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Ritual behaviours of children with autism spectrum disorders in Taiwan*

Abstract Background Ritual behaviour, while often considered as nonpurposeful or problematic, can also be regarded as functional behaviour for individuals with autism spectrum disorders (ASD). This study investigated the types and characteristics of ritual behaviour in children with ASD in a Taiwan context. Methods Sixty-four primary school teachers, who taught 71 students with ASD, were surveyed. In addition, observations with five children with ASD were conducted, and their parents were interviewed. Two control groups of students with intellectual disability and children without a disability were included in the study. Results Ritual behaviour occurred in the majority of children with ASD, and across all levels of ability. Prevalence was much higher in the ASD group as compared to the two control groups. These behaviours could be categorised into seven types, and ritual behaviour was strongly associated with sensory sensitivity. Conclusions Although ritual behaviours were diverse in nature and were common among children with ASD in Taiwan, their frequency may be associated with cultural context.