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Childhood Mental Disorders and Illnesses

Restricted, Repetitive Patterns of Behavior, Interests or Activities

Kathryn Patricelli, MA Updated: Sep 25th 2018

Some of the behavioral issues that those with autism spectrum disorder may display include:

Stereotyped or Repetitive Motor Movements, Use of Objects, or Speech. This might include simple motor activities being performed over and over, such as hand flapping or rocking back and forth. Children might also be focused on lining up toys/objects in certain patterns or flipping them around while focusing intently on them. Issues with speech might include a practice known as echolalia. Echolalia is a verbal behavior in which children repeat what they hear over and over and over again. Echolalia is not uncommon behavior in normal language development. However, typically when children echo phrases and words, they do so for a social reason. In contrast, children with autism spectrum disorder repeat phrases, words or whole paragraphs without the intention of interacting or communicating with other people.

Insistence on Sameness/Inflexible Adherence to Routines. Children with autism spectrum disorder typically like things to be done in exactly the same way every time without any modifications or changes. For example, they have to get dressed in the same order each day or the bedtime routine has to be followed or they are unable to go to sleep. They may show extreme distress at even tiny changes to routines. They might need to eat the same foods every day or have their plate arranged in the same way. They also may have very rigid thinking patterns and not be open to the possibility of having a different thought about the topic they are considering.

Highly Restricted, Fixed Interests That Are Abnormal in Intensity or Focus. Children with autism spectrum disorder may have one or two topics that are the only thing they want to talk about or think about. For example, this might be dinosaurs or computers or specific locations. They may show an inability to talk about anything else or "space out" if people aren't engaging with them about that specific topic. They may show a strong attachment or preoccupation with a special object and need to have it with them always. For example, a teenager who has a special toy that they still want to carry around with them.

Hyper- or Hypo Sensitive to Sensory Inputs. Children with ASD may be overly sensitive to sensory elements in their environment (hyper sensitive) or not at all sensitive (hypo sensitive). Hypersensitive children find themselves overloaded with even moderate levels of sensation. They work to block out sensory inputs such as light, sound and touch. Hyposensitive children, on the other hand, are not stimulated enough by normal sensory inputs and typically seek out extra stimulation. To illustrate, children who are hypersensitive to touch sensations may have a tantrum when they are touched. However, hyposensitive children may crave and seek out strong hugs that provide deep pressure. Children with high pain tolerances may injure themselves quite significantly but carry on as though nothing has happened. Oversensitive children may be unable to tolerate simple touches or certain textures.

Issues experienced by those with autism spectrum disorder are varied, complicated and sometimes, confusing. They affect people in important and intense ways. Without intervention and training, they will likely be deprived of the natural ability to physically interact, socialize and communicate with others.


Reader Comments
Discuss this issue below or in our forums.

Normal/Abnormal? - - Oct 20th 2010

Al children are 'normal'. Even children on the spectrum! However - some are neuro-typical (NT) and others are not ;)

need help with bully - - Oct 10th 2010

I am looking for help.  My son is targeted by an older high functioning autistic child who bullies him.  We are at the point of having to leave our church and any sport that this child is in with him.  I have talked with the boy's mother who is lovely and tries very hard but the boy does not understand how hateful his words are.  I have tried to help my 6 year old understand why the 9 year old is mean to him constantly but it not working.  My son's older sisters (11 and 9) understand some of what is going on and try to be tollerant but that is not going to fly when their little brother is crying.  I am concerned that my 6 year old will eventually defend himself physically.  What do I do now?

Careful Wording - - Apr 13th 2010

A very useful and informative article, however I would just ask that you be very careful with the words you chose to use.   Referring to children on the the autism spectrum as "autistic children" and neurotypical children and "normal children" creates stigma's about children with autism.  It creates a "normal" and an "abnormal", or an "us" and "them" mentality, which is not constructive when trying to create community awareness about autism.   


Dr. Dombeck's Note: It is my humble opinion that no amount of alternative labeling is going to get to the root of the labeling problem; namely that some of individuals has been singled out via diagnosis as a special group.  As soon as you have a diagnostic group which has been distinguished from a non-diagnosed group, you have the "us and them" problem built in.  If you try to soft peddle the cleavage, it is still there and cruel people will still use it cruely. 

Presently, the term "Mental Retardation" is undergoing a transformation to "Intellectual Disability" motivated by this same (and kind, and protective) impulse, but since the underlying groupings are still there, my sense is that the change will matter little.  I do not believe you can banish stigma with word changes.  The root of the stigma is deeper than the terms we use to describe it.

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