Obsessive behaviour, routines and rituals: autistic children and teenagers

Obsessions, rituals, routines and autistic children and teenagers

Many autistic children and teenagers have obsessions, routines or rituals. Some children have all of these things, and others have only one or two.

Obsessions
Autistic children and teenagers can be very intense and focused about favourite toys, activities and topics of conversation.

For example, younger children might collect things like twigs or balls or want to know the birthday of everyone they meet. They might open and close doors over and over again, or rush into each new place to find and flush the toilet. Older children might have very narrow interests or preoccupations, like needing to know everything possible about trains.

Some children move from one interest or obsession to another, and the interests last for weeks or months before they change. Others develop an interest – for example, in trains – in early childhood and continue this interest through adolescence and into adulthood.

Rituals
Some autistic children and teenagers have rituals. For example, some children might keep favourite objects in specific places, like the bottom corner of a drawer in the bedroom. They might have to get their objects out and touch them before bed. Or they might drink only from particular cups, or ask the same questions and always need specific answers.

Routines
Routines are often important to autistic children and teenagers. They can find change and transitions difficult to cope with. They might like to eat, sleep or leave the house in the same way every time. For example, children might go to bed happily if you follow their regular bedtime routines, but won’t settle if the routines are broken. They might get very upset if their route to preschool is changed, or they might insist on putting their clothes on in the same order each morning.

How obsessions, routines and rituals help autistic children and teenagers

We don’t know what causes obsessive behaviour or the need for routines and rituals. The cause might not be the same for everyone.

For young autistic children who have limited play skills, special interests can be something they enjoy.

Also, obsessions, routines and rituals help some autistic children manage stress and anxiety. When they feel stressed because they don’t understand what’s going on around them, obsessions and rituals let them take some control of their surroundings.

Sensory sensitivities can lead to some autistic children developing obsessions and rituals. For example, children might stroke people’s hair whenever they can because they enjoy the sensation or it helps them feel calm.

And some autistic children have trouble with planning, so having a rigid routine or ritual helps comfort them and relieves feelings of stress and anxiety.

You can use your child’s obsessions and special interests as rewards and motivators to help teach them new skills and behaviour.

Handling autistic children’s obsessions, routines and rituals

Some autistic children – and their families – can live with daily obsessive behaviour, routines and rituals. Others might want to find ways to handle the habits differently.

If you’re thinking about doing things differently, it can help to ask some questions about the habit and how it affects your child and family. For example:

Is your child’s behaviour affecting their ability to learn?
Is your child’s behaviour affecting their social life?
Is your child’s behaviour affecting your family’s ability to carry out day-to-day activities, or to go on holidays or trips?
How would you feel if this behaviour is the same in a few years?
Is your child’s behaviour causing harm to themselves or others?

Your answers to these questions might help you decide whether it’s worth trying to change things. And if you decide you want to work on your child’s obsessions and routines, your answers might help you work out what to focus on.

Before you develop a plan to manage your child’s obsessions, rituals and routines, it’s a good idea to think about your child’s developmental level and communication skills. For example, does your child have the communication skills to understand your instructions?

Working out what’s causing your child’s behaviour might also guide your next steps. Is it sensory? Or does your child feel anxious when faced with the unknown? You might be able to manage the sensory issues or the anxiety, which could lead to a decrease in the behaviour.

If your child’s behaviour isn’t affecting their life or other people in a negative way, but you still want to decrease it, you could consider setting some limits on the behaviour. For example, you could allow your child to talk about their special interest subject for half an hour after school. After that, they need to switch to a new activity.

You might also be able to find a positive outlet for an obsessive interest. For example, if your child has an interest in dinosaurs, keeping a scrapbook might work well.

Autistic children can get upset when they can’t do their obsessive behaviour, routines or rituals. Strategies for making changes to routines and managing difficult behaviour can help you and your family manage these situations.

Getting professional help with obsessions, routines and rituals

An experienced professional can help you understand and manage your child’s obsessive behaviour, routines or rituals.

A good first step is talking with your child’s paediatrician, psychologist, another health professional working with your child, or school support staff.