Understanding Repetitive Behaviors in Children with Autism

Author: Hao Huire, Dong Xianwen, Li Enyao, et al. Reviewer: Pediatrician Zhan Wen from the Central Hospital of Yiyang City. Curator: Hunan Medical Chat Organization.

Understanding Repetitive Behaviors in Children with Autism

The article on International Autism Day highlights the importance of understanding and supporting children's repetitive behaviors in autism.

Why does he keep turning in circles?

Five-year-old Xiaoyu is spinning in place again, going around once, twice, three times... His mother softly calls out his name, but he does not respond. When his mother reaches out to grab him, he immediately screams and dodges away, then continues spinning.

To outsiders, this may seem like an incomprehensible 'strange behavior.' However, in Xiaoyu's world, the consistent sensation of spinning in circles is the only way to bring order to the chaotic sensory input.

Understanding Their World

What is stereotypical behavior?

According to experts from the Changzheng Hospital in Yiyang City, stereotyped behavior is one of the core characteristics of autism spectrum disorder, manifested as repetitive, fixed patterns of behavior that seem to lack apparent function. Common examples include:

Body movements: shaking the body, clapping hands, spinning around, walking on tiptoes.

Object usage: repeatedly arranging toys, opening and closing doors, turning wheels.

Language repetition: continuously repeating the same phrase or slogan.

Ritualized habits: following a fixed route, eating specific foods, and rejecting any changes.

Many people misunderstand these behaviors as 'disobedience' or 'deliberate disruption.' However, the truth is far from that.

Second, stereotyped behaviors are not a 'problem,' but rather a 'coping mechanism.'

Neuroscience research shows that individuals with autism often experience 'sensory overload' when processing information—the ordinary environmental stimuli (lights, sounds, tactile sensations) can hit them with an intensity akin to a tidal wave.

Stereotyped behaviors are precisely their way of coping with this stress.

Self-regulation: repetitive actions may stimulate the release of endorphins, producing a calming effect that helps individuals regain tranquility amidst chaos.

Creating Predictability: when the external environment is filled with unpredictable changes, habitual behaviors offer a completely controllable 'safe haven.'

Some children communicate 'I'm too anxious' or 'I need a break' through repetitive behaviors.

Sensory satisfaction: certain repetitive actions can provide pleasurable sensory feedback, compensating for deficiencies in other sensory inputs.

When is intervention necessary?

Not all stereotypical behaviors need to be changed. The criterion for judgment is: does it affect the quality of life or safety?

No need for intervention: quiet rocking, arranging toys, talking to oneself—as long as it doesn’t harm themselves or others, it can be viewed as their 'comfort zone.'

Needs guidance: self-harming behaviors (head banging, hand biting), interference with learning or social interactions, and an inability to accept any changes at all.

The goal of intervention is not to 'eliminate' stereotypical behaviors, but to provide alternative options that help individuals meet the same needs in more adaptive ways.

What can we do for them?

Do not judge or forcibly intervene. Forcibly interrupting stereotypical behaviors without providing alternative outlets will only increase anxiety and may even lead to more intense reactions.

Understand the underlying functions. Observe the context in which behaviors occur—Is the environment too noisy? Is the task too difficult? Is there excessive excitement or fatigue? Identifying the reasons is essential for providing support at the root level.

Provide alternative choices. If the child needs sensory input, you can try squeeze balls, weighted blankets, or swings; if the child needs predictability, you can use a visual schedule to help them 'see' what will happen next.

Leave room for 'allowance.' In situations where it does not affect others, allow them to adjust themselves in the way they need. This is not about 'indulgence,' but rather about respect.

Breaking Misunderstandings Begins with Understanding

When we see someone clapping, shaking, or spinning repeatedly, we should not be quick to cast unusual glances. This is not a 'problem' that needs to be corrected, but rather a person who is striving to interact with the world.

On April 2nd, World Autism Day, we don't need to apply the romanticized label of 'children of the stars' to everyone. What we really need to do is to see the real individuals—acknowledging their behaviors that may seem strange but hold their own significance.

Understanding is the first step towards acceptance. And acceptance doesn’t require you to do anything special; it only requires you to be willing to take a closer look and then say:

"It's okay, you can exist in your own way."

Embrace every special child like this, along with their families behind them.

References:

1: "Diagnostic and Statistical Manual of Mental Disorders (5th Edition) (DSM-5)"

Hao Huire, Dong Xianwen, Li Enyao, et al. Research on the Correlation Between Repetitive Stereotyped Behaviors and Sensory Gatekeeping in Autism Spectrum Disorders [J]. Chinese Journal of Child Health Care, 2022, 30(04): 366-370.

Special Contributor from Hunan Medical Chat: Pediatrician Zhan Wen from the Central Hospital of Yiyang City.

Follow @HunanMedicalTalk for more health science popularization information!

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