Different Diseases Sometimes Similar Symptoms
OCD and autism are individual conditions but they have symptoms that overlap and that can make diagnosis difficult even among seasoned therapists. For example, both OCD and autism involve repetitive and compulsive behaviors as well as agitation when those compulsions are interrupted. However, the underlying reasons for those behaviors are different.
People with OCD are typically mindful of these behaviors and aware that theyre acting irrationally. They engage in compulsions intentionally, with reason, and as a way to neutralize their anxiety and stop their intrusive thoughts from coming true. They cannot swap out one ritual for another and feel as though they need to perform whatever ritual their OCD dictates. Without treatment, their obsessions and compulsions tend to get worse over time.
On the flipside, people with autism are generally not aware of their behaviors and engage in compulsions subconsciously or on an innate level. They also engage in compulsions not as a way to stop something from happening but as a way to relieve agitation, drown out noises, feel more secure in their environment, or get some other biological reward. Their compulsions are not ritualized and they can swap out one for another at will. Symptoms tend to moderate as the person ages.
Differentiating between the two diseases is vital to proper treatment, treatment that is unique to each condition. But what happens when people have OCD and autism?
The Connection Between OCD and Autism
Aspergers Syndrome/asds And Ocd
Obsessive-Compulsive Behaviors are typically associated with Aspergers syndrome and are often a major obstacle to making improvements. Whether or not AS will be folded into a new Autistic Spectrum Disorders category in the upcoming version of the American Psychiatric Associations Diagnostic and Statistical Manual, DSM-5, the importance of early identification and finding effective ways to address OCBs in this population will remain undiminished.
Because they inter-mingle and cross boundary markers with rigidities, perfectionisms, perseverations, stereotyped behaviors, habits, impulsivities, and some kinds of tics, arriving at an exact definition of OCBs can challenge even experts in the field. However, sometimes OCBs are so prevalent, systematized, and time consuming that Obsessive-Compulsive Disorder is diagnosed as a separate condition co-occurring with AS. Like Aspergers and related ASDs, OCD is often associated with problems in social functioning however, in primary OCD, social deficits tend to be much less severe and pervasive and are not embedded in the context of distinctive autistic spectrum problems like mind-blindness, idiosyncratic mannerisms and communication style, or being extremely literal.
A Parent Wonders: Are New Repetitive Behaviors Ocd Or Just Autism
May 16, 2014
Our 25-year-old son, diagnosed with PDD-NOS, has always had some repetitive behaviors. Lately, though, hes wanting to redo things such as getting undressed or showering right after hes done. Hell insist we backtrack if we drive through the neighborhood a different way because we didnt go the right way. Can you offer guidance on whether these behaviors are obsessive compulsive disorder or just part of his autism? What might help?
This weeks Got Questions? answer comes from clinical psychologist and associate professor Judy Reaven, of The Childrens Hospital and the University of Colorado School of Medicine, in Denver. Both institutions are part of the Autism Speaks Autism Treatment Network.
Great question. A number of psychological disorders including obsessive compulsive disorder, or OCD frequently co-occur with autism. But its also true that some symptoms of autism overlap with those of other disorders such as OCD. So it can be difficult to distinguish those that are related to an individuals autism from those that are part of another condition.
Obsessions vs Special InterestsOCD is often confused with the special interests or preoccupations characteristic of autism. However, OCD is less about obsessive interests, which can be quite enjoyable. Its more about behaviors that an individual feels driven to perform to reduce great distress or anxiety.
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What Should You Not Say To Someone With Ocd
What Not to Say to Someone With Obsessive-Compulsive DisorderDont worry, Im kind of OCD sometimes, too.You dont look like you have OCD.Want to come over and clean my house?Youre being irrational.Why cant you just stop?Its all in your head.Its just a quirk/tic. It isnt serious.Just relax.More itemsMay 21, 2015
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What We Did Next
Careful observation and recording of Kians behaviors and his reaction levels to rituals that were purposely interfered with by staff started to give us a picture of the strongest behaviors that were OCD led as opposed to those that were relieving sensory regulation needs. These were shared with the whole team so that the correct intervention was matched to the root drive. Ritualistic behavior, such as the drive to walk around the room or bounce on the trampoline were allowed as these were relieving a sensory need. However rituals related to OCD, such as opening and closing doors were time and place limited and over time prohibited.
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Stimming Vs Ocd: Different Motivations
OCD children are constantly bombarded with terrifying thoughts about imminent danger which cause a state of panic leading to obsessive behaviors. Children with autism do not tend to think about their stim as a purposeful action.
Professor Temple Grandin, a knowledgeable and trustworthy expert on autism, says: Most kids with autism do these repetitive behaviors because it feels good in some way . This statement is a powerful description of the difference between a person with autism who stims and the compulsive rituals of someone with OCD.
Explaining Seizures To Children With Epilepsy And Their Peers
Sometimes it can be difficult for children to understand what is happening when they are having a seizure. In addition, it can be very scary for their peers or friends who witness them. Autism Speaks has put together Visual Stories to explain to children how people with epilepsy are just like everyone else!
Visual Story for Peers of Children with EpilepsyIf a family member suffers from seizures, you may want to consider a medical alert bracelet that can inform first responders of the seizure disorder and any medications that the individual may take. There are a variety of options available on the internet.
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Interactions And Differences Between Ocd And Autism
Autism spectrum disorder symptoms are more common in children and adolescents diagnosed with obsessive-compulsive disorder, and there is a significant relationship between obsessive-compulsive disorder and the severity of autism symptoms. Further studies are needed to investigate genetic and environmental common risk factors in obsessive-compulsive disorder and an autism spectrum disorder.
There is no uniform treatment for autism, as everyone with the disease presents it differently. Therapies and strategies are available to manage the health problems that often accompany autism. These issues can be epilepsy, depression, obsessive-compulsive disorder , and sleep disorders.
While not all of these treatments will be effective for all people with an autism spectrum disorder, there are many options to consider that can help people cope with it. Autism experts or psychologists can refer a person to a treatment that reflects autism presentations.
Even though it looks like autism and OCD do not have many common points, according to researchers and professionals there is an overlap between them. There is a huge percentage. Besides, there are many people who did not get diagnosed with autism but they have autism and OCD.
Theres More To Autism Than Meets The Eye
The following information on autism and its accompanying medical and mental health issues is not meant to diagnose or replace the care of a trained and licensed healthcare professional. This is not meant to be used in place of a personal consultation. There are a number of medical and mental health issues that frequently accompany autism spectrum disorder. Many people dont realize that autism and other health issues are interrelated. These interrelated issues can include:
- Obsessive Compulsive Disorder
Autism and ADHD
Autism and ADHD have long been linked. Parents commonly report ADHD-related problems in their children with autism. Its also been found that these problems impact the function and quality of life. A 2011 study found common genetic factors in individuals with ADHD and autism. Medications can be used to ease ADHD symptoms but should be used in conjunction autism-specific behavioral therapies. Medications, typically stimulants, that might be prescribed are Ritalin, Metadate, Concerta , Adderall , Dexedrine and Vyvanse . The use of stimulants can produce side effects such as decreased appetite, irritability, emotional outbursts and difficulty falling asleep. It may take several tries to find the right dosage to treat ADHD symptoms.
Autism and OCD
Autism and Anxiety
Autism and Depression
How We Can Help You?
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Assessment Of Autism Spectrum Disorder And Other Mental Illness
For cohort members and their parents, data were extracted for diagnoses of autism spectrum disorders , OCD , anxiety disorders , depression , attention deficit hyperactivity disorder , and mental disabilities assigned by adult or child psychiatrists. Additionally, we assessed their psychiatric history, whether they had ever been admitted to a psychiatric hospital or been in outpatient care for a diagnosis of a psychiatric disorder . Date of diagnosis was defined as the first contact that led to the diagnosis of interest, irrespective of other previous psychiatric diagnoses in the case history. Parental diagnoses were classed hierarchically as non-mutually exclusive events. Information about parental age and place of residence at time of birth was obtained from the Danish Civil Registration System. For research purposes all personal information from the registers are anonymized. The Danish Data Protection Agency fully approved the study.
Ocd And Autism: Unpicking Childrens Behavior In A Dual Diagnosis
Unregulated behaviors in children on the autism spectrum and the common reasons behind these are well documented with a wealth of strategies for parents and educators to try.
For those parenting a child with an actual or suspected dual diagnosis of autism spectrum disorder and Obsessive Compulsive Disorder there is far less understanding of the effect of the combined conditions by professionals and even less helpful support in terms of materials and interventions.
Anxiety led behaviour and the need for control of the environment is common in both conditions. However the reasons for the need for control are different. The common mistake is to treat all anxiety led behavior in the same way using evidence based ASD interventions.
Unfortunately, some of these interventions can exacerbate anxieties and behaviors if they have an OCD root. This can leave parents and educators alike feeling de-skilled and unsure of where to turn to for help.
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Top Tips For Relieving Anxiety In A Child With Ocd
What If Youre Autistic And You Have Ocd
You can have both diagnoses. Some people are only aware of one diagnosis.
Researchers are learning more about brain similarities between the two conditions. People with OCD and autism share the trait of increased gray matter in a brain region called the caudate nuclei . The CN is associated with restricted and repetitive behaviors.
Treatment can be tricky because although many behaviors shared by OCD and autism seem very similar, the causes behind them are quite different.
The goal of autism and OCD treatment is to improve a persons quality of life. Sometimes no change is needed if the autistic person isnt bothered by traits like mild stimming or restricted interests.
Treatment will depend on what condition is causing stimming.
For example, if repetitive behavior is an autism stim, then an OCD-targeted treatment likely wont help since autism stims arent fear-driven.
However, if what looks like stimming is actually OCD rituals, then treatment can target the fearful thoughts that trigger those rituals.
Treatment options include:
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Ocbs And Animal Models
Given the multiple symptom domains of autism, animal models often focus on a single symptom domain such as communication measured by behaviors like ultrasonic vocalizations . Within the restrictive, repetitive domain, OCB animal models have attempted to capture the range of behaviors in ASD by studying stereotyped motor movements, repeated manipulations, repetitions leading to self-injury, to models of cognitive rigidity related to rituals and inflexible or circumscribed behaviors . Behavioral genetic approaches related to ASD have examined manipulations on a range of candidate genes and have methods to study IS or change in habit through reversal learning tasks . Carefully designed behavioral tasks for Assessing a broader range of repetitive behaviors in ASD have been utilized to test existing inbred strains of mice that may translate to ASD findings . Recently, it was reported that FKBP12 mutant mice exhibited perseverative or repetitive behavior in the marble burying task, water maze, Y-maze reversal task, and the novel object recognition and could be a model for ASD or OCD . There is treatment or therapeutic potential because FKBP12 binds the immunosuppressant drugs FK506 and rapamycin as well as regulating several signaling pathways, including mammalian target of rapamycin signaling that is disrupted in Tuberous Sclerosis.
Be Your Own Ocd And Autism Practitioner
The good news is, that as a parent or educator of a child sharing a dual condition, you are in the best place to observe your child and begin to unpick his/her behavior and the underlying causes. Starting with the response HELP! I dont understand and I dont know what to do, is actually a great place to begin. It is the questions that we ask ourselves that lead us to make discoveries that turn situations around.
We know that every child with combined ASD and OCD barriers is a different child, so the questions we need to ask ourselves will need to match our childs individual situation. There is a lot to learn from those who have been there before us however and so reading about or listening to others who have been in a similar situation is another important step to positive change.
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Helping Autistic Adults With Ocd
Obsessive-compulsive disorder is typically diagnosed in late adolescence, although it can be recognized in children before then. Adults and teenagers with autism are more prone to OCD than their peers without autism.
OCD-related thoughts and behaviors can get in the way of social interactions and make friendships difficult. The disorders symptoms can also make it hard to keep up with schoolwork or hold down a job.
Adults with comorbid OCD and autism can benefit from various treatment approaches.
- Support groups: These peer support groups provide structured social interactions in a safe and secure environment, helping individuals to feel more connected and less isolated.
- Social skills groups: These groups teach real-life skills that help members to function in everyday life. These skills can help with obtaining and maintaining a job as well as with self-care to foster independence.
- Medications: These can be helpful to manage anxiety symptoms, but they can also come with side effects that may be enhanced in people with autism. Talk to your doctor about the potential benefits versus the risks.
- Therapy: Group and individual therapy aims to work on specific symptoms of both OCD and autism. In therapy, clients can develop coping skills and tools for everyday life.
Managing Ocd In Autistic Children
Research is ongoing to discern the environmental risk factors for OCD. However, we know that because it is an anxiety disorder, it can be triggered by prolonged and pronounced stress. Increased anxiety can lead to OCD behaviors as well as emotional and physical outbursts.
For parents, keeping your child safe is the first concern. To do this, the goal is to keep your child calm and reduce potential stressors.
Here are some tips:
Talk to your childs doctor about your concerns if you suspect OCD, autism, or both. Early intervention and treatment for autism can help to reduce anxiety as well as manage symptoms of autism. This translates to a better overall quality of life and a higher degree of productivity and functioning.
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Association Between Autism Traits And Ocd Symptoms
Table 2 shows the results of linear regression analyses to examine whether AQ total score and each AQ subscale score are associated with Y-BOCS total score. In the crude model, total AQ score and all subscale scores except attention to detail were significantly associated with Y-BOCS score. In Model 1, which adjusted for confounders, a higher total AQ score and higher subscale score for imagination were positively associated with OCD symptoms. The coefficients of the associations between total AQ score with Y-BOCS remained, even after adjusting for the well-being score .
Table 2. Association between AQ Total score and each sub-scale score and Y-BOCS.
In the sensitivity analyses , the internet-survey participants showed a similar coefficient of total AQ score . Contrastingly, subscale score for communication was positively associated with Y-BOCS instead of imagination .
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