Application of the Repetitive Behavior Scale-Revised – Italian version – in preschoolers with autism spectrum disorder

• Published in: Research in developmental disabilities Vol. 48; pp. 43 - 52
• Main Authors: Fulceri, Francesca, Narzisi, Antonio, Apicella, Fabio, Balboni, Giulia, Baldini, Sara, Brocchini, Jenny, Domenici, Ilaria, Cerullo, Sonia, Igliozzi, Roberta, Cosenza, Angela, Tancredi, Raffaella, Muratori, Filippo, Calderoni, Sara
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.01.2016
• Subjects: Age Factors; Autism Spectrum Disorder - diagnosis; Autism Spectrum Disorder - psychology; Autism spectrum disorders (ASD); Behavioral Symptoms - diagnosis; Child, Preschool; Diagnostic accuracy; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Infant; Intelligence Tests; Italy; Male; Preschoolers; Psychiatric Status Rating Scales - standards; Repetitive Behaviors Scale-Revised (RBS-R); Reproducibility of Results; Restricted and repetitive behaviors (RRB); ROC Curve; Sex Factors; Stereotyped Behavior; Translating; Italy; Preschoolers; Restricted and repetitive behaviors (RRB); Autism spectrum disorders (ASD); Repetitive Behaviors Scale-Revised (RBS-R); Diagnostic accuracy
• ISSN: 0891-4222; 1873-3379; 1873-3379
• DOI: 10.1016/j.ridd.2015.10.015

•Stereotyped and Ritualistic/Sameness behaviors were the most common RRB in ASD.•RRB were not significantly correlated with chronological age or non-verbal IQ.•Ritualistic/sameness behaviors were positively correlated with autism severity.•RRB expression was not significantly different according to sex.•The Global Rating Score of RBS-R had a high diagnostic accuracy. Restricted repetitive and stereotyped patterns of behavior, interests, and activities (RRB) are mandatory features for a diagnosis of Autism Spectrum Disorder (ASD) according to the Diagnostic and Statistical Manual of mental disorders-fifth edition (DSM-5). Despite the strong diagnostic role of RRB, their expressiveness and their relationship with other clinical/demographic features in ASD is not fully elucidated. The Italian version of the Repetitive Behavior Scale-Revised (RBS-R) was applied to a relatively large sample of preschool-aged children with ASD who underwent a comprehensive clinical assessment. The relationship between RRB and sex, age, non-verbal IQ, autism severity, as well as the diagnostic accuracy of the RBS-R were explored. Stereotyped and Ritualistic/Sameness behaviors were the most common RRB in preschoolers with ASD, without widespread differences between males and females. No significant correlations between RRB and chronological age, or non-verbal IQ were detected. The expressiveness of ritualistic/sameness behaviors positively correlated with autism severity, assessed through the Calibrated Severity Score (CSS) derived from the Autism Diagnostic Observation Schedule (ADOS). Receiver Operator Characteristic (ROC) analysis showed high diagnostic accuracy using the Global Rating Score, which represents the judgment of the parents of as the RRB affect the child's life. However, while the Global Rating Score performed well, the remaining subscales did not. This investigation extends the limited research on early pattern and associated features of RRB in young children with ASD. The use of the RBS-R may increase the knowledge of the RRB complexity and variability and in turn improve the diagnostic and therapeutic procedures within the autistic spectrum.