Relationship Between Subtypes of Restricted and Repetitive Behaviors and Sleep Disturbance in Autism Spectrum Disorder.

We examined the association of two types of restricted and repetitive behaviors, repetitive sensory motor (RSM) and insistence on sameness (IS), with sleep problems in children with autism spectrum disorder (ASD). Participants included 532 children (aged 2-17) who participated in the Autism Speaks Autism Treatment Network research registry. Confirmatory factor analysis of the Autism Diagnostic Interview-Revised detected the presence of RSM and IS. RSM behaviors were positively associated with parent-reported sleep problems, and this relationship remained significant after controlling for anxiety symptoms. IS was not significantly associated with sleep problems. Better understanding of the relationship between specific types of repetitive behaviors and sleep problems may allow providers to tailor interventions to the individual presentations of their patients with ASD.

Repetitive motor behavior: further characterization of development and temporal dynamics.

Repetitive behaviors are diagnostic for autism spectrum disorders, common in related neurodevelopmental disorders, and normative in typical development. In order to identify factors that mediate repetitive behavior development, it is necessary to characterize the expression of these behaviors from an early age. Extending previous findings, we characterized further the ontogeny of stereotyped motor behavior both in terms of frequency and temporal organization in deer mice. A three group trajectory model provided a good fit to the frequencies of stereotyped behavior across eight developmental time points. Group based trajectory analysis using a measure of temporal organization of stereotyped behavior also resulted in a three group solution. Additionally, as the frequency of stereotyped behavior increased with age, the temporal distribution of stereotyped responses became increasingly regular or organized indicating a strong association between these measures. Classification tree and principal components analysis showed that accurate classification of trajectory group could be done with fewer observations. This ability to identify trajectory group membership earlier in development allows for examination of a wide range of variables, both experiential and biological, to determine their impact on altering the expected trajectory of repetitive behavior across development. Such studies would have important implications for treatment efforts in neurodevelopmental disorders such as autism.

Subcategories of restricted and repetitive behaviors in children with autism spectrum disorders.

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.

Preliminary study on determining stereotypical motor movements.

Stereotypical motor movements are one of the most common and least understood behaviors occurring in individuals with Autism Spectrum Disorder (ASD). To overcome problems with traditional methods for measuring stereotypical motor movements in persons with ASD, the Kinect sensor from Microsoft and gesture recognition algorithms were used to automatically detect hand flapping. This study provides a valuable tool to monitor stereotypes in order to understand and to cope with this problem. At the end it facilitates to identify behavioral patterns especially relevant when studying interaction skills in children with ASD.

Age-related differences in the acoustic characteristics of male leopard seals, Hydrurga leptonyx.

During the breeding season, the underwater vocalizations and calling rates of adult male leopard seals are highly stereotyped. In contrast, sub-adult males have more variable acoustic behavior. Although adult males produce only five stereotyped broadcast calls as part of their long-range underwater breeding displays the sub-adults have a greater repertoire including the adult-like broadcast calls, as well as variants of these. Whether this extended repertoire has a social function is unknown due to the paucity of behavioral data for this species. The broadcast calls of the sub-adults are less stereotyped in their acoustic characteristics and they have a more variable calling rate. These age-related differences have major implications for geographic variation studies, where the acoustic behavior of different populations are compared, as well as for acoustic surveying studies, where numbers of calls are used to indicate numbers of individuals present. Sampling regimes which unknowingly include recordings from sub-adult animals will artificially exaggerate differences between populations and numbers of calling animals. The acoustic behavior of sub-adult and adult male leopard seals were significantly different and although this study does not show evidence that these differences reflect vocal learning in the male leopard seal it does suggest that contextual learning may be present.

The efficacy of diazepam treatment for the management of acute wounding episodes in captive rhesus macaques.

The spontaneous development of self-injurious behavior (SIB) in singly housed monkeys poses a challenge for their management and well-being in captivity. Relatively little information is available on effective treatments for SIB. This study examined the effects of diazepam (Valium) on self-wounding and other abnormal behaviors in eight individually housed male rhesus monkeys (Macaca mulatta). Each monkey's response to an anxiolytic dose of diazepam (1 mg/kg or greater orally) was compared with the animal's behavior during drug-free periods. When examined across all animals, treatment with diazepam did not significantly alter wounding frequency or rates of self-directed biting without wounding. However, closer examination of the data revealed that four of the animals showed significant decreases in self-biting and wounding frequency (positive responders, PR group), whereas the remaining monkeys showed a trend towards increased wounding frequency (negative responders, NR group). Subsequent examination of colony and veterinary records demonstrated that compared with NR monkeys, PR monkeys had spent significantly more years in individual cage housing and had experienced a greater number of minor veterinary procedures. PR animals also were significantly less likely to have a documented history of self-biting behavior. Our findings suggest that SIB is not a homogeneous disorder in rhesus monkeys; rather, distinct subtypes exist that require different treatment approaches.

Fisiopatogenia de las estereotipias y su relación con los trastornos generalizados del desarrollo / No disponible

Introducción. Las estereotipias, manifestaciones neuroconductuales de movimiento de patrón fijo y repetitivo de expresiónmotora o vocal sin finalidad alguna, son la expresión fenotípica de una alteración grave del desarrollo. Tienen unaimportancia semiológica extraordinaria en neurología evolutiva y deben tenerse en cuenta como patrón en los trastornos generalizadosdel desarrollo específicos. Objetivo. Considerar la importancia semiológica en los trastornos del desarrollo y organizaruna clasificación de las estereotipias de acuerdo a los trastornos del desarrollo, delimitar el concepto de conducta estereotipaday estereotipia, y explicar neurofisiológicamente las estereotipias en los trastornos generalizados del desarrollo. Desarrollo.Se revisa la importancia de la etología en la definición y clasificación de las estereotipias y sus teorías. Se enfocan lasestereotipias del desarrollo dentro del proceso madurativo y su relación en los tipos de conducta reactivo, propositito y comunicativo.Se discute el papel del somatograma en la ontogénesis madurativa con la somatognosia. Se estudian los circuitos neurofuncionalesque sustentan dichas estructuras (talamocorticales y corticotalámicas). Se correlacionan las manifestaciones conductualespatológicas en los ítems madurativos prensión patológica oculomanual, estereotipias, fallo de la atención compartida,no lectura de caras y fracaso de la empatía, como manifestación conductual neuroevolutiva. Conclusiones. Las estereotipiasson manifestaciones conductuales patológicas de un fracaso madurativo morfofuncional de los circuitos corticotalámicos ytalamocorticales. Son expresiones fenotípicas madurativas y marcadores biológicos conductuales del fracaso del desarrollo y,por tanto, del autismo. La estereotipia oculomanual o mirarse la mano tiene el mismo valor semiológico que el fracaso en laatención conjunta, la no lectura de caras y el fracaso de la empatía

Repetitive behaviors in autism: relationships with associated clinical features.

Relationships between repetitive behaviors (RBs) and associated clinical features (i.e., cognitive and adaptive functioning levels, sleep problems, medication use, and other behavioral problems) were examined in two groups (High nonverbal IQ > or = 97 versus Low nonverbal IQ < or = 56) of children with autism spectrum disorders (n = 14; mean age = 10 years, 7 months). For the group as a whole, nonverbal cognitive ability (NVIQ) (as measured by the Leiter-R), adaptive functioning level, the presence of sleep problems, and three scales of the Aberrant Behavior Checklist (ABC) (Irritability, Lethargy, and Hyperactivity) were highly correlated with total RB scores on the Repetitive Behavior Scale-Revised (RBS-R). After controlling for NVIQ, adaptive level, sleep problems, and two scales of the ABC (Irritability and Lethargy) were not significantly associated with RB scores. However, there remained a significant positive correlation between the presence of RBs and the Hyperactivity scale of the ABC. Parent ratings of their stress levels and the presence of RBs in their children were highly correlated. The relationship between RBs and associated clinical features in autism is complex and future studies should control for cognitive ability when examining the direct and indirect relationships of these variables with RBs.

Oral dyskinesias and histopathological alterations in substantia nigra after long-term haloperidol treatment of old rats.

The pathophysiologic basis of tardive dyskinesia remains unclear, but several lines of evidence suggest that persistent neuronal changes in the basal ganglia produced by oxidative stress or glutamate toxicity may play a role, especially in the elderly. In the present study we examined whether histopathological alterations in substantia nigra are related to oral dyskinesia in a rodent model of tardive dyskinesia. Haloperidol decanoate (38 mg/kg/4 weeks) was administered to young (8 weeks) and old (38 weeks) rats for a total period of 28 weeks, and the development of vacuous chewing movements (VCM) was observed. Rats with high and low levels of VCM and saline-treated controls were analyzed for histopathological alterations. Reduced nerve cell number and atrophic neurons were prominent features in the substantia nigra of old rats with high levels of VCM. Some alterations were also present in the substantia nigra of the old rats with low levels of VCM and young rats with high VCM levels, but these were significantly less affected than the high VCM rats. These results show that the development of haloperidol-induced oral dyskinesias in old rats is associated with histopathological alterations in the substantia nigra. This suggests that nigral degeneration induced by neuroleptics may contribute to the development of persistent VCM in rats and possibly irreversible tardive dyskinesia in humans.

Stereotyped movements in a group of autistic children.

The authors studied the stereotyped movements presented by a group of 20 autistic children, evaluating the patient observation protocols according to a psychodynamic model of autism. The stereotyped movements were analysed considering ten different parameters: type, site, morphology, frequency, association, complexity, active sensory channel, trigger event, affect during stereotyped movement, and function. The results indicate that each autistic child possesses highly idiosyncratic "stereotypical behavioural equipment", which includes behaviours ranging from simple, reflex-like actions, to much more complex movement patterns. Stereotyped movements were found to appear, in response to different stimuli, at moments when the subject's psychophysical state needed "resetting". Eight possible functions of stereotyped movements were identified. These correspond to two main purposes: reinforcement or weakening of the autistic barrier. The need for rehabilitation is questioned, since not all stereotyped behaviours interfere with explorative and cognitive activities.

Repetitive behaviors in chronic schizophrenia: using the Japanese version of the Elgin Behavior Rating Scale (JEBRS).

The main aim of this study was to test the reliability and value of the Japanese Elgin Behavior Rating Scale (JEBRS) with 92 schizophrenia patients. Cronbach's alpha for the JEBRS was 0.61. All inter-rater reliability coefficients were in the satisfactory range. The JEBRS had a high stability over time. Almost all of the correlations among the nine item scores and total score in the JEBRS were significant. The total score for nine repetitive behaviors in the JEBRS was positively correlated with positive and negative symptoms. This study showed that the JEBRS is a useful and reliable scale.

Hoarding behavior in the elderly: a comparison between community-dwelling persons and nursing home residents.

OBJECTIVE: To determine correlates of hoarding behavior in frail elderly persons. METHODS: Information about nursing home residents (n = 408) and community-dwelling senior day-care participants (n = 177) was gathered through interviews with family and professional caregivers, medical chart review, and physician examinations, and included the following areas of assessment: hoarding behavior, demographic and health information, level of cognitive functioning, activities of daily living (ADL) performance, depressed affect, social functioning, manifestations of agitated behaviors, and previous stressful life experiences. RESULTS: We found that 15% of the nursing home residents and 25% of the community-dwelling senior day-care participants manifested hoarding behavior at a rate of several times a week or higher. For nursing home residents, hoarding behavior was significantly related to a larger appetite, taking fewer medications, higher social functioning, comparatively less ADL impairment, and manifestations of physically nonaggressive agitated behaviors. For senior day-care participants, hoarding behavior was significantly associated with being female, a larger appetite, comparatively less gait impairment, fewer medical diagnoses, more involvement in activities, a positive diagnosis of dementia, hallucinations, the delusion of infidelity, and manifestations of three syndromes of agitated behaviors. CONCLUSION: While hoarding behavior in our samples presents differently from compulsive hoarding described in the literature, we obtained robust findings that show that despite differences in living conditions, the elderly persons who manifested hoarding behavior were those with relatively fewer health and functional disabilities. In addition, those who exhibited hoarding behavior also manifested agitated behaviors. We suggest that future researchers develop alternative measures of hoarding behavior so as to further clarify the phenomenon of hoarding behavior in the elderly.

Consistency in the ratings of behaviors of communicatively impaired autistic and non-autistic preschool children.

Typically, children with disabilities are evaluated clinically by a number of professionals with different backgrounds whose task is to provide a diagnosis and an intervention plan. This study was carried out to describe interrater agreement for pairs of independent observers rating with different instruments the behaviors of 505 communicatively impaired autistic and nonautistic preschool children. Observers were parents, teachers, neurologists, and psychiatrists. Parents and teachers responded to behavioral questionnaires, neurologists filled out the mental status part of a standardized neurologic evaluation, and psychiatrists an observational questionnaire. All four types of observers rated sociability, language, play, attention, stereotyped, and other aberrant behaviors. Agreement between pairs of raters was significant but moderate. Owing to range restriction with smaller numbers of subjects, agreement decreased for ratings of subsamples divided according to diagnosis, cognitive level, or age. There were some differences among observers' ratings of the severity of particular categories of behaviors, with physicians generally viewing the children as more severely impaired and teachers as least impaired. Interrater agreement was not enhanced when parents and teachers rated similarly worded behavioral items. Modest interrater agreement in this study, like agreement among disparate raters of children's behaviors in other studies, suggests that observers are sensitive to different aspects of behavior and that their ratings are more likely to be complementary than unreliable.

Is the ratio of male and female dream characters related to the waking-life pattern of social contacts?

The present study investigated the relationship between the sex ratio of dream characters and the person's waking-life pattern of social contacts. Results partly confirm the continuity between waking and dreaming.

DSM-IV stereotypic movement disorder: persistence of stereotypies of infancy in intellectually normal adolescents and adults.

BACKGROUND: As part of a broader series of studies on unwanted repetitive behaviors, DSM-IV stereotypic movement disorder (SMD) was examined in an intellectually normal population. Repetitive nonfunctional behaviors, or stereotypies, are expressed during early normal development but have not been described in adults without severe psychiatric or intellectual impairment. METHOD: Lifetime and current psychiatric Axis I diagnoses were determined by structured and clinical interviews in subjects who responded to a newspaper advertisement that specifically mentioned rocking and head banging. RESULTS: Of 52 potential subjects who were screened by telephone, 32 had been previously diagnosed with an Axis I psychiatric disorder, which presumably accounted for the repetitive behavior, or were otherwise excluded. Of 20 who were interviewed in person, 12 met DSM-IV criteria for SMD; rocking or thumb sucking was present in 8 of these 12. Four of 8 rockers had a first-degree relative who had a lifetime history of a similar repetitive behavior. A lifetime history of an affective or anxiety disorder was found for 11 of 12 SMD subjects. CONCLUSION: DSM-IV stereotypic movement disorder can be diagnosed in intellectually normal individuals. Although sampling bias was probable, prominent stereotypies in individuals meeting the DSM-IV criteria for stereotypic movement disorder, which are narrower than the DSM-III-R criteria for stereotypy/habit disorder, seem likely to include rocking and thumb sucking. The likelihood of persistence of these behaviors, which are developmentally appropriate in infancy, may be enhanced by comorbidity with anxiety or affective disorders.

A case-controlled study of repetitive thoughts and behavior in adults with autistic disorder and obsessive-compulsive disorder.

OBJECTIVE: The purpose of this study was to investigate the types of repetitive thoughts and behavior demonstrated by adults with autistic disorder and compare them with those of age- and sex-matched adults with obsessive-compulsive disorder. METHOD: Fifty consecutive patients admitted to the Yale Adult Pervasive Developmental Disorders (Autism) Clinic with a primary diagnosis of autistic disorder (DSM-III-R and DSM-IV) completed the symptom checklist of the Yale-Brown Obsessive Compulsive Scale. Types of current obsessions and compulsions were evaluated. The comparison group consisted of 50 age- and sex-matched adults with obsessive-compulsive disorder (without tics) (DSM-III-R and DSM-IV). RESULTS: Direct discriminant function analysis showed that the patients with autistic disorder could be distinguished from those with obsessive-compulsive disorder on the basis of the types of current repetitive thoughts and behavior that they demonstrated. Compared to the obsessive-compulsive group, the autistic patients were significantly less likely to experience thoughts with aggressive, contamination, sexual, religious, symmetry, and somatic content. Repetitive ordering; hoarding; telling or asking (trend); touching, tapping, or rubbing; and self-damaging or self-mutilating behavior occurred significantly more frequently in the autistic patients, whereas cleaning, checking, and counting behavior was less common in the autistic group than in the patients with obsessive-compulsive disorder. In addition, a specific subset of seven obsessive-compulsive variables from the Yale-Brown Obsessive Compulsive Scale symptom checklist was identified that reliably predicted membership in the autistic group. CONCLUSIONS: These results suggest that the repetitive thoughts and behavior characteristics of autism differ significantly from the obsessive-compulsive symptoms displayed by patients with obsessive-compulsive disorder. Future studies are warranted to assess the treatment response and neurobiological underpinnings of repetitive thoughts and behavior in patients with autism and obsessive-compulsive disorder.

Assessing the functions of aberrant behaviors: a review of psychometric instruments.

Reviewed the psychometric properties, treatment utility, and conceptual basis of psychometric instruments used to identify the functions of aberrant behaviors in people with developmental disabilities. The instruments reviewed are the Motivational Assessment Scale (Durand & Crimmins, 1992), the Motivation Analysis Rating Scale (Weisheler, Hanson, Chamberlain, & Thompson, 1985), the Functional Analysis Interview Form (O'Neill, Horner, Albin, Storey, & Sprague, 1990), and the Functional Analysis Checklist (Van Houten & Rolider, 1991). Recurrent problems in this area include the lack of replicability of the reliability of these instruments, difficulties in summarizing the information from these assessment devices, difficulties in translating the assessment into treatment packages, strong individual differences in the functions of behavior problems, and, finally, issues relating to the concurrent validity, both across these instruments and across other assessment methods.