Relation between Restricted and Repetitive Behaviors and Anxiety in Autism Spectrum Disorder: A Meta-Analysis

Abstract Background Restricted and repetitive behaviors (RRBs) are increasingly being reported to limit the social adaptability of children with autism. Method Three databases (PubMed, PsycINFO, & Web of Science) were selected to conduct a systematic review to examine the consistency in which theoretical frameworks and instruments have been used to evaluate the presence and impact of RRBs in young children who may have ASD. Results Among the 36 articles examined in this review, young males represented 78.5% of the totality of participants (n = 62,339). Approximately one-third of the studies (n = 11) provided an explanation of RRBs through utilizing a theoretical framework. With respect to instrument utility, of the 35 instruments recorded, the Autism Diagnostic Observation Schedule (ADOS) was most frequently used. Conclusions The ADOS and the Autism Diagnostic Interview – Revised (ADI-R) are highly revered as they both are consistently referenced as “a gold standard.” However, due to the expensiveness of those assessments, they are underutilized, likely among vulnerable populations (e.g., economically disadvantaged, ethnic minorities, LGBTQ+), as many practitioners and parents cannot afford access to them.