Subdomains of restricted and repetitive behaviors within autism: Exploratory structural equation modeling using the diagnostic interview for social and communication disorders

Mirko Uljarević, Sarah J. Carrington, Antonio Y. Hardan, Susan R. Leekam

Research output: Contribution to journalArticlepeer-review

Abstract

The current study aimed to explore the factor structure of a broad range of restricted and repetitive behaviors (RRB) within the autism spectrum. Exploratory structural equation modeling was conducted using individual item-level data from the Diagnostic Interview for Social and Communication Disorders (DISCO). DISCO is a comprehensive semi-structured interview used by clinicians to elicit information from caregivers about the individual's profile of development and behavior. Data from a sample of 226 individuals with a clinical diagnosis of autism spectrum disorder (ASD) (189 males; M age = 11.82 years, SD age = 7.87) were analyzed. The six-factor structure provided the most optimal and interpretable fit (comparative fit index = 0.944, Tucker–Lewis index = 0.923, root mean square error of approximation = 0.018). Derived factors were interpreted as repetitive motor behaviors (RMB), unusual sensory and object focused interests (USOI), sensory sensitivity (SS), insistence on sameness (IS), circumscribed interests (CI) and stereotyped language (SL). Age was significantly negatively associated with RMB, USOI and SL but not with SS, IS or CI factor scores. None of the factors were associated with sex. ASD individuals with intellectual disability (ID) had the highest RMB, USOI, SS and SL scores while those without ID had the highest IS and CI scores. Our findings provide preliminary evidence for the utility of the DISCO as a comprehensive measure of several distinct RRB domains in both research and clinical contexts. Importantly, the current investigation highlights crucial areas for measurement development.

Lay Summary: The diagnostic Interview for Social and Communication Disorders (DISCO) is a detailed caregiver report clinical interview designed to capture a wide range of key features associated with autism spectrum disorder, including restricted and repetitive behaviors (RRB). This paper provides initial evidence that the DISCO is a promising measure for assessing a wide range of RRB including repetitive motor behaviors, insistence on sameness, circumscribed interests, unusual interests in sensory stimuli, sensory sensitivity and stereotypic language.

Original languageEnglish
Pages (from-to)861-869
Number of pages9
JournalAutism Research
Volume15
Issue number5
Early online date17 Feb 2022
DOIs
Publication statusPublished - May 2022

Bibliographical note

© 2022, The Authors. Autism Research published by International Society for Autism Research and Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

This research was supported grant R21MH121876-01 (Hardan & Jo), Australian Research Council Discovery Early Career Researcher Award DE180100632 (Uljarević), and grant EM-2021-053\10, Leverhulme Emeritus Fellowship (Leekam).

Keywords

  • circumscribed interests
  • diagnostic interview for social and communication disorders
  • factor analysis
  • insistence on sameness
  • repetitive behaviors
  • sensory sensitivity

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