Neurocognitive Functioning and Repetitive Behavior in Children with Autism Spectrum Disorder

Autism is a neurodevelopmental disorder with a behavioral profile that includes rigid, restricted, stereotyped, and repetitive patterns of behavior. The primary purposes of this study were to explore and characterize repetitive behaviors in children with autism spectrum disorder and to investigate their possible neurocognitive correlates. The Autism Behavior Questionnaire (ABQ) was constructed to explore the prevalence, frequency, age of onset, and age differences in restricted, repetitive, and stereotyped behaviors. The parents of 163 children with autism spectrum disorder completed this questionnaire. Their responses were examined using factor analysis. Next, neurocognitive tasks that reflect functioning in the dorsolateral prefrontal cortex and the ventromedial prefrontal cortex were administered to a subset of 30 children with autism. Performance on these tasks was compared with ratings of repetitive behavior. The factor structure of the repetitive behaviors in the ABQ was multidimensional, with five categories of behavior: Ritualistic and Invariant Behavior, Motor and Object Stereotypy, Obsessive Interests, Strong Preferences and Sensitivity, and Atypical Affect. The median age of onset of repetitive behaviors was late in the third year. The majority of children, moreover, exhibited behaviors from all five categories. Obsessive Interests and Ritualistic, Invariant Behaviors were reported more frequently in older children. A diagnosis of Asperger disorder was associated with a higher prevalence of behaviors in three categories. Better performance on tasks reflecting dorsolateral prefrontal functioning was significantly related to lower frequency of Motor and Object Stereotypy and Ritualistic and Invariant Behavior, and to higher frequency of Obsessive Interests. Poorer performance on measures of ventromedial prefrontal functioning was significantly related to lower frequency of Atypical Affect as well as Strong Preferences and Sensitivity. Measures of general cognitive functioning and verbal ability mediated some relationships between neurocognitive functioning and behavior. These findings show that repetitive behaviors consist of several distinct types. In addition, the prevalence of some kinds of repetitive behavior varied as a function of age and diagnostic category. The results also suggest that both the dorsolateral prefrontal cortex and the ventromedial prefrontal cortex may be associated with different types of repetitive behavior.

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