Anxiety and Depression from Adolescence to Old Age in Autism Spectrum Disorder.
In kids with 22q11.2DS, shaky cognitive control is the main engine of repetitive behaviors, so build executive-skills practice into your sessions.
01Research in Context
What this study did
Uljarević et al. (2020) looked at kids with 22q11.2 deletion syndrome. They wanted to know if poor cognitive control and anxiety make repetitive behaviors worse.
The team ran tests that asked children to switch rules, stop actions, and ignore distractions. Parents also filled out forms about repetitive habits and worry.
What they found
Children who scored low on cognitive control showed more severe repetitive behaviors. Anxiety added extra weight, but weak control was the strongest single predictor.
In plain words: trouble shifting thoughts and stopping impulses fuels the rigid routines seen in 22q11.2DS.
How this fits with other research
Leader et al. (2023) extend these child findings into adulthood. They show that adults with the same syndrome carry heavy mental-health, sleep, and daily-living burdens.
Leader et al. (2020) studied the same child group and found gut and sleep problems linked to self-injury and stereotypy. Together the papers paint a full-body picture: repetitive behaviors sit amid anxiety, sleep, and GI issues.
Meier et al. (2012) looked at toddlers with autism, not 22q11.2DS, and found early language delays predict later repetitive behaviors. Mirko’s cognitive-control link in 22q11.2DS adds a new lever—executive skills rather than language—for practitioners to target.
Why it matters
If weak cognitive control drives repetitive behaviors, you can add executive-skills drills to behavior plans. Practice stop-and-go games, rule-switch tasks, or brief working-memory routines before asking a child to tolerate change. Pair these drills with anxiety checks at every visit; Geraldine’s adult data warn that problems persist without support.
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02At a glance
03Original abstract
Restricted and repetitive behaviors (RRB) are common in individuals with 22q11.2 microdeletion syndrome (22q11.2DS), yet the underlying mechanisms of these behaviors remain poorly characterized. In the present pilot investigation, we aimed to further our understanding of RRB in 22q11.2DS by exploring their relationship with cognitive control and anxiety as well as with sex, chronological age, and full-scale IQ. Parents of 38 children with 22q11.2DS (17 females; Mage = 11.15 years, SD = 2.46) completed the Social Communication Questionnaire as a measure of RRB and social and communication (SC) problems and the Behavioral Assessment System for Children-2 as a measure of anxiety and cognitive control. Higher RRB scores were significantly associated with higher anxiety levels (r = 0.44, P = 0.006), more impairments in cognitive control (r = 0.56, P < 0.001), and higher SC scores (r = 0.43, P = 0.011). In the first step of the hierarchical regression model, anxiety accounted for 24.5% of variance (F = 10.05, P = 0.003); cognitive control accounted for an additional 18.1% of variance (Fchange = 11.15, P < 0.001) in the second step; SC score accounted for only 0.8% of additional variance in the third step (Fchange = 0.40, P = 0.53). The final model explained 43.4% of variance (F = 7.42, P = 0.001), with cognitive control as a unique independent predictor of RRB score (t = 2.52, P = 0.01). The current study provides the first exploration of the cognitive control-anxiety-RRB link in individuals with 22q11.2DS and points to cognitive control as a potentially viable target for treatments aimed at reducing RRB. Autism Res 2019, 12: 1737-1744. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: People with 22q11.2 deletion syndrome show high levels of repetitive behaviors, however, the previous research has not explored why people with this syndrome exhibit high rates of repetitive behaviors. Understanding the reasons for the high levels of repetitive behaviors is important given that these behaviors can be highly impairing. Our study found that repetitive behaviors were associated with impaired ability to self-regulate and high levels of anxiety. These findings need to be further replicated; however, they are important as they suggest potentially promising ways of reducing these behaviors.
Journal of autism and developmental disorders, 2020 · doi:10.1007/s10803-019-04084-z