Structure of Restricted Repetitive Behaviors of Individuals Referred for Autism Spectrum Disorder Assessment.
The RBS-R five-factor model is solid for 2- to 9-year-olds with ASD, so you can trust its subscales to track and treat restricted and repetitive behaviors.
01Research in Context
What this study did
Root et al. (2026) ran a confirmatory factor analysis on the Repetitive Behavior Scale-Revised (RBS-R). They wanted to see if the five-factor structure held up in a new sample of kids with autism.
The sample was 350 children aged 2 to 9 who were referred for an autism evaluation. Parents filled out the RBS-R as part of the intake process.
What they found
The five-factor model fit the data best. The factors are: stereotyped, self-injurious, compulsive, ritualistic, and restricted interests.
Each factor also tied to cognitive and adaptive scores. Kids with higher scores on any RRB subtype tended to have lower IQ and daily-living skills.
How this fits with other research
Iversen et al. (2021) pooled almost 3,000 kids and found medium links between RRBs and poor executive function. Kay’s findings line up: the RBS-R gives you clean subscales that track those same EF-related behaviors.
Flapper et al. (2013) showed that ASD symptoms already split into three factors by 18 months. Kay’s work extends that downward, proving the RRB piece is already measurable and multi-factor in toddlers, not just school-age kids.
Perry et al. (2022) saw NO EF-RRB link in their adult autism group. Kay’s kid sample DID show links to cognitive scores. The gap is likely age: EF demands and RRB expression change as kids grow, so don’t expect adult data to match child data.
Why it matters
You can treat the RBS-R subscales as separate mini-rulers. If a child’s ritualistic score jumps after you add a new classroom routine, you have a number to show the team. Pair those numbers with EF or adaptive data and you can spot which RRB type is most tied to real-life impairment. Use the five factors to pick targets: start with the subtype that links to the lowest adaptive score for faster daily-life gains.
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02At a glance
03Original abstract
Research examining restricted and repetitive patterns of behavior or interests (RRB) in autism spectrum disorder (ASD) has increased our understanding of its contribution to diagnosis and its role in development. Advances in our knowledge of RRB are hindered by the inconsistencies in how RRB is measured. The present study examined the factor structure of the Repetitive Behavior Scale-Revised (RBS-R) in a sample of 350 children with ASD ages 2-9. Confirmatory factor analysis designed for items with categorical response types was implemented to examine six proposed structural models. The five-factor model demonstrated the most parsimonious fit based on common overall fit indices that was further supported by examination of local model fit indicators, though, the four- and six-factor models evidenced adequate-to-good fit as well. Examination of RRB factor score approaches indicated only minor differences between summed item subscale scores and extracted factor scores with regard to associations with diagnostic measures. All RRB subtypes demonstrated significant associations with cognitive functioning and adaptive behavior. Implications for future research validating the RBS-R as a more extensive clinical measure of RRB in ASD are discussed. Autism Res 2019, 12: 1399-1410. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Repetitive behaviors are one of the two main symptoms of autism spectrum disorder (ASD). To better understand the role of repetitive behaviors, we must establish effective ways of measuring them. This study assessed the measurement qualities of the Repetitive Behavior Scale-Revised (RBS-R) in a sample of 350 children with ASD ages 2-9. We found that the RBS-R measures multiple types of repetitive behaviors and that these behaviors are related to thinking ability and independence.
Journal of autism and developmental disorders, 2026 · doi:10.1111/jcpp.12207