Coping with Obsessions and Rituals in Kids with ASD

By Mark Hutten, M.A.
"My [high functioning] autistic daughter has to have everything in her room just so. If anything gets moved (for example, when I dust the furniture or change her bed sheets), she has a fit. She always knows if something is missing or has been moved to a different spot. Is this part of her autism, or is it OCD, or both?"

One of the hallmarks of ASD Level 1 [High-Functioning Autism] is the development of obsessive thinking and the performing of ritual behaviors done to reduce stress and anxiety. This type of behavior can later meet the criteria in adulthood for obsessive-compulsive disorder.

ASD children often have an obsessive interest in a particular subject -- and very little interest in much else. They may obsessively seek information about maps or clocks or some other topic. 

They may also be very inflexible in their habits and may rigidly adhere to certain routines or rituals. These obsessions and compulsions are believed to be biological in origin. This means that it is very difficult to go to therapy or just talk the individual out of the rituals.


Even so, there is some evidence to suggest that cognitive-behavioral therapy may help control some of the behaviors and makes the child aware of ways to recognize when the behavior is occurring so as to stop it before it occurs. This kind of therapy, in general, can be helpful for children, teens and adults with autism because it focuses on concrete behavioral and “thought” changes necessary to function on a day-to-day basis.





Parents may need to simply be supportive of the child who so rigidly hangs onto rituals she doesn’t understand. Unless the child has done a lot of therapy, it takes a great deal of effort to fight the rituals, nor does it help to punish the child for them.

There are medications, often used in obsessive compulsive disorder, that can take the edge off of the ritual behavior and obsessions, especially when used along with cognitive behavioral therapy. No medication is without side effects, and the improvement may not be complete; however, it is worth the effort to try the medication as recommended by your child’s doctor.





PARENTS’ COMMENTS:

•    Anonymous said... OCD is definitely part of the Aspergers. Our Aspie is obsessive about her pencil sketches. She always has her sketchbook with her and no one is allowed to touch it. She will show them to us but SHE has to turn the pages. I shudder to think of what would happen if that book got damaged!
•    Anonymous said... OCD isn't always part of ASD but our toddler (2.5 yrs) is HFA and must have things in a certain way. Must wear certain clothes or have certain sheets on his bed. It's not OCD just a different aspect of the spectrum
•    Anonymous said... Our daughter had OCD, sensory issues. Drove me crazy. Not until she was nine did all these issues get diagnosed into a aspergers diagnosis So, it's part of the aspergers. We also have social issues, tics, and a few more things.
•    Anonymous said... I have 4 daughters and 2 of them are on the spectrum .. The older of the two is just the same in fact she's numbered her pillows so she knows exactly which pillow goes where ... I was told by Camhs it is partly her autism but partly as her room is her sanctuary it's where she goes to get away from everything. So it's her way of having some control.. Nothing to be worried about after all it is her room and if you think about it you probably wouldn't like someone in your bedroom moving things about .. Don't worry honestly x
•    Anonymous said... My 3 year old will line her toys up and refuses to do anything else until theyre perfect. And if a toy is missing she gets mad and wont let it go until its been found and put in line
•    Anonymous said... Roo is 7 and he likes his room neat and orderly,but he shares are room with his NT brother who lives in what can only be described as organized chaos!!! Drives Roo crazy!! I have to keep on the older one constantly to clean so Roo doesn't meltdown! I also have Roo help change sheets, dust and vaccum so that its done the way he likes it and he doesn't panic cause someone touched his stuff :)

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