Repetitive and ritualistic behaviour in children with Prader-Willi syndrome and children with autism.
Kids with Prader-Willi syndrome show autism-level ritualistic behavior and deserve the same behavioral attention.
01Research in Context
What this study did
The team compared kids with Prader-Willi syndrome to kids with autism. They used parent checklists to count repetitive and ritualistic behaviors. Both groups had similar developmental levels so the scores could be compared fairly.
What they found
Both groups showed the same amount of overall repetitive behavior. The only clear difference was in the details: kids with PWS liked to collect and hoard items, while kids with autism often lined objects up in rows.
How this fits with other research
Eisenhower et al. (2006) also saw strong rituals in preschoolers with PWS and linked ritual severity to eating issues. N et al. now show these behaviors stay high even when matched to kids with autism.
Eugenia Gras et al. (2003) first mapped PWS compulsions across age and found they do not fade. The new study adds an autism yardstick, proving the behaviors are just as intense.
Honey et al. (2007) used the same parent-report method in typical kids and autism. N et al. keep the method but swap the typical group for PWS, giving a direct severity match.
Why it matters
If you work with PWS, treat ritualistic behavior as seriously as you would with autism. Use the same assessment tools and behavior plans. Watch for collecting or hoarding items and teach replacement skills like sorting or trading. Share these findings with parents so they know the behaviors are part of the syndrome, not defiance.
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02At a glance
03Original abstract
BACKGROUND: Recent research has shown that the range of repetitive behaviour seen in individuals with Prader-Willi syndrome (PWS) extends beyond food-related behaviour. METHODS: The presence and intensity of repetitive, rigid and routinized behaviour in children with PWS was compared with that seen in children with another neurodevelopmental condition in which repetitive behaviour is common: children with autism. Parents completed the Childhood Routines Inventory (CRI). RESULTS: Contrary to our predictions, controlling for developmental level, children with PWS and children with autism showed similar levels of repetitive and ritualistic behaviour overall and on the two CRI factors measuring 'just right' and 'repetitive' behaviour. Indeed, the majority of the sample of parents of children with PWS endorsed most items on the CRI. However there was some specificity at the level of individual items with parents of children with PWS more frequently endorsing an item on 'collecting and storing objects' and parents of children with autism more frequently endorsing 'lining up objects', 'has a strong preference for certain foods' and 'seems aware of detail at home'. CONCLUSIONS: These findings confirm the range of repetitive behaviours that form part of the behavioural phenotype of PWS, including insistence on sameness and 'just right' behaviours, and uncover a surprising overlap with those seen in children with autism. Clinical management for children with PWS should include advice and education regarding management of repetitive and rigid behaviour. Future research should investigate whether the repetitive behaviours that form part of the behavioural phenotype of both PWS and autism are associated with a common neuropsychological, neurotransmitter or genetic origin.
Journal of intellectual disability research : JIDR, 2006 · doi:10.1111/j.1365-2788.2005.00726.x