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Response interruption and redirection (RIRD) can reduce stereotypy in autism spectrum disorder (ASD), but research quality varies. Ethical use requires careful consideration of individual needs and preferences for effective, affirming interventions.

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autismmethodological qualityneurodiversity-affirming practiceresponse interruption and redirection (RIRD)stereotypy

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Area of Science:

  • Behavioral Science
  • Developmental Psychology
  • Autism Spectrum Disorder Research

Background:

  • Response interruption and redirection (RIRD) is a common intervention for stereotypy in autism spectrum disorder (ASD).
  • Growing emphasis on neurodiversity-affirming practices necessitates reevaluation of RIRD's methodological rigor and ethical application.
  • Existing literature requires scrutiny regarding intervention quality and contextual appropriateness.

Purpose of the Study:

  • To systematically review the quality and ethical contextualization of published RIRD studies.
  • To evaluate RIRD research using What Works Clearinghouse (WWC) single case design standards and an ethical decision framework.
  • To assess the evidence base for RIRD's effectiveness and ethical defensibility in ASD interventions.

Main Methods:

  • Systematic review of 42 articles including 277 cases of RIRD interventions for stereotypy in ASD.
  • Application of WWC single case design standards to assess methodological quality.
  • Ethical coding using NIH principles and contextual fit literature to evaluate ethical appropriateness.

Main Results:

  • Only 9% of studies met WWC design standards without reservations; 47% did not meet standards.
  • 67% of eligible cases showed strong or moderate evidence of a functional relation between RIRD and stereotypy reduction.
  • While most participants had a rationale for treatment (76%), procedural fidelity and social validity reporting were inconsistent (38% assessed social validity).

Conclusions:

  • RIRD can be effective and ethically defensible when prerequisites like contextual fit, functional behavior assessment, high fidelity, and client preferences are met.
  • Findings highlight the need for neurodiversity-affirming, high-quality research designs for RIRD interventions.
  • Individualized decision-making is crucial to ensure RIRD supports, rather than suppresses, autistic individuals' unique ways of engaging.