The impact of raising a child with autism spectrum disorder (ASD) is frequently accompanied by elevated caregiver stress. Examining the variables that predict these elevated rates will help us understand how caregiver stress is impacted by and impacts child behaviors. This study explored how restricted and repetitive behaviors (RRBs) contributed concurrently and longitudinally to caregiver stress in a large sample of preschoolers with ASD using parallel process multilevel growth models. Results indicated that initial rates of and change in RRBs predicted fluctuations in caregiver stress over time. When caregivers reported increased child RRBs, this was mirrored by increases in caregiver stress. Our data support the importance of targeted treatments for RRBs as change in this domain may lead to improvements in caregiver wellbeing.

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Repetitive behaviors are a core symptom of autism spectrum disorders. They represent a major barrier to learning and social adaptation, affect levels of engagement in life situations, communication, social interactions and sustain social connections. Repetitive behaviors are often managed using exercise-based interventions which have been suggested to reduce repetitive behaviors and benefit mental health and behavioral functioning of individuals with ASD. The purpose of this systematic review was to explore and critically review the findings of previous studies examining effects of various exercise-based interventions on reducing autistic repetitive behaviors in children with autism spectrum disorder. Searches were limited to peer-reviewed studies written in English and published between Jan.2008- Jan. 2019. Only studies focusing on physical exercise-based interventions aiming to decrease repetitive behaviors as a symptom of an autistic spectrum disorder were included. Quality of articles included in the review was assessed using the Joanna Briggs checklists. Two researchers were involved in the quality assessment process, and any discrepancies were resolved through discussion. 5 studies were included in the final review. All studies examined the effects of short term exercise interventions on repetitive behaviors in children with ASD. There was no consistency across studies regarding types or duration of interventions, sample sizes or demographics of participants. However, the findings of the studies examined in this review provide a moderate to strong evidence that exercise-based interventions decrease repetitive behaviors. The studies reviewed included clinically relevant findings that can be used and adapted to fit different needs of children in future interventions. However, additional research using stronger and more varied designs, would be needed to determine the most beneficial types of exercise- based interventions for decreasing repetitive behaviors.

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In addition to social communication deficits, restricted repetitive behaviors (RRBs) are a key diagnostic feature of autism spectrum disorder (ASD). Two theories regarding the etiology of RRBs in ASD have been proposed: the hyper-arousal theory, and the hypo-arousal theory. Both of these theories posit the autonomic nervous system (ANS) as being dysfunctional in ASD, resulting in the occurrence of RRBs. Many studies investigating ANS activity in ASD have focused solely on its relation to social functioning. The few that have addressed RRBs have had inconclusive findings. Not only do the current theories and studies simplify ANS activity to a measure of baseline arousal levels through vague measures such as heart rate (HR) and skin conductance response (SCR), but the literature has also framed the theories as mutually exclusive. This study used respiratory sinus arrhythmia (RSA) patterns in children with and without an ASD diagnosis as an indicator of ANS functioning to analyze its relationship to the manifestation of RRBs. Baseline RSA and RSA reactivity were found to predict RRB severity and exploratory analyses revealed that these measures were associated with specific subgroups of RRBs. These results are discussed in regards to the current behavioral literature on RRBs and the benefits of finding biomarkers for these behaviors. / Master of Science

Families of children with autism spectrum disorder (ASD) in developing countries may not have as much access to needed behavioral services as families living in developed countries. Caregivers of children with ASD in developing countries would benefit from an affordable, efficient parent training to teach them behavior techniques to use with their children. Pyramidal training is a cost-efficient method of training individuals through peers and would be a supportive intervention for families in developing countries. This study used a repeated acquisition design across three variables to examine whether a caregiver could train another caregiver on three behavioral interventions. These interventions were appropriately redirecting repetitive behaviors, using praise, and requesting eye contact. The study also examined if the caregivers could acquire the three skills and the extent caregivers were receptive to this training model based on their comments about the training. The participants were six ethnic Macedonians or Albanians between the ages of 38 and 43 who were caregivers of a child with ASD. The results indicate the caregivers were able to train another caregiver on three skills for working with their child with autism, all the caregivers were able to acquire the three skills, and the training model's goals were socially appropriate based on participants' comments. This implicates professionals such as doctors, social workers, behavioral therapists, or school psychologists could use this form of parent training to share information throughout a family in order to benefit children with disabilities and their families.

Restricted and repetitive behaviors (RRBs) are some of the hallmark features of autism spectrum disorder (ASD) symptomatology. There is a knowledge gap on RRBs in adults with ASD because most of the research has focused on children and adolescents. The few studies conducted on adults with ASD have included conflicting results and variable information, especially regarding the developmental trajectories of RRBs. Therefore, this study was designed to address the lived experiences of RRBs in midlife adults with Asperger syndrome. This study was guided by the conceptual frameworks of Dunn's model of sensory processing, the 2-factor model of RRBs, and phenomenological theory. A phenomenological approach was used to conduct semistructured interviews in which 15 adults with Asperger syndrome sampled worldwide described their experiences. Participants also wrote narrative accounts. The data were analyzed through interpretative phenomenological analysis. Eight basic themes emerged from the data analysis regarding the importance of RRBs to adults with Asperger syndrome: (a) anxiety, (b) calming effect, (c) intense focus, (d) routines and rituals, (e) sensory sensitivity, (f) misinterpretation by others, (g) physical stereotypies, and (h) special interests. Findings associated with these themes showed that RRBs are used by adults with Asperger syndrome as a coping mechanism for dealing with anxiety. Treatment should focus on the elimination of the anxiety rather than the RRBs, which are just a symptom of the anxiety. The implications for positive social change include the emergence of new knowledge to promote an improvement in diagnosis, treatment, advocacy, and supportive services, thereby decreasing inequalities that exist for adults with ASD.

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