Childhood Routines Inventory Research Articles

Relationships among Sensory Responsiveness, Anxiety, and Ritual Behaviors in Children with and without Atypical Sensory Responsiveness

ABSTRACTAim: To explore relationships between sensory responsiveness, anxiety, and ritual behaviors in boys with typical and atypical sensory responsiveness. Method: Forty-eight boys, ages 5–9 participated in the study (28 boys with atypical sensory responsiveness and 20 controls). Atypical sensory responsiveness was defined as a score of ≤154 on the Short Sensory Profile. Parents completed the Sensory Profile, the Screen for Child Anxiety Related Emotional Disorders, and the Childhood Routines Inventory. Results: Children with atypical sensory responsiveness had significantly higher levels of anxiety and a higher frequency of ritual behaviors than controls. Atypical sensory responsiveness was significantly related to both anxiety and ritual behaviors, with anxiety mediating the relationship between sensory modulation and ritual behaviors. Conclusions: The findings elucidate the potential consequences of atypical sensory responsiveness and could support the notion that ritual behaviors develop as a coping mechanism in response to anxiety stemming from primary difficulty in modulating sensory input.

A Cross-Sectional Survey of Repetitive Behaviors and Restricted Interests in A Typically Developing Turkish Child Population

This study examined compulsive-like behaviors (CLBs) which are higher-order types of Repetitive Behaviors And Restricted Interests (RBRIs) in typically developing children in Turkey. Caregivers of 1,204 children between 8 and 72 months were interviewed with Childhood Routines Inventory (CRI) by trained interviewers in a cross-sectional survey. Factor analysis of the CRI revealed two factor structures comprising "just right behaviors" and "repetitive/sensory sensitivity behaviors". CLB frequency peaked at 2-4 years with declines after age four. In contrast to the previous CRI studies reporting no gender difference, CLBs were more common in males in 12-23 and 48-59 month age groups on both total CLB frequency and repetitive/sensory sensitivity behaviors. Also ages of onsets for CRI items were somewhat later than reported in other samples. Our findings supported the findings of the previous CRI studies while also revealing new perspectives in need of further investigation.

A cross-sectional comparison of routinized and compulsive-like behaviours in typical children aged from 2 to 11 years

Routinized and compulsive like behaviours (RCBs) have been described as important aspects of development seen universally in children, yet investigation is relatively scarce. One exception was the development of the Childhood Routines Inventory (CRI), which has prompted recent studies. The present study was a replication of the standardization for the CRI on a British sample and with an extended age range. It also explored possible associations with obsessive-compulsive disorder (OCD). The parents of 1,369 children (aged 2–11 years) completed the CRI, and an 8-item OCD scale for those 7 years and over. Socioeconomic status (SES) was measured by proxy post codes; 111 parents completed the questionnaire twice. The CRI had good internal consistency and test–retest reliability. There was a significant linear decline in RCBs with age; a minority of children continued to have high levels up to 11 years of age. Children designated at risk for OCD had higher CRI scores. Anxious behaviours reported by parents of children aged 7 years or over were associated with higher levels of RCBs. Factor analysis of the CRI identified three factors: “Repetitive”, “Just Right” and “Sensitivity”.

Cortical activity and children's rituals, habits and other repetitive behavior: A visual P300 study

This study examines the link between children's repetitive, ritualistic, behavior and cortical brain activity. Twelve typically developing children between the ages of 6 and 12 years were administered two visual P300, oddball tasks with a 32-electrode electroencephalogram (EEG) system. One of the oddball tasks was specifically designed to reflect sensitivity to asymmetry, a phenomenon common in children and in a variety of disorders involving compulsive behavior. Parents completed the Childhood Routines Inventory. Children's repetitive, compulsive-like behaviors were strongly associated with faster processing of an asymmetrical target stimulus, even when accounting for their P300 latencies on a control task. The research punctuates the continuity between observed brain-behavior links in clinical disorders such as OCD and autism spectrum disorders, and normative variants of repetitive behavior.

Thought-Action Fusion in Childhood: Measurement, Development, and Association with Anxiety, Rituals and Other Compulsive-like Behaviors

A new inventory assessing thought-action fusion (TAF) in children is presented. We explore the psychometric properties of this instrument and examine the associations between TAF, ritualistic and compulsive-like behavior (CLB) and anxiety. Three hundred thirteen children ages 7-14 (M = 10.16, SD = 1.92) representing six grades (grouped into three grade levels (grades 2-3, 4-5, and 6-7) completed the Thought-action Fusion Inventory for Children (TAFIC) and the Child Revised Manifest Anxiety Scale. One hundred thirty-five parents or guardians completed the Childhood Routines Inventory. Results revealed high internal consistency in the TAFIC (Cronbach's α = .92). TAF scores changed with age: Older children reported less TAF than younger children. Stepwise multiple regression analyses revealed that: (1) physiological anxiety predicted CLB in early childhood; (2) TAF predicted CLB in older children. Consistent with structural developmental theories, TAF changes throughout development, but plays a role in the normative regulation of affective states, as well as in the development of ritualistic compulsive like behavior in children.

Normative childhood repetitive routines and obsessive compulsive symptomatology in 6‐year‐old twins

To investigate the association between normative repetitive routines of childhood and paediatric obsessive compulsive symptom syndrome (OCSS) and the extent to which it is genetically mediated. In a two-phase design a community sample of 4,662 6-year-old twin-pairs were sampled and 854 pairs were assessed in the second phase for normative repetitive routines using the Childhood Routines Inventory (CRI) and for OCSS by maternal-informant diagnostic interview. The OCSS phenotype was defined using standard diagnostic criteria for obsessive compulsive disorder, though regardless of impairment. In the bivariate model, correlation between the CRI defined phenotype and the OCSS phenotype was estimated to be .40 (95% CI .27-.50), and this correlation was attributable wholly to additive genetic effects. The bivariate model also provided estimates of heritability of the two phenotypes separately: 55% (95% CI 80-89%) for the OCSS phenotype, with the remaining variance attributable mainly to non-shared environment, and 50% (95% CI 39-62%) for CRI assessed normative repetitive routines of childhood, with 36% of the remaining variance attributable to shared environment and 14% to non-shared. The moderate correlation between normative childhood repetitive routines and obsessive compulsive symptomatology, attributable to genetic factors, is consistent with the hypothesis that high levels of this trait in young children constitute a risk factor for the development of obsessive compulsive symptoms.

Restricted and Repetitive Behaviours, Sensory Processing and Cognitive Style in Children with Autism Spectrum Disorders

Many individuals with autism tend to focus on details. It has been suggested that this cognitive style may underlie the presence of stereotyped routines, repetitive interests and behaviours, and both relate in some way to sensory abnormalities. Twenty-nine children with diagnosis of high functioning autism or Asperger syndrome completed the Embedded Figures Test (EFT), and their parents the Short Sensory Profile and Childhood Routines Inventory. Significant correlations were found between degree of sensory abnormalities and amount of restricted and repetitive behaviours reported. Repetitive behaviours, age and IQ significantly predicted completion time on the EFT. The results suggest a cognitive link between an individual's detail-focused cognitive style and their repetitiveness. No such relationship was found with sensory processing abnormalities, which may arise at a more peripheral level of functioning.

Repetitive and ritualistic behaviour in children with Prader–Willi syndrome and children with autism

Recent research has shown that the range of repetitive behaviour seen in individuals with Prader-Willi syndrome (PWS) extends beyond food-related behaviour. The presence and intensity of repetitive, rigid and routinized behaviour in children with PWS was compared with that seen in children with another neurodevelopmental condition in which repetitive behaviour is common: children with autism. Parents completed the Childhood Routines Inventory (CRI). Contrary to our predictions, controlling for developmental level, children with PWS and children with autism showed similar levels of repetitive and ritualistic behaviour overall and on the two CRI factors measuring 'just right' and 'repetitive' behaviour. Indeed, the majority of the sample of parents of children with PWS endorsed most items on the CRI. However there was some specificity at the level of individual items with parents of children with PWS more frequently endorsing an item on 'collecting and storing objects' and parents of children with autism more frequently endorsing 'lining up objects', 'has a strong preference for certain foods' and 'seems aware of detail at home'. These findings confirm the range of repetitive behaviours that form part of the behavioural phenotype of PWS, including insistence on sameness and 'just right' behaviours, and uncover a surprising overlap with those seen in children with autism. Clinical management for children with PWS should include advice and education regarding management of repetitive and rigid behaviour. Future research should investigate whether the repetitive behaviours that form part of the behavioural phenotype of both PWS and autism are associated with a common neuropsychological, neurotransmitter or genetic origin.

Rituals and compulsivity in Prader-Willi syndrome: profile and stability.

Prader-Willi syndrome (PWS) is characterized by an increased risk for obsessive-compulsive disorder. This study investigated the nature of compulsive-like behaviours in the PWS. Parents of 50 individuals with PWS (aged 5-18 years) and 50 typically developing 4-year-old children completed the Childhood Routines Inventory. This instrument measures compulsive-like behaviours in normative childhood. Many childhood compulsive behaviours are prevalent among older children and adolescents with PWS. Group differences were observed in that the PWS group, independent of age, gender and cognitive dysfunctions, exhibited more intense compulsive behaviours related to insistence on sameness in many daily activities and social contexts. Findings also revealed an age-independent low-prevalent pattern of PWS compulsivity, probably related to other features in the PWS symptomatology. Compulsions of childhood do not subside with age in adolescents with PWS. The findings indicate that the differentiation between delayed childhood rituals and pathological manifestations of compulsive features is complex in PWS populations.

Magical beliefs and rituals in young children.

Thirty-one children were administered a structured interview that assessed their beliefs about magic, tricks and wishes. Children were also presented with demonstrations of magic tricks/illusions, and asked to offer explanations as to how they worked. Parents completed the Childhood Routines Inventory (CRI), a 19-item parent report measure that assesses children's rituals, habits and sensory-perceptual experiences that we have termed "compulsive-like" behavior. Results indicated that children's rituals and compulsions were positively related to their magical beliefs, and inversely related to their uses of concrete, physical explanations to describe various phenomena. In particular, children's beliefs about the effects of wishing were most consistently correlated with their compulsive-like rituals and routines. The findings extended the work on magical beliefs and obsessive-compulsive phenomena to the normative manifestation of compulsive behaviors found in typical development.

Visual Organization and Perceptual Closure Are Related to Compulsive-like Behavior in Typically Developing Children

The relationship between visual organization, perceptual closure, and behaviors were examined in a sample of young children. Fifty-one preschool-aged children were administered a variety of measures assessing visual organization and perceptual closure, and embedded-figures performance. Parents reported on their children's compulsive-like behaviors (i.e., Just Right perceptions and repetitive behaviors). Children's performance on visual organization and perceptual-closure tasks were significantly related to their compulsive-like behaviors, and these associations were mediated by mental age. The results further validate the Childhood Routines Inventory (CRI) and highlight the sensory/perceptual components of the construct of normative compulsive-like behavior in young children.

Ritual, Habit, and Perfectionism: The Prevalence and Development of Compulsive-like Behavior in Normal Young Children

Young children engage in a significant amount of ritualistic, repetitive, and compulsive-like activity that appears to be part of their normal behavioral repertoire. Empirically, little is known about the onset, prevalence, and developmental trajectory of these phenomena. A parent-report questionnaire, the Childhood Routines Inventory (CRI), was developed to assess compulsive-like behavior in young children, and was administered to 1,492 parents with children between the ages of 8 and 72 months. The CRI has strong overall internal consistency and a distinct two-factor structure. The frequency of compulsive-like behaviors changes with age: Two-, 3-, and 4-year-olds engaged in more compulsive behavior than children younger than 1 year of age and older than 4 years of age. Results are discussed from a developmental psychopathology framework and for their implications for future research in this area.