Review on behavioral journal addressing Autism Spectrum Disorder. Find an article from a behavioral journal that specifically provides treatment addressing Autism Spectrum Disorder.
Review on behavioral journal addressing Autism Spectrum Disorder.
Find an article from a behavioral journal that specifically provides treatment addressing Autism Spectrum Disorder.
Review the article for its design, intervention success and practical strategies offered for clinicians/therapists.
Repetitive and restricted behaviors and interests are a major feature of Autism Spectrum Disorder (ASD). Insistence on sameness, rigid adherence to rituals and routines and resistance to change, and related symptoms can have a highly disruptive impact on an individual’s ability to transition from one task to the next and progress through the different steps within a task.
Difficulties with transitions can represent a major barrier in treatment and care, impede learning, and contribute to significant distress in individuals with an ASD. A number of behavioral approaches to facilitating transitions in persons with an ASD have been investigated. The current paper reviews the available research on strategies to support individuals in transitions between daily activities and tasks. Current trends and future directions are discussed.
Restricted, repetitive patterns of behavior which often manifest as insistence on sameness, inflexible adherence to routines, or ritualized patterns of behavior are among the defining features of Autism Spectrum Disorders (American Psychiatric Association (APA), 2013). Despite shifting emphases over the years with regard to diagnostic criteria, including evolving theories on the nature and diagnostic significance of specific social and communication deficits, “sameness” features have remained prominent in every conceptualization of autism dating back to the original seminal paper.
Kanner (1943) described “repetitions carried out in exactly the same way,” “verbal rituals recurring all day long,” “insistence on sameness,” satisfaction “unless someone made a persistent attempt to interfere with … self-chosen activities,” and “dread of change” in his original sample of children. Variations on these original observations have been described in individuals with autism for 70 years. In the DSM-V, insistence on sameness is included within the broader category of restricted, repetitive behavior.
While there is no universally agreed upon definition of insistence on sameness, the term has perhaps most often been used to refer to adherence to rituals and routines and resistance to change which were highlighted in Rutter’s definition of autism (Rutter 1971) and influential in formulating diagnostic criteria used in earlier versions of the Diagnostic and Statistical Manual (DSM). In discussing insistence on sameness, Rutter (1978) additionally referred to limited play patterns, intense object attachments, and unusual preoccupations.
Both the current and the previous version of the DSM (DSM-V, APA 2013; DSM-IV-TR, APA 2000) consider these to be core features of Autism Spectrum Disorders, despite other changes in criteria. The DSM-V (APA 2013) specifically lists “extreme distress at small changes” and “difficulties with transitions” as example criteria. Widely utilized autism screening and assessment scales invariably incorporate items and/or subscales related to the sameness domain of problems including resistance to change, repetitive behaviors, restricted interests, and/or difficulty with transitions (Lord et al. 1994, 2000; Matson et al. 2009c; Schopler et al. 2010).