The following information and resources have been provided courtesy of The Lurie Center for Autism, a program of Massachusetts General Hospital and Mass General for Children.

The Lurie Center for Autism is committed to advancing treatments for and knowledge about Autism Spectrum Disorder (ASD) and other developmental disorders, and translating these discoveries into exceptional clinical care. A program of Massachusetts General Hospital and Mass General for Children, The Lurie Center is a multidisciplinary treatment, research, training, and advocacy organization dedicated to supporting individuals and their families across the lifespan.

This resource is intended to provide information so that you can be better informed. It is not a substitute for medical advice and should not be used to treat any medical conditions.

“Restricted, repetitive patterns of behavior, interests, or activities”(1) are a core characteristic of Autism spectrum disorder (ASD). These can present as repetitive movements (e.g., repeatedly tapping or lining up items), adherence to routine,and/or ritualized behaviors. For instance, individuals may follow a rigid sequence of steps when getting ready in the mornings or before bedtime. They may display food-related rituals, such as insisting on using a particular cup or plate or only eating specific food items. The repetitive and ritualized behaviors in ASD can become quite involved and impairing.

These features can overlap with those seen in obsessive compulsive disorder (OCD), which can lead to diagnostic confusion. To help distinguish between the repetitive and ritualized behaviors of ASD and those of OCD, it is helpful to consider their function. OCD compulsions serve to minimize the anxiety associated with obsessive thoughts. For example, a person who is fearful of germs might excessively wash their hands or shower for prolonged periods of time. The rituals may not always logically relate to the outcome the individual is trying to avoid. For example, a person may repeatedly arrange objects in the environment to prevent a loved one from getting harmed. By contrast, the repetitive and ritualized behaviors in ASD often appear pleasurable for the individual and may not be preceded by obsessive thoughts. In both ASD and OCD, interrupting or blocking the repetitive and ritualized behaviors can cause distress.

Differentiating between ASD and OCD repetitive behaviors can help identify those treatment approaches (e.g., behavioral interventions, medication management) that will be most effective.

Revised 10/2022.

Resources

1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).Washington, DC.