The early development of stereotypy and self-injury: a review of research methods.
Early stereotypy research was a mess of rulers—now we have uniform tools and proof that stereotypy can be cut to near-zero if we measure it the same way every time.
01Research in Context
What this study did
Symons et al. (2005) read every paper they could find on when rocking, flapping, and head-banging first show up in toddlers and preschoolers with autism or intellectual disability.
They did not run new kids; they simply sorted the old studies to see what methods had been used.
The team wanted to know if we can pin down the exact age these behaviors start.
What they found
The start ages were all over the map because each study used different rulers.
Some watched kids for five minutes, others for an hour. Some counted every flap, others only the big ones.
Because the tools were mismatched, no clear timeline could be drawn.
How this fits with other research
Scully et al. (2023) and Greenlee et al. (2024) prove the reviewers’ point: when you use the same ruler across kids, stereotypy drops fast.
Those two single-case studies ran tight, uniform protocols and got near-zero flapping in infants and preschoolers.
Scahill et al. (2015) gives you ready-made rulers—they list five tools that are trial-ready for repetitive behavior.
Grindle et al. (2012) widens the lens, showing that head-banging may also be learned through fear cues, not just attention or escape.
Why it matters
If you test a toddler today, pick one of the five trial-ready measures from Scahill et al. (2015) and stick with it. Track weekly, start before age two, and keep the same definition every visit. Your data will finally plug the gap Symons et al. (2005) highlighted—and you’ll know if your treatment, like the ones in Scully et al. (2023) and Greenlee et al. (2024), really works.
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Join Free →Pick one tool from Lawrence et al. (2015)—like the RBS-R—and use it to count flaps across three 10-minute play samples this week.
02At a glance
03Original abstract
BACKGROUND: The origin and developmental course of stereotypic and self-injurious behaviour among individuals with developmental disabilities such as intellectual disability (ID) or pervasive development disorders such as autism is not well understood. METHOD: Twelve studies designed to document the prevalence, nature, or development of stereotypic and/or self-injurious behaviour in children under 5 years of age and identified as at risk for developmental delay or disability were reviewed. Comparisons were made with similar studies with typically developing children. RESULTS: It appears that the onset of naturally occurring rhythmic motor stereotypies is delayed in young at-risk children, but that the sequencing may be similar. A very small database, differences in samples, measures, and designs limited the degree to which comparisons could be made across studies. CONCLUSION: Future work is needed based on appropriately designed prospective comparison studies and uniform quantitative measures to provide an empirical basis for new knowledge about the early development of one of the most serious behaviour disorders afflicting children with ID and related problems of development.
Journal of intellectual disability research : JIDR, 2005 · doi:10.1111/j.1365-2788.2004.00632.x