Restricted and repetitive behavior (RRB) is a group of heterogeneous maladaptive behaviors. RRB is one of the key diagnostic features of autism spectrum disorders (ASDs) and also commonly observed in Prader-Willi syndrome (PWS). In this study, we assessed RRB using the Repetitive Behavior Scale-Revised (RBS-R) in two ASD samples (University of Illinois at Chicago [UIC] and University of Florida [UF]) and one PWS sample. We compared the RBS-R item endorsements across three ASD cohorts (UIC, UF and an ASD sample from Lam, The Repetitive Behavior Scale-Revised: independent validation and the effect of subject variables, PhD thesis, 2004), and a PWS sample. We also compared the mean RBS-R subscale/sum scores across the UIC, UF and PWS samples; across the combined ASD (UIC + UF), PWS-deletion and PWS-disomy groups; and across the combined ASD sample, PWS subgroup with a Social Communication Questionnaire (SCQ) score ≥15, and PWS subgroup with a SCQ score <15. Despite the highly heterogeneous nature, the three ASD samples (UIC, UF and Lam's) showed a similar pattern of the RBS-R endorsements, and the mean RBS-R scores were not different between the UIC and UF samples. However, higher RRB was noted in the ASD sample compared with the PWS sample, as well as in the PWS subgroup with a SCQ score ≥15 compared with the PWS subgroup with a SCQ score <15. Study limitations include a small sample size, a wide age range of our participants, and not controlling for potential covariates. A future replication study using a larger sample and further investigation into the genetic bases of overlapping ASD and RRB phenomenology are needed, given the higher RRB in the PWS subgroup with a SCQ score ≥15.
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Acknowledgements We extend our sincere gratitude to our research participants and their family members for their enthusiastic support and participation in our study. We gratefully acknowledge Susan Craft, Krista Garner, Christy Lynn, Christine Keeling, the UF Child & Adolescent Psychiatry fellows (Drs. Isaac Isaac, Kristina Kise, Thomas Simeone, Julian Walters, Trina Webb, and Catrina Wilkins), the staff of the UF Center for Autism and Related Disabilities (CARD), and Dr. Jennifer L. Miller for their expert assistance with participants’ assessment and recruitment. This work was supported in part by a 2007 NARSAD young investigator award (SJK), the 2008 PWSA (USA) Research Award (SJK), NIH R03MH083673 (SJK), NIH K23MH082883 (SJK), NIH K23MH082121 (SJ), and NIH Autism Center of Excellence P50 HD055751 (EHC).