An analogue assessment of repetitive hand behaviours in girls and young women with Rett syndrome.
Repetitive hand movements in Rett syndrome appear automatic, so skip social-consequence interventions and test each behavior separately.
01Research in Context
What this study did
Matson et al. (2004) ran an analogue functional analysis on eight girls and young women with Rett syndrome.
They tested whether attention, demands, or toys changed the girls’ constant hand-mouthing and wringing.
Each condition lasted ten minutes and was repeated several times in a single-case design.
What they found
Hand movements stayed above 60% of intervals in every condition.
No social consequence made the behavior clearly rise or fall.
The authors concluded the movements are likely automatic, not reinforced by people or tasks.
How this fits with other research
Taylor et al. (1993) saw a different picture. In one girl, some self-injury was escape-maintained and some was automatic.
That study reminds us to test each behavior separately; hand stereotypy and self-injury can have different functions even in the same child.
Galuska et al. (2006) and Ward et al. (2021) later showed these girls can make intentional eye-gaze choices.
So the girls have voluntary control in one channel (eyes) while hand movements stay automatic, highlighting a split within the same nervous system.
Why it matters
If the hand behavior is automatic, giving attention or removing tasks will not reduce it.
Save treatment time for sensory or biomedical strategies instead of social consequences.
Also, keep testing other behaviors—eye-gaze, self-injury—because they may still be operant.
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Join Free →Run a brief alone/play condition first; if hand stereotypy stays high, drop attention-based plans and consult the medical team about sensory or medical routes.
02At a glance
03Original abstract
BACKGROUND: Rett syndrome is a neurodevelopmental disorder that almost exclusively affects females. In addition to neurodevelopmental regression and loss of hand skills, apraxia, deceleration of head growth, and increasing spasticity and scoliosis, a number of behavioural features are also seen, including stereotypic hand movements, hyperventilation and breath holding. The aim of the study was to investigate the extent to which analogue environmental conditions affected the frequency of repetitive hand behaviour in eight girls and young women with Rett syndrome. METHOD: The frequency of repetitive hand movements was observed every 10 s for four 4-min sessions under the following conditions: Continuous Adult Attention, Adult Demands, Stimulation and No Stimulation. RESULTS: The frequency of repetitive hand movements was high -- they occurred in above 60% of all intervals in all conditions for all participants and at nearly 100% for some participants in some conditions. For one participant the frequency of repetitive hand movements was somewhat reduced in the Stimulation condition; for another it was relatively increased in the No Stimulation condition. CONCLUSIONS: Overall, environmental manipulations had relatively limited effects on repetitive hand behaviours. Repetitive hand behaviour in Rett syndrome may be maintained by automatic reinforcement or neurochemical processes and may not be primarily influenced by contingent reinforcement.
Journal of intellectual disability research : JIDR, 2004 · doi:10.1111/j.1365-2788.2003.00590.x