Repetitive Behaviors in Autism – The Gap in Treatment of Core Symptoms

There remains a clear unmet medical need for an effective pharmacotherapy to treat the core symptoms of this serious disorder given that there are no approved marketed drugs for this indication. Only two medications have received FDA approval to treat irritability (an  associated, not “core”, symptom of autism) in children with autism.

Repetitive behaviors and/or an interest in engaging in a restricted activities are one of the three core symptoms of autism. These behaviors are officially called “stereotypy” or “perseveration” and manifest in at least one of the following forms.

  • Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
  • Apparently inflexible adherence to specific, nonfunctional routines or rituals
  • Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
  • Persistent preoccupation with parts of objects

Many autistic patients will find it extremely upsetting if these behaviors are disrupted for any reason and can lead to sever stress and emotional outbursts. As a result, many autistic patients may demand strict consistency in their daily routines and environment.

These behaviors come in a wide array of forms and vary dramatically between patients. Some patients will exhibit these behaviors almost constantly, others only when they are anxious or disturbed. Repetitive behaviors in autism can vary radically from person to person, and can range from passionate and inflexible interest in a particular subject to violent self-destructive behaviors, such as head banging. Some people on the autism spectrum engage in repetitive behaviors constantly, while others only occasionally perseverate when they’re stressed, anxious or upset.

Repetitive behaviors are not only disturbing to caregivers but can play a significant part in impeding a patient’s ability and willingness to communicate with others and engage with world around them. For example any patient that compulsively wringing their hands or biting their skin is obviously inhibited in their ability to appropriately engage with their environment.