Repetitive behaviour
Repetitive behaviour
Repetitive behaviour is a term that includes a wide range of behaviours such as stereotyped behaviours (e.g. rocking, spinning, hand flapping), compulsive behaviours (e.g. lining up objects), insistence on sameness (e.g. adhering to a routine), restricted interests (e.g. attachment to a particular object) and repetitive speech (e.g. asking the same questions over and over again). Some of these behaviours are seen in certain stages of development in typically developing infants but may reappear with age in some disorders, including in CdLS. Repetitive behaviour in CdLS may be associated with anxiety, sensory problems or social demands (161, 162,163). More frequent repetitive behaviours are usually seen in individuals with more marked intellectual disability or with ASD (161,163). Stereotyped behaviour and compulsive-like behaviours are common in CdLS (162), and also may include ritualistic behaviours such as lining up or tidying objects. Repetitive behaviour in CdLS does not seem to be associated with the genetic cause of the syndrome (10) and research into repetitive behaviour in CdLS has not indicated any clear changes in repetitive behaviour over time (161,163).
It is often not appropriate to intervene with repetitive behaviour unless the behaviour is causing a problem for the individual. If interventions are needed, they should consider the function of the repetitive behaviour and the reasons why the individual is engaging in the behaviour (e.g. due to anxiety). Interventions should consider these factors as well as environmental factors, such as predictability in daily structure.
Specific medications, such as selective serotonin reuptake inhibitors (SSRIs) (e.g. Prozac), have been increasingly used in CdLS, especially for obsessive-compulsive disorders and mood disorders, although these have not proven successful in reducing repetitive behaviour in individuals with autism. These medications can result in the worsening of behaviours or activation of other behaviours. Another group of medications, second generation anti-psychotics, can also be used in CdLS, especially in managing body rigidity and need for sameness, which can escalate into disruptive behaviours.
