Obsessions, repetitive behaviour and routines can be a source of enjoyment for autistic people and a way of coping with everyday life. But they may also limit people's involvement in other activities and cause distress or anxiety. Find out what you can do to help.
My mind was constantly whirring with thoughts, worries and concerns. The time spent with my obsession was the only time in which I had a clear mind – it gave me that much sought-after relaxation.
Young person with Asperger syndrome
Many autistic people have intense and highly-focused interests, often from a fairly young age. These can change over time or be lifelong. It can be art, music, trains, computers, car registration numbers, bus or train timetables, postcodes, table tennis, traffic lights, numbers, shapes or body parts such as feet or elbows. For many younger children it's Thomas the Tank Engine, dinosaurs or particular cartoon characters.
Autistic people might also become attached to objects (or parts of objects), such as toys, figurines or model cars – or more unusual objects like milk bottle tops, stones or shoes. An interest in collecting is also quite common.
Autistic people often report that the pursuit of such interests is fundamental to their wellbeing and happiness, and many channel their interest into studying, paid work, volunteering, or other meaningful occupation. The interest can:
- provide structure, order and predictability, and help people cope with the uncertainties of daily life
- give someone a way to start conversations and feel more self-assured in social situations
- help someone to relax and feel happy
Is it an obsession or a hobby?
It is the intensity and duration of a person's interest in a particular topic, object, or collection that marks it out as an obsession.
- Does the person appear distressed when engaging in the behaviour or trying to resist the behaviour? For example, someone who flaps their hands may then try to sit on their hands.
- Is the person unable to stop the behaviour independently?
- Is the behaviour impacting on the person's learning?
- Is the behaviour limiting the person's social opportunities?
- Is the behaviour causing significant disruption to other people, eg parents, carers and family? (Clements and Zarkowska, 2000)
If your answer to any of the questions above is 'yes', and the behaviour is actually a real issue for them, for you, or for other people in their life, there are ways you could help.
I quickly become overwhelmed [in social situations]. Is it surprising that I then feel like blocking the world out and literally putting my thoughts back in order? That I start to rock to tell myself which feelings are mine? That I start speaking to myself or groaning to block out other sounds and so that I know which thoughts are mine? I think anyone experiencing life this way would do the same.
Repetitive behaviour in autistic people is not the same as OCD (Obsessive Compulsive Disorder), which is an anxiety disorder in which people experience repetitive thoughts and behaviours that are upsetting to them.
Repetitive behaviour may include arm or hand-flapping, finger-flicking, rocking, jumping, spinning or twirling, head-banging and complex body movements. You may also see the repetitive use of an object, such as flicking a rubber band or twirling a piece of string, or repetitive activities involving the senses (such as repeatedly feeling a particular texture). This is known as 'stimming' or self-stimulating behaviour.
Although repetitive behaviour varies from person to person, the reasons behind it may be the same:
- an attempt to gain sensory input, eg rocking may be a way to stimulate the balance (vestibular) system; hand-flapping may provide visual stimulation
- an attempt to reduce sensory input, eg focusing on one particular sound may reduce the impact of a loud, distressing environment; this may particularly be seen in social situations
- to deal with stress and anxiety and to block out uncertainty
- to pass the time and provide enjoyment.
Routines and resistance to change
Reality to an autistic person is a confusing, interacting mass of events, people, places, sounds and sights... Set routines, times, particular routes and rituals all help to get order into an unbearably chaotic life. Trying to keep everything the same reduces some of the terrible fear.
Jolliffe (1992) in Howlin (2004), p.137.
The world can seem a very unpredictable and confusing place to autistic people, who often prefer to have a daily routine so that they know what is going to happen every day. They may want to always travel the same way to and from school or work, or eat exactly the same food for breakfast.
The use of rules can also be important. It may be difficult for an autistic person to take a different approach to something once they have been taught the 'right' way to do it.
Sometimes minor changes such as moving between two activities, can be distressing; for others big events like holidays, starting or changing school, moving house or Christmas, which create change and upheaval, can cause anxiety.
Some autistic people have daily timetables so that they know what is going to happen, when. However, the need for routine and sameness can extend beyond this. You might see:
- changes to the physical environment (such as the layout of furniture in a room), or the presence of new people or absence of familiar ones, being difficult to manage
- rigid preferences about things like food (only eating food of a certain colour), clothing (only wearing clothes made from specific fabrics), or everyday objects (only using particular types of soap or brands of toilet paper)
- a need for routine around daily activities such as meals or bedtime. Routines can become almost ritualistic in nature, having to be followed precisely with attention paid to the tiniest details
- verbal rituals, with a person repeatedly asking the same questions and needing a specific answer
- compulsive behaviour, for example a person might be constantly washing their hands or checking locks. This does not necessarily mean they have obsessive compulsive disorder (OCD) but if you are concerned about this, speak to your GP in the first instance.
People's dependence on routines can increase during times of change, stress or illness and may even become more dominant or elaborate at these times (Attwood, 1998)
Unexpected changes are often most difficult to deal with. People on the autism spectrum may not be comfortable with the idea of change, but may be able to cope better if they can prepare for changes in advance.
How you can help
Does the obsession, routine or repetitive behaviour restrict the person's opportunities, cause distress or discomfort, or impact on learning? If not, then it may not be necessary to intervene. If it is causing difficulties, or is in some way unsafe, they may need support to stop or modify the behaviour, or reduce their reliance on it.
Understand the function of the behaviour
Think about the function of the repetitive behaviour, routine or obsession. What does the person get out of it? Does it reduce anxiety, or block out noise? Learn more about behaviour in our behaviour - top tips.
Modify the environment
Does the person always seem to find a particular place like a classroom, hard to cope with? Is it too bright? You might find that modifying the environment (eg turning off strip lighting) can help to reduce sensory discomfort. If the behaviour is a way of getting sensory input, look for alternative ways of achieving the same sensation.
Make the world a more structured and predictable place. A more structured environment could reduce boredom, which is sometimes a reason for repetitive behaviour. You might prepare a range of enjoyable or calming activities to re-direct the person to if they seem bored or stressed.
Try using visual supports (such as daily timetables), social stories™, or pre-planning strategies to prepare for change or events that might be stressful, or daily transition times. Egg timers or time timers can help someone to understand abstract concepts like time, plan what they need to do, in what order, and understand the concept of waiting.
Find product suppliers in our Autism Services Directory, visit Do 2 Learn for some free picture symbols, or find out about apps that you can use to structure time or build social stories™.
Learn more about how you can help with change, sequencing, transition and break times.
Develop strategies to manage anxiety, such as introducing the Brain in Hand app. Consider contacting an autism experienced counsellor.
Repetitive behaviours, obsessions and routines are generally harder to change the longer they continue. A behaviour that is perhaps acceptable in a young child may not be appropriate as they get older, eg obsession with stroking other people's hair, with copying people's accents, or with shiny things - meaning they collect change that people leave around. It will help if you can set limits around repetitive behaviours from an early age and look out for any new behaviour that emerges.
If you need to, set clear, consistent limits - for example, ration an object, the time a person should spend talking about a subject, or the places where they can carry out a particular behaviour. Behavioural change is most likely to be successful and the person less likely to be distressed if you start small and go slowly. Increase time restrictions and introduce other limits gradually.
Decide together a realistic target and put together a plan to reach that target over a period of time. It is important to set small, realistic goals to help build on success and increase confidence.
Think about whether the person would find it easier to engage in the interest for shorter periods throughout the day or for longer periods but less often.
Consider what needs to be changed. Are they unable to stop engaging in the activity? Work on lessening the duration. Is the issue that they constantly start the activity throughout the day even when they are trying to focus on other things? Work on lessening the frequency. If it is a mixture of both, focus on one aspect to change at first, to increase the chance of success and reduce anxiety.
- Week 1: decide on the plan and target, creating a visual support explaining the change.
- Week 2: Jane is allowed to talk about train engines for 15 mins, every hour.
- Week 3: Jane is allowed to talk about train engines for 10 mins, every hour.
- Week 4: Jane is allowed to talk about train engines for 10 mins every 2 hours.
Continue in this way until you meet the goal, which is to find a balance between engaging with the interest enjoyably and engaging with other activities.
If you place limits around obsessions or repetitive behaviour, you might need to think about things the person can do instead.
Think of alternative activities to direct the person to when they have met their quota of the activity you are working on. For example, if they have spoken to family about their interest for the set amount of time that day, consider directing them to record their thoughts on their phone or write them down in an interest book. Whilst the family are no longer engaging in the activity, the thoughts are still expressed, hopefully meeting the person’s need and therefore lowering their anxiety. You could also ensure that if they wanted to express their thoughts about their interest again before their next allotted time that they could write things down and you will talk to them about their notebook thoughts later. You could use visual supports to explain these additional activities.
It might be possible for the person to engage in their interest in new ways, perhaps joining a club or group, or studying or working in a related area.
Where the activity relates to sensory needs, provide an alternative activity that has the same function, eg:
- someone who rocks to get sensory input could use a swing
- someone who flicks their fingers for visual stimulation could use a kaleidoscope or a bubble gun
- someone who puts inedible objects in their mouth could have a bag with edible alternatives (that provide similar sensory experiences) such as raw pasta or spaghetti, or seeds and nuts
- a person who smears their poo could have a bag with play dough in it to use instead.
Support skill development
The following skills can help with managing stress or uncertainty (which may lead to repetitive behaviour).
Developing social skills such as how to start a conversation, appropriate things to talk about, and how to read other people's 'cues' (eg, we sometimes raise our eyebrows slightly if we want to speak or say something like 'Yes, but...') may mean someone feels more confident and doesn't need to rely on talking about particular subjects, such as a special interest.
Self-regulation skills are any activities that help a person to manage their own behaviour and emotions.
If you can help the person to identify when they are feeling stressed or anxious and help them learn alternative strategies to use, you may, in time, see less repetitive and obsessively habitual behaviour. Strategies to consider might be relaxation techniques such as taking 10 deep breaths or squeezing a stress ball, as well as finding ways to communicate their need for support either verbally or, if that is too difficult, by showing a red card or writing a note.
Many autistic people have difficulty with abstract concepts such as emotions, but there are ways to turn emotions into more 'concrete' concepts, eg stress scales.
You can use a traffic light system, visual thermometer, or a scale of 1-5 to present emotions as colours or numbers. For example, a green traffic light or a number 1 can mean 'I am calm'; a red traffic light or a number 5, 'I am angry'.
Make use of interests and obsessions
Highly-focussed interests can be used to increase a person's skills and areas of interest, promote self-esteem, and support socialising. Obsessions can be developed into something more functional.
- An obsession with computers could be developed into someone studying or working in IT.
- A person with a special interest in historical dates could join a history group and meet people with similar interests.
- A person with knowledge of sport or music would be a valuable member of a pub quiz team.
- An obsession with rubbish could be used to develop an interest in recycling, and a child given the job of sorting items for recycling.
- A parent showing an interest in their child's loved computer game could improve their relationship with one another.
- Collaborative and cooperative computer games can help to build relationships and social skills.
- An interest in particular sounds could be channelled into learning a musical instrument.
- A strong preference for ordering or lining up objects could be developed into housework skills.
- Someone with an interest in a particular TV show could practise IT skills by creating a presentation about it.
- You could teach internet safety while they discuss their interest on web forums and social media.
If you and other people the person knows can show an interest in their obsession this may be welcomed and help to boost their self-esteem.
Showing an interest in a child's obsession can help a parent to enjoy a level of communication that had perhaps never seemed achievable before.
Young person with Asperger syndrome
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Last reviewed 11 October 2016.