Spackman Emily, Geng Alicia, Smillie Luke D, Frazier Thomas W, Hardan Antonio Y, Alvarez Gail A, Whitehouse Andrew, Schuck Rachel K, Leekam Sue R, Uljarević Mirko
Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
Child & Adolescent Psychiatry and Child Development, Stanford University, Stanford, CA, USA.
J Autism Dev Disord. 2024 May 29. doi: 10.1007/s10803-024-06404-4.
Manifestations of insistence on sameness (IS) and circumscribed interests (CI) are complex, with individuals varying considerably, not only in the types of behaviours they express, but also in terms of a behaviour's frequency, intensity, trajectory, adaptive benefits, and impacts. However, current quantitative RRB instruments capture only certain aspects of these behaviours (e.g., mostly frequency or general "severity"). Thus, the current study utilised a semi-structured caregiver interview to provide an in-depth, qualitative characterization of different aspects of IS and CI presentation. Caregivers of 27 autistic children and adolescents displaying IS and/or CI behaviours (3-16 years; 18 males; 9 females) participated in a semi-structured interview. Responses were analysed using thematic framework analysis. Framework analysis identified nine different aspects of IS and CI presentation: (1) intensity, (2) frequency, (3) emergence of behaviour, (4) changes over time, (5) day-to-day fluctuations, (6) purpose/adaptive benefit, (7) experiences of distress, (8) challenges for the individual, their family, and their socialisation, and (9) management strategies and their effectiveness. Autistic children and adolescents were reported to vary greatly on each of these dimensions. Findings demonstrate the complexity of IS and CI presentations and highlight the need for more comprehensive quantitative assessments that independently assess the frequency, intensity, and impact of behaviours. Further, findings reported here emphasize the need for ecologically valid measures that assess the contexts in which these behaviours occur and how their presentations can change within and across days.
对相同性的坚持（IS）和局限兴趣（CI）的表现很复杂，个体差异很大，不仅在他们表现出的行为类型上，而且在行为的频率、强度、发展轨迹、适应性益处和影响方面。然而，当前的定量重复刻板行为工具仅捕捉这些行为的某些方面（例如，主要是频率或一般的“严重程度”）。因此，本研究采用半结构化的照顾者访谈，以深入、定性地描述IS和CI表现的不同方面。27名表现出IS和/或CI行为的自闭症儿童和青少年（3至16岁；18名男性；9名女性）的照顾者参与了半结构化访谈。使用主题框架分析对回答进行分析。框架分析确定了IS和CI表现的九个不同方面：（1）强度，（2）频率，（3）行为的出现，（4）随时间的变化，（5）日常波动，（6）目的/适应性益处，（7）痛苦经历，（8）对个体、其家庭及其社交的挑战，以及（9）管理策略及其有效性。据报告，自闭症儿童和青少年在这些维度上各有很大差异。研究结果表明了IS和CI表现的复杂性，并强调需要进行更全面的定量评估，以独立评估行为的频率、强度和影响。此外，此处报告的研究结果强调需要采用生态效度高的测量方法，以评估这些行为发生的背景以及它们的表现在一天之内和不同天之间如何变化。
