Obsessions - When is it Necessary to Correct Them?

Repetitive behaviours help your autistic child in various ways.

Repetitive behaviours help your autistic child in various ways. Instead of extinguishing the behaviours entirely, finding a healthy balance between accepting and changing the behaviours may be a better approach.

Introduction – What are obsessions and repetitive behaviours?

Restricted and repetitive behaviours (RRBs) and interests are key features of autism (American Psychiatric Association, 2017). Many autistic children have intense interests towards their favourite toys and topics. These obsessive interests include collecting and being attached to objects or toys; having a narrow preoccupation with a subject such as trains. They may engage in self-stimulating behaviours and stereotyped movements like hand flapping, head banging, and rocking, and ritualistic behaviours like repeatedly lining up toys in a specific order. Autistic individuals tend to adhere strictly to rituals such as keeping their favourite objects in particular places.

Routines provide predictability for individuals with autism as they have a high need for sameness. They may find it upsetting when there are changes in their daily routine. For instance, your child may be used to going to school by the school bus and may be very upset if your child has to make changes such as taking another mode of transportation to school. When a child with autism has to follow a schedule in an order that is different from the usual, such as showering at an earlier or a later time, they may also find the change upsetting.

Parents who may have observed these behaviours in their autistic child may label them as “obsessions” or “compulsions.” According to Baron-Cohen (1989), however, we should be cautious in using the term “obsession” to describe the behaviours seen in autism as it “implies that such behaviours … are similar to those seen in obsessive-compulsive disorder”. A person with obsessive-compulsive disorder (OCD) may have the compulsion of washing their hands for several hours, where the individual may report a sense of uncontrollability and disturbance towards their behaviour. However, as autistic children are unable to talk about how they experience their activities or interests, we cannot assume that the activities they engage in are disturbing. Some individuals may even enjoy talking about their interests. Hence, there is insufficient evidence on whether the behaviours seen in autism satisfy the definition of obsessions. Instead of using the term “obsessions,” the term “repetitive behaviours” should be used to describe the behaviours seen in autism.

How do these repetitive behaviours help autistic children and teenagers?

1. Children with autism engage in these repetitive behaviours and talk about their interests because they are something they enjoy. For a child with limited play skills, engaging in repetitive behaviours may also be something that keeps them occupied.

2. Following routines, having rituals, and engaging in repetitive behaviours may serve as a coping method to regulate their stress and anxiety. These behaviours can give them a sense of control over unpredictable surroundings.

3. Self-regulatory behaviours or stimming may help individuals with autism regulate their sensory input. For instance, they may rock their body to stimulate the vestibular system to increase sensory input. The regulation of their sensory input allows them to feel more relax and happy.

4. It serves as a form of expression. For instance, an autistic child may express their excitement or frustration through hand flapping.

Should we correct the repetitive behaviours?

Due to the above reasons on how repetitive behaviours can help autistic children and teenagers, attempts to stop the behaviour from happening may not be helpful and may even be distressing and uncomfortable for your child. Hence, finding a balance between acceptance and change might be a better approach instead of extinguishing the behaviour entirely. Nevertheless, some behaviours may interfere with their abilities to learn and engage in social interactions. Hence, when you are considering changing the behaviours, think about the answers to these questions.

• 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 or caregiver’s abilities to carry out day-to-day activities?

• How would you feel if this behaviour is the same in a few years? Are the behaviours appropriate when your child grows older?

• Is your child’s behaviour causing harm to themselves or others?

To correct the behaviours, we have to understand the causes of the repetitive behaviours and find alternative ways to fulfil your child’s need to engage in the repetitive behaviour.

• If your child’s repetitive behaviours are due to sensory needs or it serves as a coping mechanism to regulate their anxiety, managing the sensory issues or finding alternative ways to calm themselves down can help to reduce the repetitive behaviours.

• If your child is trying to express feelings of excitement or frustration by engaging in those repetitive behaviours, teaching them ways to communicate those feelings can help to reduce their tendency to engage in the repetitive behaviours.

• For a child with limited play skills, parents or the therapist working with your child can model play skills so that your child learns to play appropriately.

• If repetitive behaviours happen because of behavioural issues, such as an escape from tasks, behavioural techniques can reduce these behaviours.

• If your child’s behaviours cause harm to others or themselves, intervention is necessary.

If your child’s behaviours are not detrimental to their lives, but you still want to decrease them, you can think about setting limits on the behaviours. An example would be having a time limit for your child to engage in or talk about their interests. After they have done so, they will next engage in another activity.

Some intense interests may help facilitate social interactions or join meaningful jobs. It will be helpful to find a positive outlet for these interests, such as having a scrapbook about dinosaurs for children who enjoy talking about dinosaurs or joining gaming clubs for individuals who have an intense interest in computer games so that they can interact with others who have similar interests. Allowing them to pursue their interests, instead of hindering them, increases their chances of gaining social skills, aids in their learning, and contributes to their happiness.

Conclusion

To know whether to correct the repetitive behaviours, we need to understand why they occur and then find out if there are alternative ways to fulfil your child’s needs. Instead of extinguishing the repetitive behaviours entirely, finding a healthy balance between accepting and changing the behaviours could be beneficial to your child’s learning, social interaction skills, and happiness.

Written by Sylvia.

References:

American Psychiatric Association. (2017). Diagnostic and statistical manual of mental disorders: Dsm-5.

Baron-Cohen, S. (1989). Do autistic children have obsessions and compulsions? British Journal of Clinical Psychology, 28(3), 193–200. https://doi.org/10.1111/j.2044-8260.1989.tb01369.x

Harrop, C., & Kasari, C. (2020, May 6). Learning when to treat repetitive behaviors in autism: Spectrum: Autism Research News. Spectrum. https://www.spectrumnews.org/opinion/viewpoint/learning-when-to-treat-repetitive-behaviors-in-autism/.

Laber-Warren, E. (2021, May 12). The benefits of special interests in autism: Spectrum: Autism Research News. Spectrum. https://www.spectrumnews.org/features/deep-dive/the-benefits-of-special-interests-in-autism/.

Obsessions and repetitive behaviour - a guide for all audiences. Autism support - leading UK charity - National Autistic Society. (2021). https://www.autism.org.uk/advice-and-guidance/topics/behaviour/obsessions/all-audiences.

Obsessive behaviour, routines and rituals: autistic children and teenagers. Raising Children Network. (2020, November 19). https://raisingchildren.net.au/autism/behaviour/understanding-behaviour/obsessive-behaviour-asd.

Restricted Interests: Obsessions, "Special Topics," and Attention Deficits. Restricted Interests: Obsessions, "Special Topics," and Attention Deficits | Interactive Autism Network. (2007). https://iancommunity.org/cs/challenging_behavior/challenging_behavior_restricted_interests.

Rudy, L. J. (2020, July 15). Repetitive Behaviors in Autism. Verywell Health. https://www.verywellhealth.com/repetitive-behaviors-in-autism-260582.

Sarris, M. (2018, October 15). Behaviors that Puzzle: Repetitive Motions and Obsessive Interests in Autism. Behaviors that Puzzle: Repetitive Motions and Obsessive Interests in Autism | Interactive Autism Network.

https://iancommunity.org/cs/simons_simplex_community/repetitive_motions_and_obsessions.