Summarize articles that discuss executive function and decision-making skills as they may contribute to repetitive behaviors.

‘Executive function’ is an umbrella term for functions such as planning, working memory, impulse control, inhibition and mental flexibility, as well as for the initiation and monitoring of action. A study conducted by Shafritz et al.,(2008) indicates that individuals with autism have lower activity in some brain regions compared with controls. The repetitive behaviors that are observed in individuals with autism are associated with this abnormal activity in the ‘executive’ brain system, which is responsible for attention, planning and for inhibiting inappropriate behaviors. A study conducted by Dalton et al., (2005) indicate that approximately 80% of adults with autism have some form of repetitive behaviors.

Only a few studies have tested repetitive behaviors using imaging. For this study, Shafritz had the participants lie inside the fMRI machine, holding a button in each hand. They were required to press the button in the corresponding hand for a specific geometric shape. 97% of the time, the shape was consistent but occasionally a different shape would appear and the participants had to press the other button. This test was designed to tap into the cognitive processes underlying the repetitive behaviors without making movements (in order to lie still during the scanning). Pressing the second button meant that the individuals had to change a previously repeated behavior. Shafritz found that compared with controls, adults with autism have more trouble switching to the new button for the target shapes.
The fMRI scans show that during these tasks, those with autism have lower brain activity compared with controls in three brain regions: the dorsolateral prefrontal cortex; the posterior parietal cortex; and the basal ganglia, deep within the brain. These areas are components of the brain’s executive functioning circuitry. Individual’s whose test results were higher for restricted and repetitive behaviors demonstrated lower brain activity in two smaller regions of the circuit: the anterior cingulate cortex and the intraparietal sulcus. This indicates that the circuit is less active which would imply a barrier to inhibiting over-learned responses, a “failure in the frontal ‘brake’ mechanism”.

Functionally, a deficit in the executive functioning impedes an individual’s ability to generate, plan, attend, and inhibit inappropriate behaviors. Turner hypothesizes that without the ability to regulate behavior appropriately or inhibit the repetitive behaviors, the autistic individual may only be able to carry out the same behavior in a repetitive fashion as if becoming “locked into” one line of thought or behavior. She also looks at the possibility of the repetitive behavior as a difficulty in generating novel behavior. We have learned of the many challenges that are faced by autistic individuals (motor planning, face processing, sensory processing, global to local processing, etc, etc, ) which would further impede the ability to inhibit repetitive behaviors or generate novel behaviors during play, self-care routines, social interactions, leisure activities, work, and other areas of the autistic individual’s life.

I found one article that briefly discussed the conventional behavioral approaches to autism, such as ABA or RDI, focusing on distraction and substitute behavior with suggestions for recovering the executive functions by increasing blood flow to the specific brain regions. Brief reference was made to hyperbaric oxygen therapy (HBOT) which would increase blood flow to the specific brain regions helping to improve brain function which was stated, in turn, would facilitate the ability to exert self-control in order to limit or eradicate repetitive behavior. More information regarding hyperbaric treatment with autistic individuals can be found searching the web or library. I have attached a link to a research article specific to autism and hyperbaric oxygen treatment.

http://www.hbotalabama.com/scripts/content/documents/PDF01%20-%20HBOT%20and%20Autism%20-%20Rossignol%202006.pdf

Shafritz, Keith, et al. "The Neural Circuitry Mediating Shifts in Behavioural
Response and Cognitive Set in Autism ." Journal of Biological Psychiatry
63.10 (2008): 974-980.
Turner, Michelle. "Annotation: Repetitive Behaviour in Autism: A Review of
Psychological Research." Journal of Child Psychology and Psychiatry 40.6
(1999): 839-849