Arranging and ordering in autism spectrum disorder: Characteristics, severity, and environmental correlates

Abstract

Background There is a need for a more accurate characterisation of higher level restricted and repetitive behaviour (RRB) in autism spectrum disorder (ASD), including why it might be considered problematic and events associated with its occurrence.

Method We selected one form of higher level RRB—arranging and ordering—that was rated as severe for a large percentage of the population sampled. We interviewed 20 students’ teachers and conducted naturalistic observations for 15 of those students.

Results The characteristics of arranging and ordering varied across, and sometimes within, individuals. Problems associated with compulsive-like¹ behaviour also varied, with several unanticipated reported problems. With the exception of attention, social consequences were relatively infrequent.

Conclusions These data highlight the need for research on the assessment and treatment of arranging and ordering and clinical attention to compulsive-like behaviour in ASD. Interviews and naturalistic observations are useful for structuring additional observations and analyses.

Keywords:

• Arranging and ordering
• autism spectrum disorder
• compulsive behaviour
• higher level restricted and repetitive behaviour

Author note

This study was conducted in partial fulfillment of the first author's requirements for the doctoral degree at Western New England University, Springfield, MA, USA. Nicole M. Rodriguez is now at the Munroe-Meyer Institute, Omaha, NE, USA. We thank William H. Ahearn, Gregory P. Hanley, and Amanda M. Karsten for their thoughtful comments on an earlier version of this manuscript. There was no research funding for this study and no conflicts of interest exist.

Notes

1 The terms compulsions and compulsive-like behaviour will be used to refer to responses that share topographical similarities with the behaviour of individuals diagnosed with obsessive–compulsive disorder and for the purposes of maintaining consistency with the terminology used in the RBS-R. In particular, compulsive-like behaviour will be used when referring to any one or more of the responses included in the Compulsive Behaviour subscale of this scale.

2 To elope refers to the act of running away or leaving a supervised area or caregiver without permission.

3 The terms completeness or complete items will be used to refer to responses outlined in this operational definition.