Repeating actions or routines

Restricted and repetitive behaviorsare actions that happen again and again. They can include body movements that do not usually have social meanings, or more complex activities related to specific interests and rituals. These repetitions are not necessarily signs of disobedience. They are often ways for a child to cope with anxiety, organize their internal world, or process information.

What is typical?

Restricted and repetitive behaviors and interests are common developmental traits, and children exhibit these behaviors over time. Here’s what you might expect to see at different ages:

• Infants: Children often have favorite objects and engage in repetitive movements like rocking and flapping.
• Young children: Children may prefer certain toys, stories, and rituals, such as bedtime routines.
• Preschool students: Children show more complex behaviors, such as acting out the same scenarios in pretend play, collecting or storing objects, and developing strong interests in specific topics. For example, some children may have a strong interest in cars, learning a lot about them and recognizing different brands.
• Older children: Children may develop specialized interests or hobbies, often focusing intensely on specific subjects or activities. They might engage in repetitive routines or rituals and show a preference for consistency and predictability in their daily activities.

While routines and repetition are a normal part of development, they may become a concern when a child shows a very high level of rigidity, has intense distress when faced with changes, or when the behaviors interfere with daily life and learning.

When should I be concerned?

Many children have strong interests and may do repetitive actions. However, you should be concerned if these behaviors stop your child from interacting with others or doing other activities. If trying to stop the behavior leads to an angry outburst or an emotional crisis, it might be a problem.

Here are some signs to watch for:

Restricted interests:

• Fixated interests: Your child may like an activity or topic so much that they want to know a lot about it or do it repeatedly, excluding other activities.
• Attachment to objects: Your child may be very attached to unusual objects, like brushes or hair bands.

Insistence on routines:

• Difficulty with change: Your child may get very upset or have a crisis if they cannot do things the same way or at the same time as usual (e.g., a change in the route to the store or the time of a meal).
• Adapting to new situations: Your child may find it hard to adapt when they have to do something new or different.
• Rule-following: Your child may get upset if others do not follow the rules exactly.

Repetitive behaviors:

• Repetitive movements: Your child may repeat hand or body movements, like flapping their hands, turning their fingers, or rocking back and forth.
• Arranging objects: Your child may feel the need to arrange or sort things in a specific way, such as lining up toys.
• Spinning or lining up objects: Your child may often spin objects or line up toys.

Sensory sensitivity:

• Sensitivity to noise: Some noises or sounds, like a vacuum cleaner, may upset your child a lot.
• Sensitivity to light: Certain levels of light, like very bright light, may upset your child.
• Sensitivity to textures: Some clothes made of certain materials may make your child very upset.
• Sensitivity to smells and tastes: Certain smells or tastes may upset your child a lot.
• Food preferences: Your child may not want to eat food with certain textures, colors, or smells.

What can I do to help?

As a caregiver, being patient and supportive is important when helping a child with restricted and repetitive behaviors and interests. Here are some things you can try:

1. Reduce stress.Keep a quiet environment, speak softly, and avoid interrupting your child’s play. This helps create a calming atmosphere.
2. Create a structured schedule.Follow a consistent daily routine and give advance notice of any changes, using simple language to explain what will happen. Predictability can reduce anxiety.
3. Minimize sensory overload.Reduce annoying sounds and bright lights, and let your child wear soft, comfortable clothes. This helps manage sensory sensitivities.
4. Avoid interrupting repetitive behaviors.Do not punish tantrums that happen after stressful events. These behaviors might be how your child copes. Instead, offer short breaks for your child to calm down before returning to an activity.
5. Use your child’s interests.Communicate and play with toys they love, and read stories about their favorite subjects. This builds connection and can be used to gently encourage flexibility.
6. Offer choices.Give your child choices within a structured activity. This allows for some control and can reduce resistance to new experiences.
7. Praise flexibility.When your child tries something new or shows flexibility, offer specific praise and encouragement. This reinforces positive behavior.

If you have tried these tips and the problems continue, it might be time to seek professional help.

What kind of professional support can I seek out?

If your child’s restricted and repetitive behaviors persist and impact their routine, consider seeking an evaluation from a professional or reaching out to your child’s school for assistance. Early intervention can greatly benefit your child’s development and well-being.

If you are concerned, you should discuss it with your child’s pediatricianor family doctor. They can refer you to other specialists, including school psychologists, speech-language pathologists, and other mental health professionals like a psychologistor psychiatrist.

You can also find free support through the Unified Health System (SUS). Care often begins at your local Basic Health Unit (UBS). Other services include Child and Adolescent Psychosocial Care Centers (CAPS i), specialty centers, and clinics at university hospitals.

Remember, the goal of professional help is not to “eliminate” these behaviors, but to understand what they mean and help your child find new ways to interact with the world.