Describe the Role of Stress Upon Repetition, Perseveration, and Self-Injury

The idea that repetitive behavior serves to decrease chronically high arousal levels (stress) in ASD has been prevalent for over three decades (Hutt and Hutt, 1970; Deitz & Singh, 1992). It has been hypothesized that “nonspecific activity of the ascending reticular activating system is at a chronically high level in individuals with autism, and that the individual strives to lower this by engaging in simple stereotypies that serve as displacement activities to block further sensory input relating to the arousing situation.” It has also been hypothesized that novel activities/situations can be arousing, resulting in the individual with autism to avoid novel interactions and prefer sameness. The overarousal hypothesis is based on the notion, that as situations increase in novelty, arousal levels will increase, as will repetitive behaviors. The opposite would then be proposed, that as more routine situations/interactions are encountered, anxiety will be reduced and the frequency of repetitive behaviors will decrease (Baron, Groden, Groden, Lipsitt, 149). Charop (1986) compared the rates of echolalia in children with autism when they were presented with an unfamiliar task by both a familiar and unfamiliar person. The highest rates of echolalia were observed when the children were presented the unfamiliar task by the unfamiliar person.

As reviewed by Baron, Groden, Groden, Lipsitt in their book entitled, Stress and Coping in Autism, stereotypies occur not only in individuals with ASD but also in typically developing individuals and animals. Stereotypies can arise spontaneously in captive animals and are usually indicators of stress as such behaviors often occur in environments that are considered boring or uncomfortable and where the potential for stress is high. Some studies indicate that repetitive behaviors are a coping mechanism as they have been found to reduce heart rate such as leg swinging in children, during crib-biting in horses and during stereotypic behaviors in pigs (Baron, Groden, Groden, Lipsitt, pg.150). There are also studies that indicate a lower level of baseline cortisol levels in stereotyping animals than that of similiar animals that are nonstereotyping. This suggests that stereotypy helps animals cope better with their captive environments. Some data from populations without autism suggests stereotypies are a means of self-soothing in aversive situations as changes in plasma endorphin levels are noted. These stereotypies may develop as an effective method of self soothing initially by increasing the levels of endorphins but the role of the endorphins may change over time as the ability of medications to block endorphins and block the repetitive behaviors diminishes as the behaviors become more a part of the behavioral repertoire.

A quote from an adult with Autism, pretty thought provoking….
"Reality to an autistic person is a confusing, interacting mass of events, people, places, sounds and sights. There seem to be no clear boundaries, order or meaning to anything. A large part of my life is spent trying to work out the pattern behind everything. Set routines, times, particular routes and rituals all help to get order into an unbearably chaotic life. Trying to keep everything the same reduces some of the terrible fear." (Jolliffe, 1992 in Howlin, 1998, pp. 201-202)


Baron, Grace, et al. Stress and Coping in Autism. N.p.: Published by Oxford
University Press US, 2006.

Turner, Michelle. "Annotation: Repetitive Behaviour in Autism: A Review of
Psychological Research." Journal of Child Psychology and Psychiatry 40.6
(1999): 839-849.

Lewis, Mark, and James Bodfish. "Repetitive Behavior Disorders in Autism ."
Mental Retardation and Developmental Disabilities 4 (1998): 80-89.