Exploring the Influence of Adaptive, Affective, and Sensory Responses On Insistence On Sameness

Background:  Insistence on sameness and resistance to change are key characteristics of autism spectrum disorder (ASD) that have received very little attention within the scientific literature despite positive indications for treatment (Green et al., 2008; Ollington et al., 2012). According to Didden et al. (2008) an important focus for research surrounding behavioural flexibility would be to identify some of the constitutional variables and motivational “drives” that might influence the apparent need for insistence on sameness and resistance to change. It has been suggested that relative social immaturity, emotion regulation (Green et al., 2008) as well as affective responses may play integral roles. For example, anxiety has been suggested to influence rituals and compulsions (Evans & Gray, 2000; Matson & Dempsey, 2009), and hyperactivity and aggression have been suggested to play a role in stereotypic behaviours (Sukhodolsky et al., 2008). Considering previous research investigating possible associations between repetitive behaviours and sensory abnormalities in ASD (Boyd et al., 2009; 2010; Gabriels et al., 2008) it is also possible that atypical sensory responses may play an important part in inflexible behaviour.

Objectives:  Taking into account the potential for specific interventions that focus on particular contexts related to insistence on sameness and resistance to change (Ollington et al., 2012), the current study explored the roles of affective, sensory and adaptive behavioural responses to such situations. 

Methods:  Forty-three parents of children aged between two and 13 years of age (mean age = 6.7 years) were recruited as part of a larger study according to either no previous diagnosis (NPD) or a previous diagnosis of ASD.  Parents responded to the Behavioural Flexibility Rating Scale-Revised (BFRS-R, Green et al., 2007), the Vineland Adaptive Behaviour Scales-2^ndEd (Vineland-II, Sparrow, Cicchetti, & Balla, 2005), the Aberrant Behaviour Checklist (ABC, Aman & Singh, 1994), and the Short Sensory Profile (SSP, McIntosh, Miller, Shyu, & Dunn, 1999).

Results:  Structural Equation Modelling was used to estimate direct versus indirect effects in relation to whether group position (HFA, LFA, NPD) derived from IQ (<85, ≥85) and diagnosis (ASD, NPD) has a direct effect on group identity via the mediating variables (adaptive, affective, sensory) responses on BFRS-R scores. It was found that for both the children with HFA and LFA, insistence on sameness may be mediated by high levels of aberrant behaviour. For children in the LFA group, it also appears that sensory sensitivities and adaptive behaviour may influence behavioural flexibility.

Conclusions:  The findings indicate that there may be particular underlying characteristic differences that may differentiate high and low functioning autism in relation to behavioural flexibility that was not able to be determined by total BFRS-R scores alone. More work is required to tease out these effects, for example to particular behaviours represented by these scales with studies using a comprehensive assessment of adaptive, problem and sensory behaviours.