Abstract

Objective Restricted and repetitive behaviors (RRBs) are a heterogeneous set of behaviors common across a wide range of neurodevelopmental disorders (NDDs) and neuropsychiatric disorders (NPDs) that extend well into the general population. This study introduces 2 dimensional measurements of RRBs for use in typical and clinical populations from infancy to adulthood. Method The Childhood Routines Inventory–Revised (CRI-R) and the Adult Routines Inventory (ARI) were created and administered online to a nationally representative cohort of 3,108 parents with 3,032 children (range 12 months to 17 years 11 months). Twenty-six percent of children and 36% of adults had at least 1 NDD or NPD. Results Principal axis factoring exploratory analysis showed a 2-factor structure for the 2 instruments (motor behaviors/compulsions and rigidity/insistence on sameness). Analyses for convergent and discriminant validity, internal consistency (Cronbach α ≥ 0.94), and test-retest reliability (r ≥ 0.87) indicated strong psychometric properties. Item response theory analyses indicated strong reliability across the score range for the 2 instruments. RRB rates varied across development, peaking between the preschool and school years. Children with NDDs or NPDs (particularly those with autism spectrum disorder, schizophrenia/bipolar disorder, or obsessive-compulsive disorder/tic disorders) had increased RRBs compared with those with no diagnosis. Parent–child (0.69–0.84) and sibling–sibling (0.76–0.87) intraclass correlations indicated high heritability. Children of parents with an NDD or an NPD exhibited more RRBs compared with children of parents without NDDs or NPDs. Conclusion The CRI-R and ARI are open-source instruments with excellent psychometric properties and will be useful for developmental, clinical, and family genetic studies and for the identification of prodromal conditions involving RRBs.

Citation

Evans, D.W., Uljarević., M., Lusk. L.G., Loth, E., & Frazier, T. (2017). Development of two dimensional measures of restricted and repetitve behavior in parents and children. Journal of the American Academy of Child and Adolescent Psychiatry, 56(1), 51-58. doi:10.1016/j.jaac.2016.10.014