Autism & Developmental

Basal ganglia morphometry and repetitive behavior in young children with autism spectrum disorder.

Estes et al. (2011) · Autism research : official journal of the International Society for Autism Research 2011
★ The Verdict

More repetitive behaviors in preschoolers with autism go hand-in-hand with smaller basal ganglia and thalamus.

✓ Read this if BCBAs working with 3- to 4-year-olds who show lots of stereotypy.
✗ Skip if Clinicians focused only on adolescents or adults.

01Research in Context

01

What this study did

Researchers scanned the brains of preschoolers with autism, developmental delay, and typical development.

They measured the size of the basal ganglia and thalamus, then compared those sizes to scores on repetitive-stereotyped behaviors.

02

What they found

Kids with autism who showed more hand-flapping, lining up toys, or other repeated actions had smaller basal ganglia and thalamus volumes.

The other groups did not show this link.

03

How this fits with other research

Wu et al. (2025) extends this finding. They show that sensorimotor brain networks stay immature into adulthood, meaning the small sub-cortical structures seen here are part of a life-long atypical maturation track.

Vierck et al. (2015) is topically related. They found that older dads and male gender predict more severe repetitive behaviors, so biology and family factors both shape the same behaviors measured in the target study.

Shokouhi et al. (2012) used similar brain scans but looked at cortical folds in adolescents. Together the papers map structural differences from preschool basal ganglia to teen cortex, showing anatomy changes across development.

04

Why it matters

If a three-year-old client shows intense repetitive play, remember the motor system driving those actions may be structurally and functionally different. Use movement-rich prompts, extra motor breaks, and do not assume the child is being non-compliant; the brain region that helps shift actions is smaller. Pair your ABA plan with occupational therapy when possible.

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Add short gross-motor warm-ups before tabletop work to help kids with high repetitive behavior settle faster.

02At a glance

Intervention
not applicable
Design
other
Sample size
136
Population
autism spectrum disorder, developmental delay, neurotypical
Finding
not reported

03Original abstract

We investigated repetitive and stereotyped behavior (RSB) and its relationship to morphometric measures of the basal ganglia and thalami in 3- to 4-year-old children with autism spectrum disorder (ASD; n = 77) and developmental delay without autism (DD; n = 34). Children were assessed through clinical evaluation and parent report using RSB-specific scales extracted from the Autism Diagnostic Observation Schedule (ADOS), the Autism Diagnostic Interview, and the Aberrant Behavior Checklist. A subset of children with ASD (n = 45), DD (n = 14), and a group of children with typical development (TD; n = 25) were also assessed by magnetic resonance imaging. Children with ASD demonstrated elevated RSB across all measures compared to children with DD. Enlargement of the left and right striatum, more specifically the left and right putamen, and left caudate, was observed in the ASD compared to the TD group. However, nuclei were not significantly enlarged after controlling for cerebral volume. The DD group, in comparison to the ASD group, demonstrated smaller thalami and basal ganglia regions even when scaled for cerebral volume, with the exception of the left striatum, left putamen, and right putamen. Elevated RSB, as measured by the ADOS, was associated with decreased volumes in several brain regions: left thalamus, right globus pallidus, left and right putamen, right striatum and a trend for left globus pallidus and left striatum within the ASD group. These results confirm earlier reports that RSB is common early in the clinical course of ASD and, furthermore, demonstrate that such behaviors may be associated with decreased volumes of the basal ganglia and thalamus.

Autism research : official journal of the International Society for Autism Research, 2011 · doi:10.1002/aur.193