Factor Structure of RRBs in Verbal and Non-Verbal Preschoolers With ASD or Related Characteristics.
Use a three-factor RRB model for verbal preschoolers with autism and a two-factor model for non-verbal ones.
01Research in Context
What this study did
The team looked at restricted and repetitive behaviors (RRBs) in preschoolers with autism. They split the kids into two groups: those who could talk and those who could not.
They used math tools called factor models to see how RRB symptoms clump together. They wanted to know if talking kids show a different pattern than non-talking kids.
What they found
Talking kids showed three clear RRB groups: moving the body the same way, insisting on sameness, and repeating speech. Non-talking kids showed only two groups: body movements and sameness.
The speech-repetition group only showed up in kids who had words. This means the way we measure RRBs must fit the child’s verbal level.
How this fits with other research
Norrelgen et al. (2015) found that one in four preschoolers with autism still had no phrase speech after two years of center help. D'Agostino et al. (2025) use that same verbal split to show the speech factor only appears in kids who do talk.
Beck et al. (2021) checked if the First-Year Inventory works in 12-month baby siblings. Their goal was cleaner early screening, just like the RRB study aims for cleaner preschool measurement.
Together, the papers build a timeline: screen early with tools like FYI, then track RRBs with the right factor model once the child is three to five.
Why it matters
If you test a non-verbal preschooler with a tool built for verbal kids, you may miss key symptoms or add fake ones. Pick the two-factor model for kids without phrase speech and the three-factor model for kids with words. This small switch gives you a truer picture of RRBs and helps set better goals.
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02At a glance
03Original abstract
PURPOSE: RRBs are a core symptom domain of autism spectrum disorder (ASD). The DSM-5 defines RRBs across 4 categories, though research supporting these distinct categories has been inconsistent. The purpose of this work is to examine the factor structure of RRBs in Verbal and Non-verbal children with ASD or subthreshold symptoms, and determine child characteristics associated with these factors. METHODS: We used data from a second phase of an ongoing study to confirm the factor structure of RRBs on ADI-R items in Verbal and Non-verbal preschool children (mean age = 57.1 months, SD = 8.32), separately. Using multivariable regression, we evaluated the association between Verbal and Non-verbal children factor scores and clinical characteristics using the ADOS, CBCL, and Vineland-2. RESULTS: A 3-factor structure of RRBs (RSMB; IS; and SPEECH) was confirmed in Verbal children and a 2-factor structure (RSMB and IS) was identified for Non-verbal preschoolers. Higher scores on the ADOS RRB CSS were associated with worse RSMB factor scores in Verbal and Non-verbal preschoolers. Verbal preschoolers with worse internalizing symptoms also had worse RSMB, IS, and SPEECH factor scores. In Verbal and Non-verbal children, worse social adaptive scores were associated with worse RSMB factor scores. CONCLUSION: By analyzing Verbal and Non-verbal preschoolers separately, we confirmed the presence of a unique SPEECH factor in Verbal children. This approach indicates that RRBs coalesce in 3 factors (RSMB, IS, and SPEECH) in Verbal youth and 2 factors (RSMB and IS) in Non-verbal youth, a pattern not reflected in the current diagnostic manual.
Journal of autism and developmental disorders, 2025 · doi:10.1016/j.bpsc.2021.10.010