Characterising repetitive behaviours in children and adolescents with Down syndrome.
Repetitive behaviors are the norm, not the exception, in Down syndrome and flag sleep, mood, and language troubles you can treat.
01Research in Context
What this study did
Adams et al. (2024) asked parents of 151 kids and teens with Down syndrome about repetitive behaviors. They used a short survey called the RBS-R. Ages ranged from 3 to 18.
The team wanted to know how common these behaviors are and if they link to sleep, mood, or learning issues.
What they found
Almost every child showed some repetitive behavior. Hand flapping, rocking, and lining up toys topped the list.
Older kids had more 'higher-level' rituals, like strict routines. Boys and girls looked the same. Kids with worse sleep, mood, or language scores had more RRBs.
How this fits with other research
Liang et al. (2026) pooled accelerometer data and found kids with neurodevelopmental disorders move 13 minutes less each day. E et al. add the reason: many of those kids are busy flapping or rocking instead of running.
Carvalho et al. (2009) showed poor balance in DS comes from bad body-sense, not weak muscles. The new survey says the same kids also fidget and rock—both signs point to sensory system differences.
King et al. (2013) found kids with ID join fewer sports clubs. E et al. now show why: repetitive movements and social-adaptive problems cluster together, making team play harder.
Why it matters
Screen for RRBs at every visit—one quick parent checklist is enough. When scores are high, also ask about sleep, language delays, and emotional outbursts. Targeting these co-occurring problems can cut the behavior without a separate RRB program. Share results with teachers and coaches so they expect the movements and keep the child included in PE and recess.
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02At a glance
03Original abstract
BACKGROUND: Individuals with intellectual disability, including people with Down syndrome (DS), often exhibit restricted and repetitive behaviours (RRBs). However, RRBs have not been deeply characterised in children and adolescents with DS. METHOD: The study encompassed a cohort of 151 participants aged 4 to 18 years with DS. RRBs were assessed utilising the Repetitive Behaviour Scale-Revised. Additionally, data pertaining to cognitive and adaptive functioning, linguistic abilities, sleep patterns and emotional/behavioural issues were gathered. RESULTS: Self-injurious behaviours were reported less frequently whereas parents most commonly endorsed items related to behaviours associated with the need for sameness and ritualistic behaviours. We observed very few gender differences, whereas some age-related differences emerged, with adolescents exhibiting higher scores in items related with higher-level RRBs. The analysis of the association between RRBs and clinical features revealed that RRBs were associated with parent-reported sleep difficulties, as well as with internalising and externalising problems. We also observed a negative correlation with IQ whereas associations with adaptive skills emerged mainly for lower-level RRBs, such as motor stereotypies. Finally, RRBs were negatively associated with linguistic abilities, both expressive and receptive. CONCLUSIONS: RRBs in children and adolescents with DS are of significant clinical interest due to their associations with various clinical dimensions. Therefore, psychological and neuropsychiatric assessment should include an accurate evaluation of RRBs for young people with DS.
Journal of intellectual disability research : JIDR, 2024 · doi:10.1111/jir.13179