The word compulsion is associated with a force. Someone is compelled to do something, even if the person doesn't want to do anything at all. Compulsive behavior is common among people with autism, although the reasons for it can differ.

Some people use a catalog of compulsive behaviors to help them handle the stress of everyday life. And some people with autism engage in these acts due to a co-occurring condition, such as obsessive-compulsive disorder (OCD).

If your child with autism spectrum disorder (ASD) engages in compulsive behavior, talk with your child’s doctor. Together, you can determine whether the acts stem from autism, OCD, or something else altogether. Then, you can work on a plan to curb the behavior.

What Is Autism Compulsive Behavior?

Autism compulsive behaviors are acts people tap into or repeat in response to something happening in the environment. They're reactive movements, but they don't change the situation in any way.

People with autism may be compelled to:

  • Wave their hands.
  • Snap their fingers.
  • Rock, spin, or jump.
  • Pull their hair.
  • Scream, grunt, or yell.
  • Push or poke at their eyes.
  • Jam fingers or objects into their ears.
  • Bite their fingers or arms.
  • Bang their heads into walls.

Researchers say people with autism use a variety of behaviors in response to a single trigger. For example, when they are in a room filled with loud noises, they might push their fingers into their ears or yell loudly or bang their heads into the wall. Expose the child to the same trigger the next day, and the child might respond with a different act.

Experts say some people with autism don't see their behaviors as unusual or bizarre. They may even think of them as a helpful response to the world around them. People with ASD use these compulsive behaviors to deal with:

  • Sensory overload. People with autism can be remarkably sensitive to loud noises, bright lights, and strong scents. Some behaviors they use block out the disturbing stimulus.
  • Anxiety. Spinning and rocking distract the mind, which can make a difficult situation easier to bear.
  • Strong emotions. Flapping hands and blinking eyes can help a person with autism process a rising sense of joy, while screaming or headbanging could help to display stress or anger.
  • Boredom. Some compulsive behaviors simply feel good in the moment. People with autism might enjoy acting in this manner.

This urge to move is called many different things, including repetitive behavior, self-soothing behavior, or stimming. Many people with autism engage in these acts. In fact, when doctors attempt to spot autism in young patients, they look for evidence of these urges.

Sometimes, however, people with autism spectrum disorder engage in these behaviors for an entirely different reason.

Could It Be OCD?

Autism isn't exclusionary. People with the disorder can — and often do — have other physical and mental health challenges. Obsessive-compulsive disorder is one of them.

Researchers say people with autism are twice as likely to get a diagnosis of OCD than people without autism. It's possible the two share a genetic component that is passed down from parent to child.

Compulsive behaviors are a common OCD trait, but they manifest a little differently in people with this disease. Typically, the urge to act follows this process:

  • An intrusive thought enters the mind. The person imagines germs swirling through the air, a car ready to slam into beloved family members, or a catastrophe just waiting to happen. These thoughts are strong, uncomfortable, and impossible to ignore.
  • The urge to act grows and grows. The person feels driven to do something to make the thought disappear.
  • One behavior is the solution. Someone worried about germs washes hands, while someone worried about catastrophe might repeatedly check that the oven is turned off. The person doesn't choose from many acts. Only one will do.
  • The act seems unusual. The person often knows that the act has nothing to do with the problem or the thought. But it's impossible to resist the urge to do something.

Researchers know that repetitive behaviors in autism are very different from those attached to OCD. While people with ASD might get pleasure from their repeated acts, people with OCD rarely do.

To an outsider, these acts can look very similar, but they're fundamentally different and demand unique treatment approaches. Working with an expert is critical.

Start Here: Talk to a Doctor

Is your child snapping fingers due to autism or OCD? Would medication help? Is something else wrong? When your child is engaging in confusing activity, you're filled with questions. Your child's doctor can offer answers.

Experts explain that tests used to evaluate anxiety and OCD were made with neurotypical children in mind. Sometimes, doctors must be creative to assess the children sitting in their offices. With dozens of tests to choose from, including some that work with nonverbal children, experts can determine what motivates your child to act.

Treatment paths differ depending on your child's diagnosis. If your child has:

  • Autism only, therapy aims to make the behaviors palatable to the outside world, without eliminating them altogether.
  • Autism with OCD, therapy aims to address the disruptive thoughts, so the child isn't compelled to take action with unusual behaviors.

As a parent, it's critical to ensure that your child keeps all therapy appointments. You may have homework to complete between sessions to ensure that your child stays on track. Stick with it, and you could see public outbursts lessen in frequency.

Ideas to Try at Home

If your child has compulsive behaviors that stem from autism alone, you're an important part of the solution. Your child considers home a safe space, and you might see stimming here more than anywhere else.

Your child trusts you to tell the truth and make things better. Conversations you have at home could resonate throughout the child's life.

Help your child with these three helpful suggestions:

1. Schedule time to stim.

Children with autism find compulsive behaviors soothing, and they see no reason to stop performing them. If your child isn't causing bodily or physical harm, pleasure outweighs pain. But the social consequences may remain.

Talk with your child about stimming, and explain that it's a private, personal behavior best done at home. Write down stim times on the calendar, and treat them like any other self-care appointment. If your child has open time to enjoy the behavior, it might be less appealing at other times.

2. Find a replacement.

Sometimes, your child just can't wait to be alone to stim. If the urge arises and it's overwhelming, your child simply has to act.

Unfortunately, your child's urges can be:

  • Disruptive. Screaming, jumping, and spinning could get your child kicked off an airplane, sent to the principal's office, or removed from a friend's birthday party.
  • Dangerous. Biting arms and hands can lead to infection, while sticking things in ears can lead to hearing damage.

Look for ways to scratch the stim itch in a new way. Offer your child stress balls for the urge to clap and tap. Use headphones to block out loud noises, or suggest tapping on legs rather than tables.

3. Track and change.

Some autism compulsive behaviors are impossible to predict, but plenty of them stem from situations you can identify. When you can identify triggers, you can offer better solutions that help your child.

Keep a behavior diary, and write notes about all of the unusual behaviors you see. Notice when they started, when they intensified, and when they stopped altogether. Use that information to spot and then change your child's compulsions.

Does your child jump and spin as you prepare breakfast? Ask your child to set the table instead of watching you intently. Does your child scream while in loud grocery stores? Use headphones to reduce outside noise and make the trips easier.

It can take time and practice to spot all the triggers and address them. But when you do, you're giving your child skills that can last a lifetime. Your child can use these same techniques to amend stressful moments in adulthood.

Get Professional Help

The work you do at home is critical, and it can make an immense difference in your child’s life. But therapy can play a big role as well, and for that, you need to enlist the help of a professional.

Your child’s therapist can help your child to reduce compulsive behaviors and channel that energy into positive actions. Applied behavior analysis (ABA) therapy is the primary treatment for autism, and it can be effectively used to address compulsive behavior as well as other symptoms of autism.

If your child isn’t already receiving ABA, know that it has extensive research supporting its success in reducing various symptoms of autism. The goal of the therapy is to decrease negative behaviors, promote positive behaviors, and encourage independence in children with autism. These larger goals are broken down into smaller goals, such as improving communication skills, boosting self-reliance, and reducing compulsive behaviors.

After an initial assessment, your child’s ABA therapist will craft the best treatment plan for your child, based on your input and their observations. Some ABA therapy sessions may focus exclusively on compulsive behavior. While changes don’t happen overnight, you’ll see improvement in your child with repeated sessions.

References

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Treatments for Obsessive-Compulsive Disorder Comorbid With Autism Spectrum Disorder. International OCD Foundation.

Sweeping Study Underscores Autism's Overlap With Obsessions. (December 2015). Spectrum.

Obsessive-Compulsive Behaviors in Autism. (February 2020). JAMA.

Comorbid Autism Spectrum Disorder and OCD: Challenges in Diagnosis and Treatment. (April 2018). Psychiatry Advisor.

Understanding the Relationship Between Autism, OCD, and Repetitive Behaviors. (April 2018). Autism Spectrum News.

A Parent Discusses Self-Stimulation. National Family Association for Deaf-Blind Newsletter.

Autism Dilemma: Why Is Teen Chewing on Clothes, Swallowing Objects? (April 2016). Autism Speaks.

Applied Behavior Analytic Interventions for Children With Autism: A Description and Review of Treatment Research. (August 2009). Annals of Clinical Psychiatry.

Management of Children With Autism Spectrum Disorders. (June 2020). American Academy of Pediatrics.

A Parent Wonders: Are New Repetitive Behaviors OCD or ‘Just Autism’. (March 2014). Autism Speaks.

Treatments for Obsessive-Compulsive Disorder Comorbid With Autism Spectrum Disorder. International OCD Foundation.

Untangling the Ties Between Autism and Obsessive-Compulsive Disorder. (February 2019). Spectrum.