Poster #49 - Restricted Repetitive Behaviors of Individuals Referred for Autism Spectrum Disorder Evaluation

• In Event: 2-163 - Poster Session 08
  In Poster Session: PS 08 Section - Developmental Disabilities

Integrative Statement

Background. Most parents of children who are diagnosed with autism spectrum disorder(ASD) have concerns about their child’s development before age 2(Kowalski et al., 2011); however, the average age of diagnosis in the United States is around age 4(Filipek et al., 1999; Christensen et al., 2016; Jon Baio et al., 2018). Furthermore, while language development is cited as the most common area of first concern for children with ASD, restricted, repetitive behaviors, interests or activities, commonly referred to as restricted repetitive behaviors(RRBs) may be some of the first manifestations of ASD, often presenting prior to language development(Wolff et al., 2014). Children across a full range of abilities who are later diagnosed with ASD have significantly greater frequency, amounts, and severity of RRBs as early as 12 months of age when compared to typically developing children(Ozonoff et al., 2008; Wolff et al., 2014). Despite an increased interest in characterizing the RRBs of individuals with ASD, there are still gaps in the literature, including how RRBs may diverge in individuals who are referred for ASD evaluation who receive an ASD diagnosis as opposed to those who do not. If elucidated, differences in these behavior profiles may aid in earlier detection and diagnosis of ASD. The current project aims to characterize the RRBs of children referred to a tertiary care clinic for an ASD evaluation who receive an ASD diagnosis versus those who do not. Thus, this diverse sample represents a wide range of developmental concerns.

Method. Participants included 391 individuals seen for comprehensive clinical assessment of ASD(including the Autism Diagnostic Interview-Revised; ADI-R) at the University of Alabama at Birmingham. Two groups were identified, individuals who received an ASD diagnosis(ASD; n=229), and those who did not(non-ASD; n=162). RRBs were measured using scores from the Restricted, Repetitive, and Stereotyped Patterns of Behavior subscale of the ADI-R.

Results. Overall, the ASD group had significantly higher scores on the Restricted, Repetitive, and Stereotyped Patterns of Behaviors Subscale(t(388)=5.60, p<0.001). Specifically, the ASD group had higher scores on stereotyped and repetitive motor mannerisms(t(388)=8.28, p<0.001) and preoccupation with parts of objects or nonfunctional elements of materials(t(388)=5.62, p<0.001) than the non-ASD group. Groups did not differ on encompassing preoccupations or circumscribed pattern of interest(t(389)=1.80, p>0.05) or apparently compulsive adherence to nonfunctional routines(t(388)=0.566, p>0.05).

Conclusions. While a significant number of individuals are referred for assessment of ASD each year, only approximately half receive an ASD diagnosis in this setting. Little is known about the RRBs of individuals referred for ASD assessment who have ASD as opposed to those who do not. The current study suggests that individuals with ASD have overall increased amounts and severity of RRBs, specifically increased stereotyped and repetitive motor mannerisms and preoccupation with parts or nonfunctional elements of objects. This introduces the potential benefit of developing a screening tool using similar items to aid in differentiating individuals at higher risk for having ASD. As such, this profile may aid in detecting individuals with a true ASD diagnosis at an earlier age, allowing for better detection of affected individuals.

Authors

• Helen Root, University of Alabama at Birmingham
  Presenting Author

• Jenna Lebersfeld, University of Alabama at Birmingham
  Non-Presenting Author

• Kristi Guest, University of Alabama at Birmingham
  Non-Presenting Author

• Sarah O'Kelley, University of Alabama at Birmingham
  Non-Presenting Author