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.

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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