher burden of stereotypies. Earlier intervention and monitoring of these children have the potential to improve their long-term outcomes.

Examining stereotypy in naturalistic contexts: Differential reinforcement and context-specific redirection

This study examined stereotypy in naturalistic classroom contexts (i.e., academic programming, leisure skill acquisition) with differential reinforcement of contextually appropriate behavior (DRA). When stereotypy was problematic, redirection to the ongoing activity was provided. Contextually appropriate behavior and stereotypy were measured across all contexts prior to redirecting stereotypy to contextually appropriate behavior. Low levels of stereotypy were observed during the DRA in at least 2 contexts for all 5 participants. Context-specific redirection was added to the DRA if stereotypy persisted, and decreased stereotypy in 9 of the 10 evaluations. The results suggest that stereotypy might not be problematic in all contexts when DRA is present and redirection to contextually relevant appropriate behavior is an effective strategy.