Repetitive behaviour is an umbrella term that refers to a wide range of behaviours including:

• Stereotyped behaviours (e.g. rocking, spinning, hand flapping)
• Compulsive behaviours (e.g. lining up objects)
• Insistence of sameness (e.g. adhering to a very strong routine)
• Restricted interests (e.g. attachment to a particular object)
• Repetitive speech (e.g. asking the same questions over and over again)

In recent years it has been argued that we should understand repetitive behaviour at a fine-grained level. This means that rather than simply saying that a person engages in repetitive behaviour, researchers and clinicians should aim to describe the exact behaviours that a person engages in. Dr Jo Moss found that when you look at behaviour in this way different ‘profiles’ of repetitive behaviour are seen in different genetic syndromes where repetitive behaviour occurs. It is important to know this as it can change how we support a person and how we understand repetitive behaviour.

There are many websites that will tell you that the cause of repetitive behaviour is known. Causes often stated are anxiety, difficulties regulating emotions or because the person simply enjoys the behaviour. To date, there is no research that gives a definitive answer about why repetitive behaviour occurs; however there are lots of theories and some of these are more convincing than others.

One of the most promising ideas is that repetitive behaviour might be linked to problems with a set of brain based processes; collectively these are known as the ‘executive functions’.

Executive functions include:

• Inhibition – the ability to suppress a learnt or impulsive response
• Working memory – the ability to hold information in mind for a task at hand e.g. remembering a telephone number
• Attention shifting – the ability to move attention away from one object, task or activity to another object, task or activity.

It is argued that repetitive behaviour might occur because a person cannot stop (inhibit) a behaviour once it has started, remember information and so repetitively ask for that information, or because a person becomes ‘stuck’ on one way of acting or behaving so cannot shift to another way of behaving.

For example, in Prader-Willi syndrome a link has been made between adherence to strong routines and difficulties with executive functioning (higher cognitive processes), in particular, set-shifting (the ability to move back and forward between tasks).

Read about this research in Prader-Willi syndrome here:

https://www.findresources.co.uk/uploads/PWS/Temper%20outbursts%20in%20PWS%20research%20summary.pdf

 

The executive function account of repetitive behaviour may also be relevant in other syndrome groups.

it is often not appropriate to intervene with repetitive behaviour unless repetitive behaviour is causing a problem for the individual engaging in it, for example, interfering with their ability to engage with other activities or causing them distress.  It is also very important to be very clear about the specific behaviour you are trying to reduce as this will affect how it is managed.

 A clinical psychologist or member of a specialist behavioural team should be able to offer support with interventions for behaviours that are impacting on a person’s well-being.  These professionals can be accessed via the NHS.

If you are a clinician or researcher, you can download a measure to assess specific repetitive behaviours in our professionals section.

In addition, it is very important to read syndrome specific information on repetitive behaviour as behaviour varies significantly across groups.  You can select a syndrome by choosing a link from the list below.

Angelman

Cornelia de Lange

Cri du Chat