Exploring antecedents and outcomes of restricted and repetitive behaviours in autistic children: A thematic analysis of teacher interviews

Background: Restricted and repetitive behaviours (RRBs) are a core diagnostic feature in autism, but have received less research compared to other diagnostic areas. Qualitative research with autistic adults has reported both positive and problematic aspects of RRBs, but little qualitative research has been reported to date about the nature and outcomes of RRBs in autistic children. The present study recruited teachers in SEN schools because children have limited ability to self-reflect and report about the functions and outcomes of their behaviours. Methods: The current study recruited 11 Special Educational Needs (SEN) teachers based in specialist autism schools who were interviewed about the various RRBs and their observed antecedents and outcomes for autistic children in their schools. Results: Thematic analysis revealed two main themes about RRBs in autistic children, one view as positive and one as negative. The positive theme included subthemes of RRBs as enjoyable experiences, self-regulation, and a form of expression. The negative theme included subthemes of being potentially unsafe, disrupting learning, and having a compulsive nature. Conclusions: SEN teachers in the present study observed both positive and negative outcomes of RRBs by autistic children, consistent with reports by autistic adults about their RRBs. The views about positive outcomes challenges previous assumptions that RRBs in autistic children are inherently detrimental and always need to be reduced or eliminated. Instead, the risks of specific RRBs should be considered against their benefits for individual autistic children to differentiate RRBs that serve a positive functional purpose versus those that may be harmful.