Do autistic children have obsessions and compulsions?

Abstract

Autistic children are frequently reported to show obsessions and compulsions. This terminology implies that such behaviours in autism are similar to those seen in obsessive-compulsive disorder. However, these autistic behaviours fail to satisfy the definitions of either obsessions or compulsions, because essential subjective data (relating to unwantedness, distress, resistance, senselessness and egodystonia) are not available in the case of autistic children. Recent cognitive evidence suggests that this is because autistic children are unable to contemplate or talk about their own mental states. Because of this state of insufficient evidence, it is suggested that the terms obsession and compulsion should be used with considerable caution to describe autistic behaviours. In this paper, the more descriptive term 'repetitive activities' is used. To gain a better understanding of such repetitive activities in autism, functional analyses are needed. Examples of such analyses are discussed, and predictions from a social-cognitive deficit theory of repetitive activities are specifically considered. The paper aims to encourage research into this neglected area.