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Autism and Obsessive compulsive disorder (OCD)

There are important differences between OCD and Autism but they can occur together.

For people who have obsessive compulsive disorder (OCD) people may talk about ‘obsessions and compulsions’ but autistic people usually talk about ‘repetitive behaviours’. These can look the same, for example, switching the lights on or lining things up in the same way, but they are different. The difference is that obsessions and compulsions for people with OCD are upsetting and unwanted whilst repetitive behaviours for autistic people (e.g., interests and sensory) are often good, soothing and purposeful.

An example of this could be an autistic person or someone diagnosed with OCD who may repeatedly turn the light switch on and off. Someone who is autistic may experience some enjoyment about the sound the light switch makes when is turned on and off. Someone with OCD may believe that they need to repeat this behaviour or something bad will happen.

Repetitive behaviours are part of being autistic and should not be misunderstood as a sign that you may have OCD. Repetitive behaviours can be considered as ‘normal’ for people with autism. Some examples of these repetitive behaviours within autism can include:

  • specific interests
  • unusual sensory interests
  • making sounds or seeking out sounds
  • difficulties with changes to routines or environmental changes
  • unusual attachments to objects
  • stereotyped or unusual motor mechanisms.

If you have OCD and Autism, a professional will try to work out which behaviours are associated with OCD and which behaviours are associated with Autism. You will receive different treatments for OCD and autism.
They would also try to establish if the behaviours are driven by fear, impending doom or pleasure (i.e., enjoyment or self-soothing). This can take a little longer and may include the following:

  • goal setting (what you would like to change)
  • anxiety education (learning about anxiety and how it works)
  • developing an OCD hierarchy (the steps we can work on to break the OCD cycle)
  • exposure and response prevention (taking the steps slowly and learning to cope with little bits of anxiety at a time)
  • lots of practice inside and outside of appointments
  • planning for other situations in the future

Click here to find out more about Autism.

Click here to find out more about OCD.

How to get help

If you have any more questions on this area or would like to speak to somebody about this topic, have a look at the links or search for your local services in the blue box below. Alternatively, you can always contact your school nurse.

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