An Analysis of Treatment Efficacy for Stereotyped and Repetitive Behaviors in Autism

Abstract

Stereotyped, repetitive, ritualistic, obsessive, and compulsive behaviors are a common feature for many individuals with autism, and multiple topographies of such behavior exist. Previous reviews have discussed treatments for stereotypy and repetitive behaviors; however, to date, none have systematically evaluated the efficacy of such treatments. An abundance of treatments based on the principles of applied behavior analysis exist within the literature; however, many assume that stereotypy is maintained by automatic reinforcement. The current review aimed to evaluate the efficacy of treatments for stereotypy across disciplines including behavioral, pharmacological, and sensory-based therapies. Furthermore, this review compares the efficacy of function-based and nonfunction-based treatments for stereotypy.

A review of environmental enrichment as treatment for problem behavior maintained by automatic reinforcement

“…This combination not only reflected the largest proportion of efficacious cases in general but also accounted for the largest reductions in problem behavior when environmental enrichment alone was inefficacious. These findings are similar to those reported by Mulligan et al ().…”

“…Generally, functional analyses have been shown to increase the efficacy of subsequent treatment (Campbell, ), but the case of automatic reinforcement may represent an exception (e.g., Mulligan et al, ). In the current review, analytic (functional analyses) and nonanalytic methods (e.g., caregiver report) of functional assessment were associated with relatively similar outcomes.…”

“…Several additional reviews (e.g., DiGennaro Reed, Hirst, & Hyman, 2012;Mulligan, Healy, Lydon, Moran, & Foody, 2014) have focused on treatment for stereotypy, which is commonly maintained by automatic reinforcement. DiGennaro Reed et al (2012) found that the majority of their reviewed studies relied on consequence-based or multicomponent (antecedent and consequence) interventions, suggesting the potential inefficacy of environmental enrichment alone as a treatment for stereotypy.…”

“…In their discussion, the authors called for additional analyses of the factors involved in efficacious treatment of stereotypy. Mulligan et al (2014) compared functionbased to nonfunction-based treatment for stereotypy and found that antecedent strategies in both categories of analysis met the promising but lacking in sufficient evidence criteria outlined by Chambless and Hollon (1998). Again, the authors called for future analyses of the variables associated with successful outcomes.…”

Employment and Vocational Skills Among Individuals with Autism Spectrum Disorder: Predictors, Impact, and Interventions

“…The identification of such predictors of employment, or job failure, suggests an important target area for intervention by practitioners. Applied behavior analysis has had much success in improving variables associated with many of the identified predictors of employment such as communication abilities, interpersonal abilities, self-stimulatory behavior, social skills, self-management skill, safety skills, and organization skills (e.g., Flynn and Healy 2012;Holloway et al 2014;Matson et al 2012;Mulligan et al 2014). The evidence-based procedures that exist to teach these skills should be utilized and further investigated to improve employment prospects among this population.…”