Adult Repetitive Behaviours Questionnaire RBQ-2A
Adult Repetitive Behaviours Questionnaire RBQ-2A overview
Creator and Context
The Adult Repetitive Behaviours Questionnaire (RBQ-2A) is a 20 item self report measure of restricted and repetitive behaviours in adults.
It was developed by Sarah Barrett, Mirko Uljarevic, Susan Leekam and colleagues and published in 2015, adapted from the caregiver reported RBQ-2. It is published open access under a Creative Commons licence, which makes it one of the more permissively licensed instruments in this area.
Presenting Conditions
The RBQ-2A produces two subscales:
Repetitive motor behaviours (6 items), covering arranging, fiddling, spinning, rocking, pacing and hand or finger movements
Insistence on sameness (8 items), covering special objects, collecting, keeping things unchanged, distress at minor change, routine, redoing things until they feel right, repeating the same media and eating the same foods
Four sensory items did not load onto either subscale in the original analysis.
Administration
Self administered. Items use a mixed response format. Some items are rated on a 4 point scale and some on a 3 point scale, and for scoring the 4 point responses are collapsed to 3 points so that items are comparable.
Desired Audience
Autistic adults aged 18 and over with sufficient verbal and cognitive ability to self report. It is not suitable for adults with intellectual disability or limited language.
Restricted and repetitive behaviour is half of the diagnostic picture, and it is the half that adult self report measures usually skate over. The RBQ-2A measures it directly, and the split between repetitive motor behaviour and insistence on sameness is what makes it useful for planning support, because the two need very different accommodations.
Considerations
It measures repetitive behaviour only. It is not an autism screener and yields no autism probability.
There is no established clinical cut off. It is a dimensional measure and should not be given a threshold.
Validation samples were small and highly educated.
Sensory items are poorly captured by the two factor structure.
How to score the Adult Repetitive Behaviours Questionnaire RBQ-2A
Conducting the assessment
The person rates 20 items. Scores are expressed as a mean rather than a sum, giving a total mean score from 1 to 3.
Interpretation
The RBQ-2A produces a total mean score from 1 to 3, plus two subscale means. Higher scores indicate more repetitive behaviour.
There is no clinical cut off. Interpretation is dimensional and comparative.
In validation, autistic adults scored significantly higher than non autistic adults, with a large effect size, and there were no significant sex differences in either group.
Clinical Considerations
Do not apply a threshold. Use it to describe a profile, not to classify.
Read the two subscales separately. Insistence on sameness has very different implications for support than repetitive motor behaviour.
Pair it with a broader autism measure. On its own it says nothing about diagnosis.
Adult Repetitive Behaviours Questionnaire RBQ-2A use cases
Measuring restricted and repetitive behaviour in autistic adults
Distinguishing repetitive motor behaviour from insistence on sameness
Informing support planning and reasonable adjustments
Research in adult autism
Category
Autism
Research Summary
Barrett, S. L., Uljarevic, M., Baker, E. K., Richdale, A. L., Jones, C. R. G., & Leekam, S. R. (2015). The Adult Repetitive Behaviours Questionnaire-2 (RBQ-2A): A self report measure of restricted and repetitive behaviours. Journal of Autism and Developmental Disorders, 45(11), 3680 to 3692.
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