# Evaluating a novel approach-avoidance model of repetitive behaviors in autistic adolescents: A multi-method study

> **NIH NIH R21** · CHILDREN'S HOSP OF PHILADELPHIA · 2022 · $230,735

## Abstract

ABSTRACT
Repetitive behaviors comprise one of the two core domains of symptoms for an autism spectrum disorder
diagnosis (hereafter ‘autism’), and the lived experience of autistic individuals suggests that these behaviors serve
important functions that are largely misunderstood and poorly addressed clinically. Autistic individuals report
engaging in repetitive behaviors for reasons related to enjoyment and reasons related to distress (i.e., to
decrease stress and anxiety). The field lacks a validated model that encompasses these seemingly polarized
lived experiences, which negatively impacts our ability to provide appropriate supports, and educate the public
to better accommodate autistic individuals. The guiding scientific premise of this R21 is that autistic individuals
are driven to engage in repetitive behaviors via both approach (enjoyment) and avoidance (avoiding/easing
exposure to negative stimuli) mechanisms. The approach component of the model is supported by a burgeoning
literature and our preliminary work demonstrating that measures from the Research Domain Criteria’s Positive
Valence System are implicated for special interest repetitive behaviors. The avoidance component of the model
is supported by a robust literature and our preliminary data associating sensory reactivity and insistence on
sameness repetitive behaviors with measures from the Research Domain Criteria’s Negative Valence System.
The objective of this project is to take the first step in evaluating the approach-avoidance model of repetitive
behaviors in a study with autistic adolescents. Adolescence is a developmental period when many autistic youth
can reflect on the drivers of their repetitive behaviors. Aim 1 will recruit 250 autistic adolescents between the
ages of 13 and 17 and a caregiver to provide ratings on the type of repetitive behaviors they engage in, approach
and/or avoidance motivations for engaging in the behavior(s), and the intensity of the emotional valence
associated with each repetitive behavior. We will derive latent profiles of repetitive behaviors as a novel method
for parsing the heterogeneous clinical presentations of repetitive behaviors. Aim 2 will recruit 60 teens from Aim
1 to complete neuroimaging and behavioral protocols associated with the Research Domain Criteria’s Positive
Valence (approach), and Negative Valence systems (avoidance); the goal is to link these dimensional
assessments of approach and avoidance mechanisms with self-report of valence direction and intensity of
repetitive behaviors. We hypothesize that Aim 1 will yield 3 unique latent profiles—Predominantly Approach,
Predominantly Avoidant, and Mixed Approach/Avoidant—and that Aim 2’s canonical correlation analyses will
show the Positive Valence System to be associated with approach repetitive behaviors and Negative Valence
System to be associated with avoidance repetitive behaviors. This line of research has the potential to redefine
models of repetitive behavior to align ...

## Key facts

- **NIH application ID:** 10432267
- **Project number:** 1R21MH129777-01
- **Recipient organization:** CHILDREN'S HOSP OF PHILADELPHIA
- **Principal Investigator:** BENJAMIN YERYS
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $230,735
- **Award type:** 1
- **Project period:** 2022-05-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10432267

## Citation

> US National Institutes of Health, RePORTER application 10432267, Evaluating a novel approach-avoidance model of repetitive behaviors in autistic adolescents: A multi-method study (1R21MH129777-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10432267. Licensed CC0.

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