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Understanding Autism

Insistence on Sameness

IAN: Interactive Autism Network - Kennedy Krieger Institute

Individuals with an ASD tend to crave sameness and loathe change.1 There is a tendency to do or think about the same things over and over, as if doing so were a comfort or a compulsion. (See Stimming and Restricted Interests.)

It is a classic sign of autism: a child lines up toys in a certain order, again and again. Unlike typical kids, who might experiment with lining up their train cars in a variety of ways, and move them along the track once they've decided on an order, a child with an ASD may have one acceptable order.and tantrum if a single car is moved out of place. Individuals with an ASD also tend to become upset when there is a break in routine, or when it is time to transition from one activity to another.

Some individuals with ASDs have actual "rituals," where certain things must be done in an exact way every time. First, mom must hand the child the yellow towel with the ducky on it; second, the child must step out of the tub; third, mom can pull the bathtub plug, fourth, mom can dry the child off. Heaven help mom if she pulls the plug out of sequence or if that ducky towel is in the laundry. The child may fall to pieces, insisting that the tub be refilled and the entire sequence be done again, this time in the right way. Tony Atwood, an expert on Asperger's Syndrome, describes how these routines can become more and more torturous:

"The bedtime routine may have started with only lining up three toys, but becomes an elaborate ritual where dozens of toys have to be placed according to strict rules of order and symmetry. When a journey to a destination has followed the same route several times, there is the expectation that this must be the only route and no deviation is tolerated." 2 What drives this need for sameness? Is it a form of control, a way to hang on in a world that seems too unpredictable and frightening? We do not know for sure, but the need is unmistakably there.

The need for sameness can make a person with an ASD look very rigid to the outside world. Family members may sometimes feel held hostage to certain routines or rituals, dreading the scene that will ensue if they interfere with them.

This rigidity can have other social implications, as well. For example, a person with an ASD may become extremely inflexible regarding rules, and want to help enforce them, to the dismay of their peers. A child with an ASD may try to "script" other kids' play so that some pretend scenario is acted out exactly as they pictured it. This resembles the "lining up trains" behavior, only now it is people and their behavior that the child is trying to put in order.

Others' noncompliance often leads to upset, if not downright meltdown. The give-and-take necessary to play or interact with others in more complex, adult ways is hindered by the powerful need for sameness.

Researchers have shown that repetitive sensory and motor behaviors (like stimming), the tendency to have a "special topic," and the tendency to have rigid routines often occur together. Whether these various ways of being "stuck" are fundamentally connected in some way, neurologically speaking, is still being debated.3,4

Insistence on Sameness - References

  1. American Psychiatric Association. (2004). Diagnostic and statistical manual of mental disorders (4th ed., rev.). Washington DC: Author.
  2. Atwood, Tony. (1998). Asperger's syndrome: A guide for parents and professionals. London and Philadelphia: Jessica Kingsley Publishers. (pg. 92)
  3. Carcani-Rathwell, I., Rabe-Hasketh, S., & Santosh, P.J. (2006). Repetitive and stereotyped behaviors in pervasive developmental disorders. Journal of Child Psychology and Psychiatry, 47(6), 573-581. Abstract
  4. Szatmari, P., Georgiades, S., Bryson, S., Zwaigenbaum, L., Roberts, W., Mahoney, W., Goldberg, J., & Tuff, L. (2006). Investigating the structure of the restricted, repetitive behaviours and interests domain of autism. Journal of Child Psychology and Psychiatry, 47(6), 582-590. Abstract




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