Response Interruption and Redirection for Stereotypy: A Quality Review and Ethical Considerations

Response interruption and redirection (RIRD) is a commonly evaluated intervention for reducing stereotypy, a core feature of autism spectrum disorder (ASD). Although RIRD has been recognized as an evidence-based practice, increasing emphasis on neurodiversity affirming and contextually grounded intervention has highlighted the need to reexamine both the methodological rigor of the literature and the conditions under which RIRD is appropriate. This systematic review evaluated the quality and ethical contextualization of published RIRD studies by applying the What Works Clearinghouse (WWC) single case design standards and an ethical decision framework informed by the National Institutes of Health guiding principles and contextual fit literature. A total of 42 articles met inclusion criteria, yielding 277 cases. Of these, approximately 9% met WWC design standards without reservations, 44% met standards with reservations, and 47% did not meet standards. Of the 144 cases eligible for evidence review, 67% demonstrated strong or moderate evidence of a functional relation. Ethical coding showed that most participants (76%) had an explicit rationale for treatment, yet reporting of procedural fidelity and social validity remained inconsistent. Only 38% of articles assessed social validity. Among those that did, stakeholder ratings were consistently positive, and participant-based measures indicated that when given a choice, individuals often preferred RIRD over alternatives. Taken together, findings suggest that RIRD can be effective and ethically defensible when implemented following established prerequisites such as contextual fit, functional behavior assessment, high fidelity implementation, and consideration of client preferences. Implications for practice and recommendations for designing neurodiversity affirming, high quality RIRD research are discussed.Public Significance StatementStereotypic behaviors, such as hand-flapping or vocal repetition, are an important part of many autistic individuals' experiences. While reducing stereotypy can sometimes help with learning or social access, it is essential that interventions respect each person's needs and preferences. This review examined the strength and contextual appropriateness of research supporting response interruption and redirection (RIRD), an intervention sometimes used to reduce stereotypy. Findings show that while RIRD can be helpful, the quality of research varies, and the procedure should only be used when clearly justified, preferred, and implemented with care. This means that careful, individualized decision-making is needed when considering RIRD to ensure it supports, rather than suppresses, the unique ways autistic individuals communicate and engage with the world.