Repetitive Behaviour Questionnaire (RBQ-Long)

Question 1

Does he/she operate light switches, taps, the toilet flush etc. repeatedly when it is not necessary to do so?

Never or rarely One or more bouts of this behaviour daily 15 or more bouts of this behaviour daily (or at least one bout an hour) 30 or more bouts of this behaviour daily (or at least two bouts an hour)

Please describe this behaviour: Is there any specific time or situation when this behaviour is especially likely to occur?

Question 2

Does he/she arrange toys or other items in rows or patterns?

Never or rarely One or more bouts of this behaviour daily 15 or more bouts of this behaviour daily (or at least one bout an hour) 30 or more bouts of this behaviour daily (or at least two bouts an hour)

Please describe this behaviour: Is there any specific time or situation when this behaviour is especially likely to occur?

Question 3

Does he/she repeatedly fiddle with toys or other items?

For example, does he/she spin, twiddle, bang, tap, twist, flick or wave anything repetitively?

Never or rarely One or more bouts of this behaviour daily 15 or more bouts of this behaviour daily (or at least one bout an hour) 30 or more bouts of this behaviour daily (or at least two bouts an hour)

Please describe this behaviour: Is there any specific time or situation when this behaviour is especially likely to occur?

Question 4

Does he/she touch parts of his/her body or clothing repeatedly?

For example, does he/she repeatedly rub his legs, pull at the buttons on his/her clothing, or touch his/her ear or elbow etc.?

Never or rarely One or more bouts of this behaviour daily 15 or more bouts of this behaviour daily (or at least one bout an hour) 30 or more bouts of this behaviour daily (or at least two bouts an hour)

Please describe this behaviour: Is there any specific time or situation when this behaviour is especially likely to occur?

Question 5

Is he/she attached to anything in particular?

For example, does he/she carry a teddy, a blanket or stick etc. around with him/her?

No particular attachment to any object Attachment to an object commonly used as a comforter (e.g. teddy, blanket etc.) Attachment to an unusual object (e.g. stick, glove etc.)

Please describe this behaviour:

Question 6

Does he/she obsessively collect or hoard items of any sort?

No obsessive or unusually keen collecting or hoarding Very keen collector of usual items (e.g. stamps, football cards etc.) Very keen collector of unusual or odd items (e.g. leaflets, jar lids, sticks etc.)

Please describe this behaviour:

Question 7

Does he/she spin him/herself around and around?

Never or rarely One or more bouts of this behaviour daily 15 or more bouts of this behaviour daily (or at least one bout an hour) 30 or more bouts of this behaviour daily (or at least two bouts an hour)

Is there any specific time or situation when this behaviour is especially likely to occur?

Question 8

Does he/she rock backwards and forwards, or side to side, either when sitting or when standing?

Never or rarely One or more bouts of this behaviour daily 15 or more bouts of this behaviour daily (or at least one bout an hour) 30 or more bouts of this behaviour daily (or at least two bouts an hour)

Is there any specific time or situation when this behaviour is especially likely to occur?

Question 9

Does he/she bang his/her head? Does he/she do this repetitively?

Never or rarely One or more bouts of this behaviour daily 15 or more bouts of this behaviour daily (or at least one bout an hour) 30 or more bouts of this behaviour daily (or at least two bouts an hour)

Is there any specific time or situation when this behaviour is especially likely to occur?

Question 10

Does he/she pace or move around repetitively?

For example, does he/she walk to and fro across a room, or around the house or garden repetitively?

Never or rarely One or more bouts of this behaviour daily 15 or more bouts of this behaviour daily (or at least one bout an hour) 30 or more bouts of this behaviour daily (or at least two bouts an hour)

Please describe this behaviour: Is there any specific time or situation when this behaviour is especially likely to occur?

Question 11

Does he/she make repetitive hand and/or finger movements?

For example, does he/she repetitively wave, flick, flap or twiddle his/her hands or fingers repetitively?

Never or rarely One or more bouts of this behaviour daily 15 or more bouts of this behaviour daily (or at least one bout an hour) 30 or more bouts of this behaviour daily (or at least two bouts an hour)

Please describe this behaviour: Is there any specific time or situation when this behaviour is especially likely to occur?

Question 12

Does he/she make other repetitive body movements?

For example, does he/she repeatedly clasp his/her hands, tap his/her feet, swing his/her legs or jump etc.?

Never or rarely One or more bouts of this behaviour daily 15 or more bouts of this behaviour daily (or at least one bout an hour) 30 or more bouts of this behaviour daily (or at least two bouts an hour)

Please describe this behaviour: Is there any specific time or situation when this behaviour is especially likely to occur?

Question 13

Does he/she ever injure him/herself?

For example, does he/she bite, scratch, knock or pick him/herself? Does he/she do this repeatedly?

Never or rarely One or more bouts of this behaviour daily 15 or more bouts of this behaviour daily (or at least one bout an hour) 30 or more bouts of this behaviour daily (or at least two bouts an hour)

Please describe this behaviour: Is there any specific time or situation when this behaviour is especially likely to occur?

Question 14

Does he/she insist on things about the house staying the same?

For example, does he/she insist on furniture staying in the same place, or curtains being open or closed etc.?

No Mild problem which does not affect others Serious problem which affects others on a regular basis

Please describe this behaviour:

Question 15

Does he/she insist on other items being put out, kept or stored in the same way?

For example, does he/she like ornaments, toys or cassette tapes kept in the same places or positions?

No Mild problem which does not affect others Serious problem which affects others on a regular basis

Please describe this behaviour:

Question 16

Does he/she play the same music, game or video, or read the same book repeatedly?

Never or rarely Regular feature of behaviour, but will tolerate alternatives when necessary Highly regular and highly rigid feature of behaviour. Will not tolerate any alternatives

Please describe this behaviour:

Question 17

Does he/she insist on using the same objects or items in any other situation?

For example, does he/she insist on using the same chair, plate, bed linen or door? (DO NOT count any insistence on using the same mug or cup)

Never or rarely Regular feature of behaviour, but will tolerate alternatives when necessary Highly regular and highly rigid feature of behaviour. Will not tolerate any alternatives

Please describe this behaviour:

Question 18

Does he/she insist on wearing the same clothes or refuses to wear new clothes?

Never or rarely Regular feature of behaviour, but will tolerate alternatives when necessary Highly regular and highly rigid feature of behaviour. Will not tolerate any alternatives

Please describe this behaviour:

Question 19

Does he/she insist that certain items of clothing must always be worn or worn in the same situation or in the same way?

For example, does he/she insist on always wearing a vest, or wearing a hat to the shops, or always buttoning a shirt to the collar?

Never or rarely Regular feature of behaviour, but will tolerate alternatives when necessary Highly regular and highly rigid feature of behaviour. Will not tolerate any alternatives

Please describe this behaviour:

Question 20

Does he/she insist on eating the same foods, or a very small range of foods, at every meal?

Never or rarely Regular feature of behaviour, but will tolerate alternatives when necessary Highly regular and highly rigid feature of behaviour. Will not tolerate any alternatives

Please describe this behaviour:

Question 21

Does he/she insist on moving or travelling by the same route?

For example, does he/she insist on taking the same route when moving about the house, going for a walk, or travelling in the car?

Never or rarely Regular feature of behaviour, but will tolerate alternatives when necessary Highly regular and highly rigid feature of behaviour. Will not tolerate any alternatives

Please describe this behaviour:

Question 22

How does he/she react if any changes are made to his/her surroundings at home?

For example, if you move the furniture, or rearrange the way that certain items are stored or organised?

May comment on, or notice the change but shows no negative reaction Accepts the change, but shows some degree of anxiety or mildly negative reaction Will accept the change, but shows extreme anxiety or strong negative reaction (e.g. tantrum) Will not accept the change. Persistently attempts to rearrange the items

Question 23

Are there any aspects of routine that he/she insists must remain the same?

For example, does he/she insist on always bathing before breakfast, on going to the shops every afternoon, or on watching a video after every meal?

No Mild problem which does not affect others Serious problem which affects others on a regular basis

Please describe this routine:

Question 24

Does he/she make rituals out of everyday activities such as eating, dressing, getting in the car, walking up stairs etc.?

No Mild problem which does not affect others Serious problem which affects others on a regular basis

Please describe this activity and ritual(s):

Question 25

Does he/she have any rituals that are linked to particular occasions or places?

For example, does he/she have specific rituals for the supermarket, the Doctor's surgery or a relative's house?

No Mild problem which does not affect others Serious problem which affects others on a regular basis

Please describe this ritual(s):

Question 26

How does he/she react if his/her daily routine is changed?

May comment on, or notice the change but shows no negative reaction Accepts the change, but shows some degree of anxiety or mildly negative reaction Will accept the change, but shows extreme anxiety or strong negative reaction (e.g. tantrum) Will not accept any change to routine

Question 27

Does he/she 'echo' or repeat what other people say?

Never or rarely One or more bouts of this behaviour daily 15 or more bouts of this behaviour daily (or at least one bout an hour) 30 or more bouts of this behaviour daily (or at least two bouts an hour)

Is there any specific time or situation when this behaviour is especially likely to occur?

Question 28

Does he/she say the same things, or make the same noises, repeatedly?

For example, does he/she say the same word repeatedly or other sounds such as hums or growls or clicking noises? Or does he/she use the same 'stock phrases' frequently?

Never or rarely One or more bouts of this behaviour daily 15 or more bouts of this behaviour daily (or at least one bout an hour) 30 or more bouts of this behaviour daily (or at least two bouts an hour)

Please describe this behaviour: Is there any specific time or situation when this behaviour is especially likely to occur?

Question 29

Does he/she talk about the same topic over and over again?

Never or rarely One or more bouts of this behaviour daily 15 or more bouts of this behaviour daily (or at least one bout an hour) 30 or more bouts of this behaviour daily (or at least two bouts an hour)

Please describe this behaviour: Is there any specific time or situation when this behaviour is especially likely to occur?

Question 30

Does he/she have any interests or hobbies? Please describe these briefly.

In particular, does he/she have any interests or preoccupations which you would describe as overly keen, obsessional, or unusual in any way?

Please describe any such interests in as much detail as you can:

In summary would you say that he/she has:

A varied pattern of interests which he/she will pursue spontaneously and without prompting One or more obsessional interests, but also other usual interests which he/she will pursue spontaneously and without prompting Only obsessional interests which he/she will pursue spontaneously Has no particular interests or hobbies that he/she will pursue spontaneously (DO NOT include watching TV as an interest or hobby)

Question 31

What was the earliest repetitive activity that you remember your son or daughter showing?

Describe the earliest repetitive activity: How old was he/she when this began?

Question 32

Of all the behaviours in this questionnaire that your son or daughter engage in, which one would you say is the most marked or the most noticeable?

Question 33

Of all the behaviours in this questionnaire that your son or daughter engage in, which one would you say causes the greatest problem in day-to-day life?

Repetitive Behaviour Questionnaire

Instructions

RBQ-Long Assessment Results

Clinical Interpretation

Recommendations:

Important: