Dimensional Assessment of Restricted and Repetitive Behaviors: Development and Preliminary Validation of a New Measure

J Am Acad Child Adolesc Psychiatry. 2023 May;62(5):568-581. doi: 10.1016/j.jaac.2022.07.863. Epub 2022 Dec 13.

Abstract

Objective: This study aimed to provide initial validation of the Dimensional Assessment of Restricted and Repetitive Behaviors (DARB), a new parent-report measure designed to capture the full range of key restricted and repetitive behaviors (RRB) subdomains.

Method: Parents of 1,892 children and adolescents with autism spectrum disorder (mean [SD] age = 10.81 [4.14] years) recruited from the SPARK (Simons Foundation Powering Autism Research for Knowledge) research match completed the DARB, several existing RRB instruments, and measures of social and communication impairments and anxiety. A subsample of 450 parents completed the DARB after 2 weeks to evaluate the test-retest stability.

Results: Exploratory graph analysis conducted in the exploratory subsample identified 8 dimensions that were aligned with hypothesized RRB subdomains: repetitive sensory motor behaviors, insistence on sameness, restricted interests, unusual interests, sensory sensitivity, self-injurious behaviors, obsessions and compulsive behaviors, and repetitive language. The confirmatory application of the exploratory structural equation modeling conducted in the confirmatory subsample showed that the derived factor structure had a good fit to the data. Derived factors had excellent reliability, convergent and divergent validity, and very strong test-retest stability and showed a distinct pattern of associations with key demographic, cognitive and clinical correlates.

Conclusion: The DARB will be useful in a variety of research and clinical contexts considering the prominence and clinical impact of RRB in autism spectrum disorder. Strong preliminary evidence indicates that the new scale is comprehensive and captures a wide range of distinct RRB subdomains not simultaneously captured by any of the existing instruments.

Keywords: assessment; autism spectrum disorder; repetitive behaviors; validation.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Autism Spectrum Disorder* / diagnosis
  • Autism Spectrum Disorder* / psychology
  • Child
  • Child Behavior Disorders / diagnosis
  • Child Behavior Disorders / psychology
  • Child Behavior*
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Parents
  • Reproducibility of Results
  • Symptom Assessment* / methods
  • Symptom Assessment* / standards