Autism Awareness Campaign - Obsession

In next few posters I will be touching upon some of the behavioural issues associated with Autism. Many of these may not be known widely. From an awareness point of view, they are very important.  Managing behavioural issues is what the parents, care givers, doctors and psychologists are grappling with throughout the life of an autistic individual. 

A young person with Asperger’s Syndrome (which is also being considered within autism spectrum) wrote. “My mind was constantly whirring with thoughts, worries, and concerns.  The time spent with my obsession was the only time in which I had a clear mind - it gave me that much sought-after relaxation”.

Here “Obsession” seems to give the person the much needed relaxation.  The obsession is nothing but intense and highly-focussed interests seen in majority of the autistic persons.  It can be art, music, trains, computers, car registration numbers, bus or train time tables, postcodes, traffic lights, numbers, shapes of body parts such as feet or elbows.  Autistic people often report that the pursuit of such interests is fundamental to their well being and happiness.  It is the intensity and duration of a person’s interest in a particular topic or object that marks it out as an obsession.  

Don’t we the Neurotypical individuals also have obsessions? Yes, we do.  Then why it is considered to be a predominant behavioural issue in autistic persons? Such obsessions are known as Obsessive Compulsive Disorder (OCD).  OCD is seen in general population also, limited to about 2%, whereas in autistic population it is quite high.  

Symptoms of OCD are more or less the same in autistic and non-autistic persons.  But, the treatment approach is very different. A person with autism who is absorbed in rocking or hand flapping or who insists on playing with the same toy every day at the same time is generally doing so without consciously thinking about the behaviour.   Autism persons may hum obsessively, for example, in order to drown out subtle noises that Neurotypical individuals would never notice.  [My daughter Pratibha has quite a few obsessions, one of them being, keeps humming in different situations such as when she plays sitar, when she cooks, when she tries to concentrate on any activity.]  In contract, a non-autistic person with OCD exhibiting the same behaviours is doing so consciously.  Their thought process latches onto the behaviour as an obsession, and they perform it ritualistically out of a fear of bad things happening if they cannot complete the ritual.  Their disorder is based around their thoughts and the coping mechanisms that use to deal with those thoughts. 

Answers to the following questions would decide whether any help is needed to control the obsessions. 

1. Does the person distressed when engaging in the behaviour or trying to resist the behaviour? 
2. Is the person unable to stop the behaviour independently? 
3. Is the behaviour impacting on the person’s learning? 
4. Is the behaviour limiting the person’s social opportunities? 
5. Is the behaviour causing significant disruption to other people, e.g. parents, caregivers and family?

Applied Behavioural Analysis (ABA) based techniques seem to help in managing some of the obsessive behaviours.