A nurse is educating the parents of a 3-year-old child who has autism spectrum disorder (ASD). Which of the following patterns of behavior should the nurse include in the teaching? (Select all that apply.)

A. Fixation on certain items or topics: Children with ASD often develop intense interests or focus on specific objects or topics, which is a characteristic behavior and should be included in parental education. B. Frequent changes in routine: Children with ASD typically struggle with changes in routine and may become distressed when routines are disrupted, so frequent changes are not characteristic and should not be encouraged. C. Display of self-harming behaviors such as head-banging: Some children with ASD may engage in self-injurious behaviors, including head-banging or biting, particularly during times of frustration or sensory overload. D. Spontaneous and unpredictable behaviors: Behaviors in ASD are usually repetitive or predictable rather than spontaneous; unpredictability is not a defining characteristic. E. Adhering to a rigid routine: A strong preference for sameness and strict adherence to routines is common in children with ASD and should be recognized by caregivers. F. Avoidance of repetitive activities: Children with ASD typically engage in repetitive behaviors such as hand-flapping, rocking, or repeating words, so avoidance of these is not typical.