Cited by 296Autism Spectrum Disorder ResearchChild Nutrition and Feeding IssuesObsessive-Compulsive Spectrum Disorders

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The Relationship Between Anxiety and Repetitive Behaviours in Autism Spectrum Disorder

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Rodgers, J., Glod, M., Connolly, B., McConachie, H.·2012·Journal of Autism and Developmental Disorders

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Abstract

Children with Autism Spectrum Disorder are vulnerable to anxiety. Repetitive behaviours are a core feature of Autism Spectrum Disorder (ASD) and have been associated anxiety. This study examined repetitive behaviours and anxiety in two groups of children with autism spectrum disorder, those with high anxiety and those with lower levels of anxiety. Children with high anxiety had more repetitive behaviours than those without anxiety. Within the anxiety sample, higher levels of insistence on sameness were associated with more anxiety. No association was found between sensory motor repetitive behaviours and anxiety in this group. In the non-anxious sample, anxiety was associated with sensory motor repetitive behaviours. These findings indicate a differential relationship for repetitive behaviours in relation to anxious and non-anxious children with ASD.

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Background
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Paragliola, G., & Coronato, A. (2013) · International Conference on Intelligent Environments (IE) · doi:10.1109/ie.2013.12 · Cited by 11
Effect of stress on learning and motivation-relevance to autism spectrum disorder
Theoharides, T. C., & Kavalioti, M. (2019) · International Journal of Immunopathology and Pharmacology · doi:10.1177/2058738419856760 · Cited by 12
Complex Comorbid Presentations Are Associated with Harmful Behavior Problems among Children and Adolescents with Cerebral Palsy
Leader, G., Molina Bonilla, P., Naughton, K., Maher, L., Casburn, M., Arndt, S., & Mannion, A. (2021) · Developmental Neurorehabilitation · doi:10.1080/17518423.2020.1770353 · Cited by 10
Restricted, Repetitive Behaviours and Interests in the Workplace: Barriers, Advantages, and an Individual Difference Approach to Autism Employment
Bury, S. M., Hedley, D., & Uljarević, M. (2021) · Autism and child psychopathology series · doi:10.1007/978-3-030-66445-9_15 · Cited by 15
Executive function, repetitive behaviour and restricted interests in neurodevelopmental disorders
Perry, V., Ellis, K., Moss, J. F., Beck, S. R., Singla, G., Crawford, H., Waite, J., Richards, C., & Oliver, C. (2022) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2021.104166 · Cited by 13
Uncertainty, Sensory Processing, and Stress in Autistic Children During the COVID-19 Pandemic
Cardon, G. J., & Bradley, M. (2023) · Research in Autism · doi:10.1016/j.rasd.2023.102202 · Cited by 12
The impact of COVID-19 measures on parent-reported restricted and repetitive behaviours in pre-school children with autism
Boterberg, S., Zanatta, A., Moerman, F., Schaubroeck, S., Siew, J., Schryver, M. D., & Roeyers, H. (2022) · Heliyon · doi:10.1016/j.heliyon.2022.e09727 · Cited by 9
Behaviour across the lifespan in Cornelia de Lange syndrome
Groves, L., Oliver, C., & Moss, J. F. (2020) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000671 · Cited by 9
Relationship between social anxiety and separation anxiety symptoms with insistence on sameness with the mediating role of sensory hypersensitivity
Keshavarz, S., & Esmaeilpour, K. (2025) · BMC Psychology · doi:10.1186/s40359-025-02369-w · Cited by 8
“Studies, including Boelen et al.‘s (2014) study in a non-autistic population and Rodgers et al.‘s (2012) study in an autistic population, have shown a relationship between separation anxiety and insistence on sameness [7, 31].”
Challenging Behaviors and Task Transitions in Autism: Translating Clinical Phenomenology and Basic Behavioral Process
Williams, D. C. (2015) · Autism and child psychopathology series · doi:10.1007/978-1-4939-2656-5_4 · Cited by 8
The High-Functioning Group: High-Functioning Autism and Asperger Syndrome in Adults
Barahona-Corrêa, B. (2017) · Springer eBooks · doi:10.1007/978-3-319-42713-3_5 · Cited by 14
Refining our Understanding of Anxiety in Autistic Youth: Examining the Role of Behavioral Inflexibility
Harrop, C., Bodfish, J. W., Lecavalier, L., Dallman, A., Jones, D. R., Pritchett, J., Whitten, A., & Boyd, B. A. (2023) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-023-06079-3 · Cited by 7
“Multiple studies have examined the associations between restricted and repetitive behaviors (RRBs) and anxiety in autism (Boulter et al., 2014; Gotham et al., 2014; Jenkin-son et al., 2020; Rodgers et al., 2012; Russell et al., 2019; Wigham et al., 2015).”
Obtaining Testimony from Autistic People
Maras, K. (2021) · Springer eBooks · doi:10.1007/978-3-030-70913-6_7 · Cited by 10
Teacher-student -task -interactions in a motor skills programme for an adolescent boy with autism spectrum disorder: a systematic observation study ( Interacción profesor-alumno-tarea en un programa de desarrollo de capacidades motrices en un adolescente con TEA: un estudio de observación sistemática )
Ajamil, D. L., Gutiérrez, I., Pérez‐Albéniz, A., Merino, P., & Anguera, M. T. (2020) · Journal for the Study of Education and Development Infancia y Aprendizaje · doi:10.1080/02103702.2020.1802148 · Cited by 7
Behavioral Inflexibility Across Two Neurogenetic Conditions: Down Syndrome and Fragile X Syndrome
Harrop, C., Dallman, A., Lecavalier, L., Bodfish, J. W., & Boyd, B. A. (2021) · American Journal on Intellectual and Developmental Disabilities · doi:10.1352/1944-7558-126.5.409 · Cited by 8
Bridging the gap: unveiling key links between autism and anxiety symptoms in autistic children and youth using a network analysis in pooled data from four countries
Zaidman‐Zait, A., Hollocks, M. J., Kerns, C. M., Magiati, I., McVey, A. J., Smith, I. M., Bedford, R., Bennett, T. A., Duku, E., Georgiades, S., et al. (2025) · Child and Adolescent Mental Health · doi:10.1111/camh.70026 · Cited by 7
“…studies examining the relationships between anxiety and speci ﬁ c subdomains of the autism phenotype (e.g., preference for sameness and sensory processing differences) (Duvekot, Ende, Verhulst, & Greaves-Lord, 2018; Rodgers, Glod, Connolly, & McConachie, 2012; Russell, Frost, & Ingersoll, 2019).”
Self-citation
The effect of anxiety and autism symptom severity on restricted and repetitive behaviors over time in children with fragile X syndrome
Moskowitz, L. J., Will, E., Black, C. J., & Roberts, J. E. (2024) · Journal of Neurodevelopmental Disorders · doi:10.1186/s11689-024-09569-2 · Cited by 6
“Evidence for this interaction appears in non-syndromic ASD (nsASD), where, despite RRBs being a core diagnostic feature of ASD, they are associated with increased anxiety symptom severity in this population [67, 70].”
Background
Relation between Restricted and Repetitive Behaviors and Anxiety in Autism Spectrum Disorder: A Meta-Analysis
Jefferson, S. G., & Erp, L. S. (2022) · Child & Family Behavior Therapy · doi:10.1080/07317107.2022.2111750 · Cited by 8
“These threats, which often induce a sense of fear, elicit a heightened level of anxiety (Leekam et al., 2011; Rodgers et al., 2012).”
Background
Associations between early trajectories of amygdala development and later school-age anxiety in two longitudinal samples
Burrows, C. A., Lasch, C., Gross, J., Girault, J. B., Rutsohn, J., Wolff, J. J., Swanson, M. R., Lee, C.-M., Dager, S. R., Cornea, E. A., et al. (2023) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2023.101333 · Cited by 7
“Core ASD symptoms of social skill difficulties, sensory processing differences, and inflexible adherence to routines may contribute to these atypical anxieties (Leyfer et al., 2006; Mayes et al., 2011; Rodgers et al., 2012).”
Background
Psychological interventions for adults with ASD: clinical approaches
Spain, D., O’Neill, L., Harwood, L., & Chaplin, E. (2016) · Advances in Autism · doi:10.1108/aia-09-2015-0016 · Cited by 6
Anxiety Levels of Children with Developmental Disorders in Japan: Based on Reports Provided by Parents
Ishimoto, Y., Yamane, T., & Matsumoto, Y. (2019) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-019-04092-z · Cited by 6
Predisposing Factors for Elevated Restricted and Repetitive Behavior in Typically Developing Toddlers
Larkin, F., Meins, E., & Leekam, S. (2018) · Infancy · doi:10.1111/infa.12264 · Cited by 6
“Joosten et al. (2009) found that the same motor and sensory behaviors (e.g., head banging) tended to be self-stimulatory in children with intellectual disabilities, but were used to escape situations by children with ASD.”
BackgroundInfluential
Coocurrencia entre ansiedad y autismo. Las hipótesis del error social y de la carga alostática
Pérez, I. P. (2013) · Revista de Neurología · doi:10.33588/rn.56s01.2012652 · Cited by 9
“Rodgers et al [26] analizaron la relación entre ansiedad y comportamientos repetitivos en dos grupos de niños con autismo: el primero con altos niveles de ansiedad y el segundo con bajos.”
Background
Modeling flexible behaviour in autism spectrum disorder and typical developmentPreprint
Crawley, D., Zhang, L., Jones, E. J. H., Ahmad, J., Cáceres, A. S. J., Oakley, B. F. M., Charman, T., Buitelaar, J. K., Murphy, D., Chatham, C. H., et al. (2019) · PsyArXiv (OSF Preprints) · doi:10.31234/osf.io/h7jcm · Cited by 7
Effects of Medical Cannabis Treatment for Autistic Children on Anxiety and Restricted and Repetitive Behaviors and Interests: An Open-Label Study
David, A., Stolar, O. E., Berkovitch, M., Kohn, E., Hazan, A., Waissengreen, D., & Gal, E. (2024) · Cannabis and Cannabinoid Research · doi:10.1089/can.2024.0001 · Cited by 5
Measuring Anxiety in Autistic Children: Assessing the Validity of the Anxiety Scale for Children with Autism Spectrum Disorder
Goulding, K., Campbell, L., & Freeman, E. E. (2024) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe14090168 · Cited by 5
“…restricted and repetitive behaviours, avoidance of unexpected events to increase the predictability of daily life, and inflexibility with change [36,37], as well as findings that have suggested that the intolerance of uncertainty may mediate the relationship between anxiety and autism…”
Background
The Impact of Anxiety on Decision Making in Individuals with Intellectual and Developmental Disabilities or a Diagnosis on the Autism Spectrum
Adams, D., & Malone, S. A. (2021) · Springer eBooks · doi:10.1007/978-3-030-74675-9_8 · Cited by 5
Characterising repetitive behaviours in children and adolescents with Down syndrome
Fucà, E., Costanzo, F., & Vicari, S. (2024) · Journal of Intellectual Disability Research · doi:10.1111/jir.13179 · Cited by 7
Neurological Validation of ASD Diagnostic Criteria Using Frontal Alpha and Theta Asymmetry
Bitsika, V., Sharpley, C. F., Evans, I. D., & Vessey, K. A. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13164876 · Cited by 5
“It is not inconceivable that difficulty in comprehending others’ spoken communications could engender a high state of social anxiety, which has been shown to precede RRB in autistic persons [38].”
Background
Relationships between Anxiety, Repetitive Behavior and Parenting Stress: A Comparative Study between Individuals with Autism from Spain and Colombia
Rodríguez‐Jiménez, T., & Martínez‐González, A. E. (2024) · Brain Sciences · doi:10.3390/brainsci14090910 · Cited by 5
“These findings are fully consistent with previous studies [22,29–32].”
BackgroundResult
A Parent-Mediated, Cognitive Behavioral Therapy Group Treatment for Young Children With High-Functioning Autism Spectrum Disorder and Comorbid Anxiety: Development and Case Illustration of the Fun With Feelings Program
Cook, J. M., Donovan, C. L., & Garnett, M. S. (2017) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.31.3.204 · Cited by 5
The Executive Function Account of Repetitive Behavior: Evidence From Rubinstein-Taybi Syndrome
Waite, J., Beck, S. R., Powis, L., & Oliver, C. (2022) · American Journal on Intellectual and Developmental Disabilities · doi:10.1352/1944-7558-128.1.49 · Cited by 6
Intolerance-of-uncertainty and anxiety as serial mediators between emotional dysregulation and repetitive patterns in young people with autism
Beneytez, C. (2023) · Research in Autism · doi:10.1016/j.rasd.2023.102116 · Cited by 5
Behavioral and molecular insights into anxiety in ube3a and fmr1 zebrafish models of autism spectrum disorders
Dougnon, G., & Matsui, H. (2025) · Translational Psychiatry · doi:10.1038/s41398-025-03741-5 · Cited by 3
The Role of Anxiety Symptoms in Understanding Restricted, Repetitive Behaviours and Interests in Autism Spectrum Disorders
Ben‐Sasson, A., & Stephenson, K. G. (2021) · Autism and child psychopathology series · doi:10.1007/978-3-030-66445-9_11 · Cited by 6
Legal Defense in Criminal Cases
Crehan, E. T., & Ury, F. S. (2021) · Springer eBooks · doi:10.1007/978-3-030-70913-6_6 · Cited by 5
Autism interest intensity in early childhood associates with executive functioning but not reward sensitivity or anxiety symptoms
Godfrey, K., Espenhahn, S., Stokoe, M., McMorris, C. A., Murias, K., McCrimmon, A. W., Harris, A. D., & Bray, S. (2021) · Autism · doi:10.1177/13623613211064372 · Cited by 5
““Higher order” restricted and repetitive behaviors (including but not limited to intense interests) have been associated with anxiety symptoms in autistic children and adolescents (Lidstone et al., 2014; Rodgers et al., 2012).”
BackgroundResultInfluential
Are restricted and repetitive behaviours in two‐ and six‐year‐olds associated with emotional and behavioural difficulties?
Carrington, S. J., Uljarević, M., Meins, E., Fernyhough, C., McConachie, H., Couteur, A. S. L., & Leekam, S. (2023) · JCPP Advances · doi:10.1002/jcv2.12209 · Cited by 4
“Other studies with young people with ASD (Lidstone et al., 2014; Rodgers et al., 2012) also showed a selective association between anxiety and IS, but not RSM RRBs.”
Self-citation
A case study of the American Sign Language patterns of a natively-exposed Deaf autistic signer
Singleton, J. L., Walker, K., Meier, R. P., & Shield, A. (2023) · Language Acquisition · doi:10.1080/10489223.2023.2272837 · Cited by 5
“A second cluster of autism traits (sensory sensitivities, insistence on sameness, restricted/focused interests and repetitive behaviors) has also been associated with anxiety symptoms (Rodgers et al. 2012).”
Development and psychometric properties of the Clinical Anxiety Scale for People with Intellectual Disabilities (ClASP-ID)
Mingins, J. E., Tarver, J., Pearson, E., Edwards, G., Bird, M. O., Crawford, H., Oliver, C., Shelley, L., & Waite, J. (2024) · Journal of Neurodevelopmental Disorders · doi:10.1186/s11689-024-09554-9 · Cited by 6
Impact of Belgian COVID-19 lockdown restrictions on autistic individuals’ socio-communicative behaviors and their parents’ quality of life
Weyland, M., Maes, P., Kissine, M., & Defresne, P. (2022) · PLoS ONE · doi:10.1371/journal.pone.0273932 · Cited by 5
“Homework from school (Yes, No), Implemen- tation of homeschooling (Yes, No), Schedule at home (New schedule, Same schedule, No schedule), Implementation of rules at home (on a 5-point Likert item), Implementation of ASD strategies (on a 5-point Likert item) were used as fixed effects to regress the two indexes.”
BackgroundInfluential
Psychopathology
Pandolfi, V., & Magyar, C. I. (2015) · Autism and child psychopathology series · doi:10.1007/978-3-319-19183-6_7 · Cited by 4
Atypical Physiological Response to Less Controllable Sensory Stimulation in Children with ASD
Matsushima, K., Matsubayashi, J., Toichi, M., Funabiki, Y., Kato, T., Awaya, T., Tsuchida, R., & Kato, T. (2022) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-022-00927-z · Cited by 3
“Many studies have shown that RRBs often coexist with atypical sensory features from infant to adolescent (e.g., Boyd et al., 2010; Lidstone et al., 2014).”
BackgroundInfluential
The multisensory base of bodily coupling in face-to-face social interactions: Contrasting the case of autism with the Möbius syndrome
Ciaunica, A., Schilbach, L., & Deroy, O. D. (2018) · Philosophical Psychology · doi:10.1080/09515089.2018.1504908 · Cited by 3

Authors: Rodgers, J., Glod, M., Connolly, B., & McConachie, H.
Affiliations: University of Newcastle Australia (AU)
Corresponding author: Rodgers, J.
ORCID: Rodgers, J.
Glod, M.
McConachie, H.
Venue: Journal of Autism and Developmental Disorders
Publisher: Springer Science and Business Media LLC
Published: 2012-04-17
Volume: 42
Issue: 11
Pages: 2404-2409
ISSN: 0162-3257 (ISSN-L)
1573-3432
DOI: 10.1007/s10803-012-1531-y
OpenAlex: W2141257736
Cited by: 296
References: 35
Citations by year: 2026: 10 · 2025: 15 · 2024: 30 · 2023: 21 · 2022: 25 · 2021: 38 · 2020: 34 · 2019: 29 · 2018: 18 · 2017: 19 · 2016: 16 · 2015: 15 · 2014: 10 · 2013: 15 · 2012: 1
FWCI: 6.72
Type: journal article
Language: en
Open access: green
doi.org
Licence: www.springer.com/tdm (tdm)
Locations: Journal of Autism and Developmental Disorders (publishedVersion)
PubMed (publishedVersion)
Newcastle University ePrints (Newcastle Univesity)
Funders: National Institute for Health and Care Research (PB-PG-0408-16069)
National Institutes of Health
Research for Patient Benefit Programme
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
Keywords: autism spectrum disorder, anxiety, repetitive behavior, insistence on sameness, children, comorbidities
MeSH terms: Adolescent, Anxiety, Child, Child Development Disorders, Pervasive, Female, Humans, Intelligence, Male, Stereotyped Behavior

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The Relationship Between Anxiety and Repetitive Behaviours in Autism Spectrum Disorder

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