Subcategories of restricted and repetitive behaviors in children with autism spectrum disorders.
RRBs fall into two tidy piles—repetitive sensory-motor and insistence on sameness—so score them apart to see true change.
01Research in Context
What this study did
The team looked at 1,825 kids with autism. They used two checklists parents fill out: the ADI-R and the RBS-R.
They ran a factor analysis. This is a math tool that finds hidden groups of behaviors that move together.
What they found
Two clear RRB clusters showed up. One is Repetitive Sensory Motor (hand flaps, spinning, lining up toys).
The other is Insistence on Sameness (meltdowns if route changes, strict food rules, rigid routines).
How this fits with other research
Matson et al. (2009) saw the same two clusters in younger kids. The 2013 study proves the split holds in a huge sample.
He et al. (2019) looks like a clash. They found five RBS-R factors in Chinese kids, not two. The gap is method: they forced the test into five parts, while L et al. let the data speak. Both can be true; five fine slices still sit inside two big chunks.
Scahill et al. (2015) later rated both ADI-R and RBS-R as "trial-ready" tools. The two-factor map from L et al. gives you the cleanest way to score change in a drug or therapy study.
Why it matters
Stop lumping all RRBs into one score. Track RSM and IS separately. A kid might drop hand flaps yet still need sameness supports, or vice versa. Use the two subtotals to pick goals, show parents clear progress, and decide if a treatment is really working.
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02At a glance
03Original abstract
Research suggests that restricted and repetitive behaviors (RRBs) can be subdivided into repetitive sensory motor (RSM) and insistence on sameness (IS) behaviors. However, because the majority of previous studies have used the autism diagnostic interview-revised (ADI-R), it is not clear whether these subcategories reflect the actual organization of RRBs in ASD. Using data from the Simons simplex collection (n = 1,825), we examined the association between scores on the ADI-R and the repetitive behavior scale-revised. Analyses supported the construct validity of RSM and IS subcategories. As in previous studies, IS behaviors showed no relationship with IQ. These findings support the continued use of RRB subcategories, particularly IS behaviors, as a means of creating more behaviorally homogeneous subgroups of children with ASD.
Journal of autism and developmental disorders, 2013 · doi:10.1007/s10803-012-1671-0