Date of Award


Document Type


Degree Name

Doctor of Philosophy in Clinical Psychology (PhD)


Clinical Psychology

First Advisor/Committee Member

Beverly J. Wilson, Ph.D.

Second Advisor/Committee Member

David G. Stewart, Ph.D.

Third Advisor/Committee Member

Kathleen Lehman, Ph.D.


Restricted and repetitive behaviors (RRBs) have been a core symptom of Autism Spectrum Disorder (ASD) since discovered in the 1940’s (Kanner, 1943). More specifically, insistence on sameness, which is considered a subtype of RRBs, has been shown to affect children with considered higher verbal skills in this population. In addition, it is well documented that anxiety symptoms commonly co-occur with ASD, and anxiety symptoms (AS) and IS have been linked through previous research. Using archival data, the purpose of the present study was to investigate the conditional effect on anxiety symptoms on the relation between developmental status (DS) and insistence on sameness (IS) in children with ASD with verbal abilities greater than 85. The sample included 108 individuals (ages 3:0 – 6:11) and was comprised of two groups. The first group was the ASD group, which consisted of 36 children diagnosed with ASD (Male = 27, Female = 9), and the second group was comprised of 72 typically developing (TD) children (Male = 44, Female = 28). All participants were involved in a greater study called the Study of Autism and Self-Regulation (STAR). Findings revealed a significant interaction between DS and IS (B = .06, SE = .03, p = .04, ΔR2 = .36) at low, moderate, and high levels of anxiety symptomatology. Developmental status was shown to have a main effect on IS (B = -5.78, SE = 1.71, p = .001). Additionally, verbal ability and age were significantly correlated with developmental status. The relations between anxiety symptoms and DS, AS and VA, and AS and IS were insignificant. Interestingly, and contrary to expectations, only children with typical development varied in frequency of their IS behaviors based on their level of anxiety symptoms. Anxiety symptom levels had no impact on IS in the ASD group. This suggests that anxiety in general may onset behavior problems with sameness in populations’ non-specific to ASD. Therefore, more research is needed to understand the potential relations among ASD, AS and IS in children.