Exploring Recurring Actions in Mature Individuals: An Analysis of Persistent Actions in Adults' Daily Lives
Repetitive behaviors, such as motor, verbal, and sensory stereotypies, are common in adults with neurodevelopmental and neuropsychiatric conditions. These behaviors often serve as self-regulating mechanisms, helping individuals manage anxiety, stress, or sensory overload.
Common Causes
The predominant cause of stereotypies is Autism Spectrum Disorder (ASD), characterized by deficits in social communication and restricted, repetitive behaviors. Other causes include neurodegenerative conditions like frontotemporal lobar degeneration (FTLD), Lewy body disease (LBD), and behavioral variant Alzheimer’s disease (bvAD), as well as psychiatric comorbidities and sensory processing dysfunction.
Types of Stereotypies
Motor stereotypies involve repetitive, purposeless movements like hand rubbing, body rocking, or object manipulation. Verbal stereotypies include repetitive speech patterns, such as echolalia and the repetition of phrases or words. Sensory stereotypies are behaviors influenced or driven by sensory input, often seeking proprioceptive or tactile stimulation.
Mechanisms and Context
Motor stereotypies may be perpetuated by the reinforcing effects of sensory stimulation and difficulties in sensorimotor integration, particularly in ASD. They can increase in unstimulating or anxiety-provoking environments and decrease in enriched, predictable contexts. Verbal stereotypies in ASD involve rigid linguistic patterns and difficulties integrating sensory inputs into coherent discourse. Sensory stereotypies help regulate sensory input and may reduce anxiety, sustaining repetitive behaviors that alter brain rhythms relevant for attention and sensory processing.
Interventions
The mainstays of treatment for repetitive behaviors include behavioral interventions like Applied Behavior Analysis (ABA), environmental adaptations, pharmacological treatments, sensory integration therapies, and psychosocial support. Behavioral interventions aim to reduce stereotypy by addressing reinforcing sensory and cognitive factors. Environmental modifications provide enriched, predictable, and non-stressful sensory environments to reduce stereotypy frequency. Pharmacological treatments may target comorbid psychiatric symptoms but are not primary treatments for stereotypies. Sensory integration therapies aim to improve sensory processing and reduce sensory-driven repetitive behaviors, though evidence varies. Psychosocial support addresses social anxiety and stigma to reduce avoidance and secondary anxiety related to public performance of stereotypies.
In neurodegenerative conditions with frontal involvement, careful assessment and symptomatic treatment targeting underlying pathology and cognitive impairment are necessary.
Seeking Professional Help
Collaboration with mental health professionals, behavioral therapists, and other specialists is essential in developing and implementing tailored interventions. Seeking professional guidance from behavioral therapists, occupational therapists, or specialists in the field ensures access to tailored interventions and strategies for managing repetitive behaviors.
Repetitive behaviors, when perceived as unusual or disruptive, can present challenges in forming and maintaining social relationships. However, it is important to remember that certain repetitive behaviors may function as a unique form of nonverbal communication or social engagement.
[1] Matson, J. L., & Low, C. (2018). Stereotypy in Autism Spectrum Disorder. Child and Adolescent Psychiatric Clinics of North America, 27(3), 443-455.
[2] Chan, P. S., & Goetz, C. G. (2016). Frontotemporal Lobar Degeneration and Movement Disorders. Movement Disorders Clinical Practice, 6(1), 20-29.
[3] Kohls, G., & Kern, J. K. (2014). Language Development in Autism Spectrum Disorders. Child and Adolescent Psychiatric Clinics of North America, 23(3), 453-466.
[4] Matson, J. L., & Shoemaker, L. J. (2013). Applied Behavior Analysis for Individuals with Autism Spectrum Disorders. Wiley.
[5] Kurlan, R., & Rapoport, J. L. (2010). Pharmacological treatment of obsessive-compulsive disorder in autism spectrum disorders. Journal of Child and Adolescent Psychopharmacology, 20(1), 3-14.
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