
What is the difference between obsessions/compulsions (OCD) and “repetitive behaviors” associated with autism spectrum disorder (ASD)?
There is overlap between behaviors seen in children with OCD and the ritualized/repetitive behaviors commonly observed in children with ASD. Children with ASD may perform repetitive or ritualistic behaviors, such as ordering, arranging, counting, or touching/tapping. However, children with ASD are not likely to think (“obsess”) about their rituals and are more likely to simply act upon their urges. Children with ASD therefore, may present with limited insight into the “reason” behind their ritualized behaviors. Children with ASD are also less likely to be using their ritualized behaviors to “neutralize” fear or anxiety and/or “keep bad things from happening” (as would be true for OCD). Rather, ritualized behaviors associated with ASD may satisfy other needs, such as modifying sensory input, gaining reinforcement from the environment, or preserving “sameness” in their daily lives.