OCD and ASD: How can you tell the difference?
Many of the symptoms of ASD and OCD overlap or appear similar, so it is no surprise that the manifestations of these conditions can sometimes be confusing. Children with ASD often display repetitive or obsessive behaviors, extreme need to adhere to routine, resistance to change, and social anxiety. When these feelings are a product of ASD, they are referred to as self-stimulatory (for the purpose of this blog, we will refer to them as “stims”) behavior. Children with OCD frequently exhibit these traits as well, but they are different due to the thought processes involved behind them.
So, what are the important differences between OCD and stims in ASD? The key difference is the motivation for these behaviors, not the behaviors themselves. Similarly, OCD and ASD can be easily differentiated by learning the person’s own opinion or feelings regarding these behaviors and symptoms.
OCD, ASD and Fear
In people with OCD, obsessive behaviors and thoughts are typically followed by uncomfortable feelings stemming from the need to partake in them and often start with sensations of great dread and fear. In other words, a child or adult who must repeat the same task or think things through over and over may be very aware that this is unnecessary and even unreasonable but is often overcome with very strong feelings that trigger this pattern. People of all ages who have OCD often wants these behaviors gone and feel like they interfere with their daily life and values. They may even actively seek help and work towards changing them.
In contrast, a person with ASD does not usually feel guilt or regret based on their need to have to do things their own way. The repetitive behaviors or thoughts are done because they evoke a good feeling in them, which stands in stark contrast from the feelings or imminent danger, fear or regret that accompany OCD.
A simple test to understand your child’s motivations
When trying to identify the condition associated with these symptoms, it is very useful to ask your child whether they engage in obsessive or repetitive behavior out of fear. Ask your child if they believe that something bad will happen if they don’t act the way they do when you observe these repetitive actions.
It is also extremely useful to observe the result of trying to stop these behaviors or actions from occurring. A repetitive act in OCD is different from a stim in ASD in that it is related to very deep and strong fears. While a child with ASD won’t be distressed and may shift to a new activity or behavior if you interfere, a child with OCD may become so overwhelmed and distressed that they will refuse to stop and may even have strong emotional reactions. Of course, all children are different so doing this more than once and with professional guidance would yield the best results. It is important to realize that no test is foolproof. Regardless, it can be a good starting point in allowing you to pinpoint the underlying cause for these behaviors.
In conclusion, it is important to understand that OCD and ASD share some similar symptoms, but the causes and thought processes behind them are very different and, therefore, warrant very different treatments and therapies. It is, therefore, very important to be observant and willing to act and ask the right questions.