Conceptualization of a heuristic to predict increase in restricted and repetitive behaviour in ASD across the short to medium term

Restricted and repetitive behaviors (RRBs) are central to the diagnosis of Autism Spectrum Disorder (ASD), yet there is a paucity of research in this domain. Despite the lack of conceptual clarity, and related empirical findings to underpin practice, clinicians are called on to not only diagnose people with ASD, but also to make prognostic predictions across the short to medium term. These prognostic decisions impact the interventions selected and access to programs. This paper synthesizes available evidence to inform a model of repetitive patterns of thought, ritualistic behaviors and insistence on sameness, arguably the cluster of behavior most likely to be seen in main stream clinical settings and schools and design a heuristic that could be applied by clinicians to aid prognostic decisions and form the basis of further research eventually leading to actuarial models.