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Beware diagnosis of autism spectrum disorder based on stereotype behaviour

Relying too much on observed stereotypical and repetitive behaviour may result in incorrect diagnosis of autism spectrum disorder in people with a learning disability and sensory impairments, a study suggests
Picture shows a child scratching himself. Relying too much on observed stereotypical and repetitive behaviour may result in incorrect diagnosis of autism spectrum disorder in people with a learning disability and sensory impairments, a study suggests.

Relying too much on observed stereotypical and repetitive behaviour may result in incorrect diagnosis of autism spectrum disorder in people with a learning disability and sensory impairments, a study suggests

Relying too much on observations of stereotypical and repetitive behaviours in people with learning disabilities may be associated with overdiagnosis of autism spectrum disorder (ASD), according to a study.

The finding indicates that practitioners working with people who have learning disabilities and sensory impairments should adopt a judicious approach to presumed diagnoses of autism.

Stereotypies often felt to be important in recognising autism spectrum conditions

The Dutch study explored patterns and differences between stereotypical and repetitive behaviours, as presented by people with a learning disability who had co-morbid sensory impairments and autism, and those who did not also have autism.

The presence of stereotypies has often been felt

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Relying too much on observed stereotypical and repetitive behaviour may result in incorrect diagnosis of autism spectrum disorder in people with a learning disability and sensory impairments, a study suggests

Picture shows a child scratching himself. Relying too much on observed stereotypical and repetitive behaviour may result in incorrect diagnosis of autism spectrum disorder in people with a learning disability and sensory impairments, a study suggests.
Picture: iStock

Relying too much on observations of stereotypical and repetitive behaviours in people with learning disabilities may be associated with overdiagnosis of autism spectrum disorder (ASD), according to a study.

The finding indicates that practitioners working with people who have learning disabilities and sensory impairments should adopt a judicious approach to presumed diagnoses of autism.

Stereotypies often felt to be important in recognising autism spectrum conditions

The Dutch study explored patterns and differences between stereotypical and repetitive behaviours, as presented by people with a learning disability who had co-morbid sensory impairments and autism, and those who did not also have autism.

The presence of stereotypies has often been felt important in recognising the presence of autistic spectrum conditions.

The study looked at 59 individuals who had a moderate to profound learning disability, of whom 32 were also autistic and 27 were not. All had visual impairments and 16 also had auditory impairments.

Video recordings of participants engaging in various ‘play’ activities were observed, rated and coded for the presence and intensity of motor stereotypies such as hand flapping or spinning, self-injury such as eye poking or self-scratching, vocal stereotypies such as repetitive squealing, and repetitive behaviours with objects such as tapping or balancing.

All autistic and 85% of non-autistic participants were found to engage in stereotypical behaviours. Significantly more autistic people engaged in self-injurious stereotypies than people without autism. Autistic people were also found to show a larger number of different types of stereotypical behaviours.

Treatment should be aimed at reducing stereotyped behaviours

There was, however, enough overlap of behavioural presentation across both groups to question their value in supporting diagnoses of autism in people with learning disabilities and co-morbid sensory impairments.

The authors say: ‘Future research should look at factors that cause stereotyped behaviour in people with sensory and intellectual disabilities, so that over-diagnosis of ASD is prevented and treatment can be aimed at reducing stereotyped behaviours, especially the types that harm the individual.’


Reference

de Vaan G, Vervloed MPJ, Knoors H et al (2019) Profiles of stereotyped behaviour in people with combined sensory impairments and intellectual disabilities


Dave Atkinson, an independent consultant nurse, looks at a study that says relying too much on observed stereotypical and repetitive behaviour may result in incorrect diagnosis of ASD in people with a learning disability and sensory impairments.Dave Atkinson is an independent consultant nurse

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