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Autism

Interventions for Stereotypical Behaviors

Stereoytpic behaviors such as hand flapping, ritualistic pacing, spinning, lining up objects, or visual inspection of objects are thought to be "automatically" and intrinsically rewarding for many children with autism spectrum disorders.These activities may give a child a new sensory experience that is rewarding.

One way to think about this is that many children with autism often do not have age-level play and social skills. Some pass time by engaging in repetitive motor behaviors. It is also possible that, though stereotypic behaviors are initially reinforced intrinsically, they may also become reinforced (i.e., strengthened) by social attention when caregivers try to stop or discourage the behaviors. These behaviors can interfere with learning if they occur a lot in the school setting. They can also "stigmatize" the child (i.e., make him or her appear odd).

Behavioral interventions

There are at least 3 possible behavioral interventions (forms of behavior modification) that may be used to reduce such repetitive behaviors. These interventions are usually employed separately, but they may also be done simultaneously. If parents wish to reduce such behavior, they should seek the help of a behavior therapist.

Medication interventions

Some medicines may also help to reduce repetitive or compulsive behaviors. Sometimes the serotonin selective reuptake inhibitors (SSRIs; the Prozac-like medicines) are helpful. Examples are citalopram, sertraline, and paroxetine. The newer types of antipsychotic medicine (called "atypical" or "novel" antipsychotics) are sometimes helpful for reducing stereotypic behaviors. Examples of these medicines are risperidone, aripiprazole, and ziprasidone.

Ordinarily, the antipsychotics would not be used solely to reduce repetitive behaviors, however, unless such behaviors were linked to other, more serious, behaviors. This is not frequent, but sometimes Ritalin-like medicines (methylphenidate, amphetamine) may actually make stereotypic behaviors increase in some children with autism-spectrum disorders. Parents and doctors should be watchful for this if a child with an autism-spectrum disorder is starting a new medicine for ADHD or if the dose of the medicine is increased.

It is important that a child manifesting stereotypic behaviors be taken to a clinic familiar with autism and related issues, as well as with psychopharmacological management. Only then can a plan be best formulated.

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Last Reviewed: Mar 24, 2009

Michael G Aman, PhD Michael G Aman, PhD
Professor of Psychology and Psychiatry
College of Medicine
The Ohio State University

Eric   Butter, PhD Eric Butter, PhD
Clinical Associate Professor of Pediatricsl
Adjunct Assistant Professor of Psychology
College of Medicine
The Ohio State University