Restricted and Repetitive Behaviors in Intellectual Disabilities: A Scoping Review with a Systematic Search of the Literature

BACKGROUND: Restricted and Repetitive Behaviors (RRBs) are a core feature of autism and are present in numerous neurodevelopmental disorders and Intellectual Disabilities (ID). These behaviors include repetitive movements, restricted interests, and insistence on sameness, among others. RRBs can cause distress, self-injury, and affect development. The proper assessment of RRBs is critical for the design of clinical trials and the identification of outcome measures for patients with ID, but unfortunately, the scientific literature lacks a deeper characterization of RRBs, particularly in individuals with ID. The goal of this study is to review the current literature to describe the RRB profile in ID (mild, moderate, severe, and profound). METHODS: A systematic search of the literature in PubMed, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) was performed for articles in the past 10 years. RESULTS: Following de-duplication and screening, a total of 20 articles met the inclusion criteria for this review. Various repetitive behaviors were described across all levels of ID. The most common behaviors included broad repetitive movements, hand- and finger-stereotypies, restricted interests, and self-injury. No major differences were observed between individuals across all levels of ID. DISCUSSION: This review explores the relationship between RRBs and different levels of ID, highlighting the different assessment approaches utilized in various studies. A similar RRB profile across all levels of ID could be beneficial for diagnosis and, potentially, for standardized treatment of RRBs. CONCLUSION: Standardized assessment tools for RRB profiles are recommended for proper evaluations of the complex behavioral profiles in individuals with ID.