Abstract
Although many researchers have examined the prevalence of stereotypy in individuals with developmental disabilities, the results of previous studies have not been aggregated and analyzed methodically. Thus, we conducted a systematic review of studies reporting the prevalence of stereotypy in individuals with developmental disabilities. Our results indicated that the average prevalence of stereotypy across studies was 61 % and that individuals with autism spectrum disorders had the highest reported prevalence (i.e., 88 %) across specific diagnoses. Children and adults generally had similar overall prevalence measures, but the specific forms varied with age and diagnosis. Studies using the Repetitive Behavior Scale-Revised and the Autism Diagnostic Schedule-Revised generally reported higher estimates of prevalence of specific forms of stereotypy when compared to the Behavior Problem Inventory. However, the latter seemed more sensitive than the Aberrant Behavior Checklist for overall prevalence. Studies with a low risk of bias found a lower prevalence of stereotypy than those with a high risk of bias. Our systematic review underlines the importance of continuing research efforts to improve the assessment and treatment of stereotypy in individuals with developmental disabilities.
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Aman, M. G., Singh, N. N., Stewart, A. W., & Field, C. J. (1985). The Aberrant Behavior Checklist: a behavior rating scale for the assessment of treatment effects. American Journal of Mental Deficiency, 89, 485–491.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Baumgardner, T. L., Reiss, A. L., Freund, L. S., & Abrams, M. T. (1995). Specification of the neurobehavioral phenotype in males with Fragile X syndrome. Pediatrics, 95, 744–752.
Berkson, G., & Tupa, M. (2000). Early development of stereotyped and self-injurious behaviors. Journal of Early Intervention, 23, 1–19. doi:10.1177/10538151000230010401.
Bhattacharya, R., Sanyal, D., Roy, K., & Saha, S. (2009). A study of cluster behavioral abnormalities in Down syndrome. Indian Journal of Medical Sciences, 63, 58–65. doi:10.4103/0019-5359.49232.
Bishop, S. L., Hus, V., Duncan, A., Huerta, M., Gotham, K., Pickles, A., & Lord, C. (2013). Subcategories of restricted and repetitive behaviors in children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43, 1287–1297. doi:10.1007/s10803-012-1671-0.
Bodfish, J. W., Crawford, T. W., Powell, S. B., Parker, D. E., Golden, R. N., & Lewis, M. H. (1995). Compulsion in adults with mental retardation: prevalence, phenomenology, and comorbidity with stereotypy and self-injury. American Journal on Mental Retardation, 100, 183–192.
Bodfish, J. W., Symons, F. J., Parker, D. E., & Lewis, M. H. (2000). Varieties of repetitive behavior in autism: comparisons to mental retardation. Journal of Autism and Developmental Disorders, 30, 237–243. doi:10.1023/A:1005596502855.
Capone, G. T., Grados, M. A., Kaufmann, W. E., Bernad-Ripoll, S., & Jewell, A. (2005). Down syndrome and comorbid autism-spectrum disorder: characterization using the Aberrant Behavior Checklist. American Journal of Medical Genetics, 134A, 373–380. doi:10.1002/ajmg.a.30622.
Chadwick, O., Kusel, Y., Cuddy, M., & Taylor, E. (2005). Psychiatric diagnoses and behaviour problems from childhood to early adolescence in young people with severe intellectual disabilities. Psychological Medicine, 35, 751–760. doi:10.1017/S0033291704003733.
Chowdhury, M., Benson, B. A., & Hillier, A. (2010). Changes in restricted repetitive behaviors with age: a study of high-functioning adults with autism spectrum disorders. Research in Autism Spectrum Disorders, 4, 210–216. doi:10.1016/j.rasd.2009.09.006.
Clarke, D. J., & Dykens, E. M. (1997). Correlates of maladaptive behavior in individuals with 5p- (cri du chat) syndrome. Developmental Medicine and Child Neurology, 39, 752–756. doi:10.1111/j.1469-8749.1997.tb07377.x.
Clarke, D. J., & Marston, G. (2000). Problem behaviors associated with 15q- Angelman Syndrome. American Journal on Mental Retardation, 105, 25–31. doi:10.1352/0895-8017(2000)105%3C0025:PBAWQA%3E2.0.CO;2.
Cox, A., Klein, K., Charman, T., Baird, G., Baron-Cohen, S., Swettenham, J., & Wheelwright, S. (1999). Autism spectrum disorders at 20 and 42 months of age: stability of clinical and ADI-R diagnosis. Journal of Child Psychology and Psychiatry, 40, 719–732. doi:10.1111/1469-7610.00488.
Cuccaro, M. L., Nations, L., Brinkley, J., Abramson, R. K., Wright, H. H., Hall, A., & Pericak-Vance, M. A. (2007). A comparison of repetitive behaviors in Aspergers disorder and high functioning autism. Child Psychiatry and Human Development, 37, 347–360. doi:10.1007/s10578-007-0052-y.
Cuccaro, M. L., Tuchman, R. F., Hamilton, K. L., Wright, H. H., Abramson, R. K., Haines, J. L., & Pericak-Vance, M. (2012). Exploring the relationship between autism spectrum disorder and epilepsy using latent class cluster analysis. Journal of Autism and Developmental Disorders, 42, 1630–1641. doi:10.1007/s10803-011-1402-y.
Cunningham, A. B., & Schreibman, L. (2008). Stereotypy in autism: the importance of function. Research in Autism Spectrum Disorders, 2, 469–479.
Davies, M., Udwin, O., & Howlin, P. (1998). Adults with Williams syndrome. Preliminary study of social, emotional and behavioural difficulties. British Journal of Psychiatry, 172, 273–276.
Didden, R., Sturmey, P., Sigafoos, J., Lang, R., O’Reilly, M. F., & Lancioni, G. E. (2012). Nature, prevalence, and characteristics of challenging behavior. In J. L. Matson (Ed.), Functional assessment for challenging behaviors (pp. 25–44). New York: Springer New York.
Dunlap, G., Dyer, K., & Koegel, R. L. (1983). Autistic self-stimulation and intertrial interval duration. American Journal of Mental Deficiency, 88, 194–202.
Fecteau, S., Mottron, L., Berthiaume, C., & Burack, J. A. (2003). Developmental changes of autistic symptoms. Autism, 7, 255–268. doi:10.1177/13623613030073003.
Flores, C. G., Valcante, G., Guter, S., Zaytoun, A., Wray, E., Bell, L., & Kim, S. J. (2011). Repetitive behavior profiles: consistency across autism spectrum disorder cohorts and divergence from Prader-Willi syndrome. Journal of Neurodevelopmental Disorders, 3, 316–324. doi:10.1007/s11689-011-9094-3.
Fodstad, J. C., Rojahn, J., & Matson, J. L. (2012). The emergence of challenging behaviors in at-risk toddlers with and without autism spectrum disorder: a cross-sectional study. Journal of Developmental and Physical Disabilities, 24, 217–234. doi:10.1007/s10882-011-9266-9.
Freeman, R. D., Soltanif, A., & Baer, S. (2010). Stereotypic movement disorder: easily missed. Developmental Medicine and Child Neurology, 52, 733–738. doi:10.1111/j.1469-8749.2010.03627.x.
Goldman, S., Wang, C., Salgado, M., Greene, P., Kim, M., & Rapin, I. (2009). Motor stereotypies in children with autism and other developmental disorders. Developmental Medicine and Child Neurology, 51, 30–38. doi:10.1111/j.1469-8749.2008.03178.x.
Greaves, N., Prince, E., Evans, D. W., & Charman, T. (2006). Repetitive and ritualistic behaviour in children with Prader–Willi syndrome and children with autism. Journal of Intellectual Disability Research, 50, 92–100. doi:10.1111/j.1365-2788.2005.00726.x.
Hattier, M. A., Matson, J. L., MacMillan, K., & Williams, L. (2013). Stereotyped behaviours in children with autism spectrum disorders and atypical development as measured by the BPI-01. Developmental Neurorehabilitation, 16, 291–300. doi:10.3109/17518423.2012.727107.
Hessl, D., Tassone, F., Cordeiro, L., Koldewyn, K., McCormick, C., Green, C., & Hagerman, R. J. (2008). Brief report: aggression and stereotypic behavior in males with fragile X syndrome—moderating secondary genes in a "single gene" disorder. Journal of Autism and Developmental Disorders, 38, 184–189. doi:10.1007/s10803-007-0365-5.
Hill, J., & Furniss, F. (2006). Patterns of emotional and behavioural disturbance associated with autistic traits in young people with severe intellectual disabilities and challenging behaviours. Research in Developmental Disabilities, 27, 517–528. doi:10.1016/j.ridd.2005.07.001.
Hiraiwa, R., Maegaki, Y., Oka, A., & Ohno, K. (2007). Behavioral and psychiatric disorders in Prader-Willi syndrome: a population study in Japan. Brain & Development, 29, 535–542. doi:10.1016/j.braindev.2007.01.005.
Huxley, A., Van-Schaik, P., & Witts, P. (2005). A comparison of challenging behaviour in an adult group with Down’s syndrome and dementia compared with an adult Down’s syndrome group without dementia. British Journal of Learning Disabilites, 33, 188–193. doi:10.1111/j.1468-3156.2005.00323.x.
Jones, R. S. P., Wint, D., & Ellis, N. C. (1990). The social effects of stereotyped behaviour. Journal of Intellectual Disability Research, 34, 261–268. doi:10.1111/j.1365-2788.1990.tb01537.x.
Kim, H. S., & Lord, C. (2010). Restricted and repetitive behaviors in toddlers and preschoolers with autism spectrum disorders based on the Autism Diagnostic Observation Schedule (ADOS). Autism Research, 3, 162–173. doi:10.1002/aur.142.
Lam, K. S. L., & Aman, M. G. (2007). The Repetitive Behavior Scale-Revised: independent validation in individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37, 855–866. doi:10.1007/s10803-006-0213-z.
Lam, K. S. L., Bodfish, J. W., & Piven, J. (2008). Evidence for three subtypes of repetitive behavior in autism that differ in familiality and association with other symptoms. The Journal of Child Psychology and Psychiatry, 49, 1193–1200. doi:10.1111/j.1469-7610.2008.01944.x.
Lanovaz, M. J., & Sladeczek, I. E. (2012). Vocal stereotypy in children with autism spectrum disorders: a review of behavioral interventions. Behavior Modification, 36, 146–164. doi:10.1177/0145445511427192.
Lanovaz, M. J., Robertson, K., Soerono, K., & Watkins, N. (2013). Effects of reducing stereotypy on other behaviors: a systematic review. Research in Autism Spectrum Disorders, 7, 1234–1243. doi:10.1016/j.rasd.2013.07.009.
Lord, C., Rutter, M., & Le Couteur, A. L. (1994). Autism Diagnostic Interview-Revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685. doi:10.1007/BF02172145.
Lundqvist, L. O. (2011). Psychometric properties and factor structure of the Behavior Problems Inventory (BPI-01) in a Swedish community population of adults with intellectual disability. Research in Developmental Disabilities, 32, 2295–2303. doi:10.1016/j.ridd.2011.07.037.
Lundqvist, L. O. (2013). Prevalence and risk markers of behavior problems among adults with intellectual disabilities: a total population study in Orebro County, Sweden. Research in Developmental Disabilities, 34, 1346–1356. doi:10.1016/j.ridd.2013.01.010.
MacDonald, R., Green, G., Mansfield, R., Geckeler, A., Gardenier, N., Anderson, J., & Sanchez, J. (2007). Stereotypy in young children with autism and typically developing children. Research in Developmental Disabilities, 28, 266–277. doi:10.1016/j.ridd.2006.01.004.
Matson, J. L., Kiely, S. L., & Bamburg, J. W. (1997). The effect of stereotypies on adaptive skills as assessed with the DASH-II and Vineland Adaptive Behavior Scales. Research in Developmental Disabilities, 18, 471–476. doi:10.1016/S0891-4222(97)00023-1.
Matson, J. L., Smiroldo, B. B., & Hastings, T. L. (1998). Validity of the Autism/Pervasive Developmental Disorder subscale of the Diagnostic Assessment for the Severely Handicapped-II. Journal of Autism and Developmental Disorders, 28, 77–81.
Matson, J. L., Wilkins, J., & Macken, J. (2008). The relationship of challenging behaviors to severity and symptoms of autism spectrum disorders. Journal of Mental Health Research in Intellectual Disabilities, 2, 29–44. doi:10.1080/19315860802611415.
McTiernan, A., Leader, G., Healy, O., & Mannion, A. (2011). Analysis of risk factors and early predictors of challenging behavior for children with autism spectrum disorder. Research in Autism Spectrum Disorders, 5, 1215–1222. doi:10.1016/j.rasd.2011.01.009.
Medeiros, K., Rojahn, J., Moore, L. L., & Van Ingen, D. J. (2014). Functional properties of behaviour problems depending on level of intellectual disability. Journal of Intellectual Disability Research, 58, 151–161. doi:10.1111/jir.12025.
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of Internal Medicine, 151, 264–269. doi:10.7326/0003-4819-151-4-200908180-00135.
Morrison, K., & Rosales-Ruis, J. (1997). The effect of object preferences on task performance and stereotypy in a child with autism. Research in Developmental Disabilities, 18, 127–137. doi:10.1016/S0891-4222(96)00046-7.
Murphy, O., Healy, O., & Leader, G. (2009). Risk factors for challenging behaviors among 157 children with autism spectrum disorder in Ireland. Research in Autism Spectrum Disorders, 3, 474–482. doi:10.1016/j.rasd.2008.09.008.
Myrbakk, E., & Von Tetzchner, S. (2008). The prevalence of behavior problems among people with intellectual disability living in community settings. Journal of Mental Health Research in Intellectual Disabilities, 1, 205–222. doi:10.1080/19315860802115607.
Newman, I., Leader, G., Chen, J. L., & Mannion, A. (2015). An analysis of challenging behavior, comorbid psychopathology, and attention-deficit/hyperactivity disorder in Fragile X syndrome. Research in Developmental Disabilities, 38, 7–17. doi:10.1016/j.ridd.2014.11.003.
Oliver, C., Sloneem, J., Hall, S., & Arron, K. (2009). Self-injurious behaviour in Cornelia de Lange syndrome: I. Prevalence and phenomenology. Journal of Intellectual Disability Research, 53, 575–589. doi:10.1111/j.1365-2788.2009.01179.x.
Rapp, J. T., & Vollmer, T. R. (2005). Stereotypy I: a review of behavioral assessment and treatment. Research in Developmental Disabilities, 26, 527–547. doi:10.1016/j.ridd.2004.11.005.
Reese, R. M., Richman, D. M., Belmont, J. M., & Morse, P. (2005). Functional characteristics of disruptive behavior in developmentally disabled children with and without autism. Journal of Autism and Developmental Disorders, 35, 419–428. doi:10.1007/s10803-005-5032-0.
Richler, J., Bishop, S. L., Kleinke, J. R., & Lord, C. (2007). Restricted and repetitive behaviors in young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37, 73–85. doi:10.1007/s10803-006-0332-6.
Rojahn, J., Tassé, M. J., & Sturmey, P. (1997). The Stereotyped Behavior Scale for adolescents and adults with mental retardation. American Journal on Mental Retardation, 102, 137–146. doi:10.1352/0895-8017(1997)102%3C0137:TSBSFA%3E2.0.CO;2.
Rojahn, J., Matson, J. L., Lott, D., Esbensen, A. J., & Smalls, Y. (2001). The Behavior Problems Inventory: an instrument for the assessment of self-Injury, stereotyped behavior, and aggression/destruction in individuals with developmental disabilities. Journal of Autism and Developmental Disorders, 31, 577–588. doi:10.1023/A:1013299028321.
Rojahn, J., Rowe, E. W., Sharber, A. C., Hastings, R., Matson, J. L., Didden, R., & Dumont, E. L. M. (2012). The Behavior Problems Inventory-Short Form for individuals with intellectual disabilities: part I: development and provisional clinical reference data. Journal of Intellectual Disability Research, 56, 527–545. doi:10.1111/j.1365-2788.2011.01507.x.
Rojahn, J., Barnard-Brak, L., Richman, D., Dotson, W., Medeiros, K., Wei, T., & Abby, L. (2013). Behavior problems in individuals with Cornelia de Lange syndrome: population-specific validation of the Behavior Problem Inventory-01. Journal of Developmental and Physical Disabilities, 25, 505–515. doi:10.1007/s10882-012-9329-6.
Scahill, L., Dimitropoulos, A., McDougle, C. J., Aman, M. G., Feurer, I. D., McCracken, J. T., & Vitiello, B. (2014). Children’s Yale–Brown Obsessive Compulsive scale in autism spectrum disorder: component structure and correlates of symptom checklist. Journal of the American Academy of Child and Adolescent Psychiatry, 53, 97–107. doi:10.1016/j.jaac.2013.09.018.
South, M., Ozonoff, S., & McMahon, W. M. (2005). Repetitive behavior profiles in Asperger syndrome and high-functioning autism. Journal of Autism and Developmental Disorders, 35, 145–158. doi:10.1007/s10803-004-1992-8.
Szatmari, P., Georgiades, S., Bryson, S., Zwaigenbaum, L., Roberts, W., Mahoney, W., & Tuff, L. (2006). Journal of Child Psychology and Psychiatry, 47, 582–590. doi:10.1111/j.1469-7610.2005.01537.x.
Thelen, E. (1979). Rhythmical stereotypies in normal human infants. Animal Behavior, 27, 699–715. doi:10.1016/0003-3472(79)90006-X.
Whiting, P. F., Rutjes, A. W., Westwood, M. E., Mallett, S., Deeks, J. J., Reitsma, J. B., & QUADAS-2 Group. (2011). QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Annals of Internal Medicine, 155, 529–536. doi:10.7326/0003-4819-155-8-201110180-00009.
Woodcock, K., Oliver, C., & Humphreys, G. (2009). Associations between repetitive questioning, resistance to change, temper outbursts and anxiety in Prader–Willi and Fragile-X syndromes. Journal of Intellectual Disability Research, 53, 265–278. doi:10.1111/j.1365-2788.2008.01122.x.
Zeilinger, E. L., Weber, G., & Haveman, M. J. (2011). Psychometric properties and norms of the German ABC-Community and PAS-ADD Checklist. Research in Developmental Disabilities, 32, 2431–2440. doi:10.1016/j.ridd.2011.07.017.
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The preparation of this manuscript was supported in part by a doctoral research scholarship from the Fonds de Recherche du Québec – Société et Culture to the first author and a salary award from the Fonds de Recherche du Québec – Santé (no. 30827) to the third author.
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Chebli, S.S., Martin, V. & Lanovaz, M.J. Prevalence of Stereotypy in Individuals with Developmental Disabilities: a Systematic Review. Rev J Autism Dev Disord 3, 107–118 (2016). https://doi.org/10.1007/s40489-016-0069-x
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DOI: https://doi.org/10.1007/s40489-016-0069-x