I recently had the opportunity to attend the conference “Treating OCD in the Autism Community,” sponsored by the Obsessive-Compulsive Foundation of Western Pennsylvania (OCDFWPA) and Autism Connections of PA. Going into the conference, my driving questions were: “How does OCD look in a person with autism? How do you differentiate the repetitive behaviors which we find in autism from OCD?”
As it turns out, this really was one of the major thrusts of the conference. I learned that in OCD, one has recurrent and persistent thoughts that are intrusive and unwanted. Often, the focus of these thoughts and behaviors centers on the themes of contamination, harm, hoarding, counting, and/or doubt. A person with an OCD wants to stop these thoughts from occurring and is significantly distressed about his/her inability to control these symptoms.
While the person with autism spectrum disorder often insist on sameness, adherence to routines, has highly restricted interests and focuses his thoughts and behaviors on repeating things and engaging in repetitive behaviors, in contrast to a person with OCD, a person with ASD is not bothered by his thoughts and behaviors, may not want to stop the thoughts, and may likely enjoy his specialized interests. With OCD, symptoms can wax and wane and the focus of the OCD can change over time. In persons with ASD, symptoms are typically recognized before 24 months of age, but may look differently at different stages of life.
Ryan began exhibiting repetitive behaviors when he was only one year old. He thoroughly enjoyed opening and closing doors, whether it was the microwave, a cupboard door, or closet doors. I thought this was rather odd, but at the time I did not make the connection to autism. Another repetitive behavior he had very early on was an interest in walking the stairs. When we would go to my brother’s or sister’s houses, he would repeatedly walk up and down the stairs. I attributed this to the fact that stairs were a novelty to him, since we had no stairs in our home. Around the time Ryan was 18 months old, I began putting the pieces of the puzzle together and realized that I was seeing more than just a repetitive behavior. It was at this time that my brother, pediatric neurologist Joe Barber, completed an evaluation and gave Ryan the diagnosis of ASD.
Over the years, Ryan has always had some repetitive behaviors that, for him, are calming and reduce anxiety. What I learned at the conference was that these behaviors that I see are not OCD-related, but in fact another symptom of autism.
The OCDFWPA has a wealth of resources on their website, which I encourage you to review: http://www.ocfwpa.org/resources1.html.
I hope you all have a wonderful Mother’s Day this weekend!