Autism Therapy: stereotypy

definition of stereotypy: Repetitive physical movements common in autism, like hand flapping.

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Risk Factors for Challenging Behaviors among 157 Children with Autism Spectrum Disorder in Ireland
Research in Autism Spectrum Disorders, by Murphy, O., Healy O., and Leader G., published in 2009, summarized Nov 16, 2009

Self-injury behaviors in children with autism may be more intense in children with severe intellectual disability than in other children with autism.

This study asked whether self injury, aggressive, and stereotypy behaviors were more common in some groups of children with autism than others. The researchers tested age, gender, therapy interventions, and intellectual disabilities. Age and gender were not a factor. Children getting applied behavior analysis therapy (ABA) had aggressive behaviors more often than other children, but the authors think that might be because children with behavioral problems are more likely to get therapy. Children with severe intellectual disabilities had more intense self-injury behaviors than other children with autism.


Lack of Efficacy of Citalopram in Children with Autism Spectrum Disorders and High Levels of Repetitive Behavior
Archives of General Psychiatry, by King, BH, Hollander E., Sikich L., McCracken JT, Scahill L., Bregman JD, Donnelly CL, Anagnostou E., Dukes K., Sullivan L., et al., published in 2009, summarized Aug 31, 2009

Citalopram (Cilexa®) therapy may not be helpful for improving behaviors or skills in children with autism.

This article reports results of a large randomized, placebo-controlled, double-blind study of citalopram with 149 children (5-17 years old). The children had autism, Asperger syndrome, or pervasive developmental disorder not otherwise specified (PDD-NOS). All of the children had moderate to severe compulsive or repetitive behaviors. They received citalopram therapy (10-20 mg/day) or a placebo (sugar pill) for 12 weeks. Citalopram therapy did not reduce repetitive behaviors or improve any other behaviors more than the placebo did. The authors tested more than 11 behaviors and skills using 3 different standard tests. Side effects of the drug therapy included increased energy, impulsiveness, decreased concentration, hyperactivity, stereotypy, diarrhea, sleep problems, and dry skin. The authors said that higher doses of citalopram may improve behaviors, but would also lead to more side effects. A commentary by F.R. Volkmar in the same journal issue noted that this study was large and well-designed. He agreed that citalopram may not be helpful for children with autism.


A Brief Report on the Effects of a Self-Management Treatment Package on Stereotypic Behavior
Research in Autism Spectrum Disorders, by Moore, TR, published in 2009, summarized Jul 27, 2009

A self-management treatment package (SMTP) reduced stereotypy (repetitive movements) in a young man with autism.

SMTP is a type of therapy where the person learns how to change their own behavior. Patients can be trained to be aware of their behaviors and reward themselves when they are able to change them. This case study involved an 18 year-old man with Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS). The therapy sessions took place in his residential placement center. He learned to control his stereotypy by gradually waiting longer periods without the movements, and reward himself by drinking some of his favorite soda. The time between repetitive behaviors increased from 1 second to 15 minutes.


Developing Stimulus Control for Occurrences of Stereotypy Exhibited by a Child with Autism
International Journal of Behavioral Consultation and Therapy, by Brusa, E., and Richman D., published in 2009, summarized May 21, 2009

Applied behavior analysis (ABA) may be useful in helping children with autism overcome problem stereotypic behavior.

This case study describes the use of ABA therapy to control problem behavior (stereotypy) in children with autism. The eight year-old boy in this study played with string so much that it got in the way of his schooling. The authors found that they were able to control his playing with a string by using a stimulus. The authors were not certain what helped to stop the boy from playing with the string: spoken comment, taking the string away, or giving him a reward if he stopped playing with the string. The authors note that once a child learns to stop the problem behavior (such as playing with a string), it may be a good idea to allow the child to request a time when it is ok to do the problem behavior.


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