Greaves, Nicola; (1999) Repetitive activities and compulsive behaviours in autism and Prader-Willi syndrome. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

The aim of the study was to better understand the range, type and severity of repetitive and compulsive behaviours in autism and Prader-Willi syndrome, two syndromes with associated learning disability. In addition, it was to explore the impact these behaviours have upon children who have autism or Prader-Willi Syndrome, and their parents or caregivers. Repetitive behaviours, along with social and communicative abnormalities, are diagnostic for autistic disorder forming the third axis of this triad of deficits. However, in terms of empirical study these behaviours have been the subject of far less attention than social and communicative deficits at least until recently (Rutter, 1996). Similarly, whilst obsessive and compulsive symptoms are hallmark features of Prader-Willi syndrome it is only recently that research attention has been turned towards these behaviours. The studies suggest repetitive and compulsive activities are associated with individual and family distress, are time-consuming and significantly interfere with normal social, academic or occupational functioning. The present study investigated these behaviours in autism and Prader-Willi syndrome across childhood and adolescence, and addressed the changes that occur as a function of chronological age, age-equivalence and developmental quotient (DQ). It also compared across syndromes to aid syndrome-specific models of repetitive behaviours. Lastly, repetitive and compulsive behaviours are common in typically developing children, where they are thought to serve an adaptive function. The study addressed these behaviours in typical development to increase information about normative development and to explore whether repetitive and compulsive behaviours in these syndromes follow typical sequences of development. None of the above areas has previously been investigated. This was a large scale, parent report study using standardised questionnaire measures. Three hundred and twelve parents participated in the study who had children aged between three and seventeen. Data was collected from ninety-one parents via the National Autistic Society, eighty parents via the Prader-Willi Syndrome Association, and one hundred and forty-one parents via nursery, primary and secondary schools. The results indicated that whilst children and adolescents with autism and with Prader- Willi Syndrome showed a high degree of repetitive behaviours, there were no significant differences in the number and severity of these behaviours and few differences in types of behaviours. DQ was the strongest factor influencing differences in the type, severity and number of repetitive and compulsive behaviours, where these increased as a function of lower DQ. In the typical sample, repetitive and compulsive behaviours significantly decreased by the age of twelve. Both syndromes showed more repetitive behaviours than the typical sample. Some similarities with sequences in typical development were observed in the children and adolescents with Prader-Willi Syndrome as a function of age equivalent level. Implications for syndrome specificity and suggestions for future research are discussed in the light of these findings.

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