Kelly Scott Moroz, April 2012Obsessive Interests and the Autism Spectrum
In his must-read book, The Complete Guide to Asperger's Syndrome, Tony Attwood discusses how, although people with Asperger's Syndrome have difficulties with the interpersonal aspects of life, most have remarkable ability in a chosen area of expertise; this interest often includes the accumulation and cataloging of objects or facts and information about a specific topic. The special interest is more than a hobby, can dominate the person's free time or conversation, and the focus of the interest is often eccentric. Attwood notes that children and adults with Asperger's Syndrome are more prone to having high levels of anxiety, and that their routines or rituals may develop as a coping mechanism for the unusual profile of cognitive abilities associated with Asperger's Syndrome. He presents an interesting theory that these routine-oriented behaviours might make life more predictable and help to impose some form of order, as surprises, chaos, and uncertainty are not easily tolerated by children and adults with Asperger's Syndrome. Attwood believes that these special interests serve several possible functions for the individual. The present article addresses the possibility that these special interests may contain an obsessive-compulsive theme with implications for better understanding and altering these behaviours so as to decrease social ostracizing.
Though not all individuals with a diagnosis within the Autism Spectrum will develop and partake in these special interests, so many individuals do that it is included as a potential diagnostic variable in all subtypes of the Autism Spectrum (Autism, Asperger’s Syndrome, Pervasive Developmental Disorder-Not Otherwise Specified). Attwood postulates that some potential explanations for these intense fascinations include helping to overcoming anxiety (the individual’s relative strength in the ability to acquire knowledge and facts can be a way of reducing anxiety, particularly about a subject area that initially causes them great fear, such as an individual obsessed with weather patterns who used to be phobic of tornadoes), as a source of pleasure (e.g., the interest is linked to a memory of a happier or simpler time, pleasure derived from mastering a particular skill), as a means of relaxation (repetitive activities can help a person reduce feelings of stress and relax in the predictability of routine), in an attempt to achieve coherence (the interests often involve order, such as in cataloging information or creating tables or lists), as a method of helping to understand the physical world (as opposed to exploring the social world), creating an alternative world (because, too often, these individuals real life is often associated with a lack of success with friendships, and an alternative world may provide as a pleasant escape), providing a sense of identity (people with Asperger's Syndrome often describe themselves in terms of their interests rather than their personality), and to occupy time, facilitate conversation, and indicate intelligence (there is often a comfortable assurance and fluency for the individual if the conversation is about the special interest). I believe that the potential exists for some or all of these explanations. It is noteworthy to mention, however, that approximately 25% of adults diagnosed with Asperger's Syndrome also present with clear clinical signs of Obsessive-Compulsive Disorder (OCD). Individuals with OCD experience intrusive thoughts that he or she does not want to think about (they are typically distressing and unpleasant); they engage in compulsive behaviours or rituals to reduce the stress produced by such obsessions, albeit in a superstitious manner. Since individuals who present within the Autism Spectrum in general often evidence significant signs of anxiety, it is possible that engaging in these intense interests and fascinations serves as to reduce overwhelming feelings of stress, at least temporarily. It is extremely common for children and teenagers within the Autism Spectrum to report getting negative thoughts about situations that occur during the day stuck repetitively, as if on a loop, in their minds. Many parents of these children report that they tend to have a release, in the form of a meltdown, shortly after returning home from school or a social endeavor; the build-up of such thoughts is eventually too much to handle for them.
Attwood indicates that the obsessive thoughts of children and adults with Asperger's Syndrome are much more likely to surround cleanliness, bullying, teasing, or making a mistake and being criticized. Compulsive behaviours that these individuals engage in tends to surround repetitive actions, such as ensuring that objects are in a line or symmetrical, hoarding or counting items, or having a ritual that must be completed before the child can fall asleep. Clearly, these compulsions have a superstitious flare to them (read Mark Haddon’s, The Curious Incident of the Dog in the Night to further explore this point). Engaging in compulsive or ritualistic behaviours to decrease feelings of stress tends to help individuals with OCD experience relief in the short term, but, in the long run, the effect is like drinking salt water to quench one’s thirst. With many of the children whom we work with at our office (who present within the Autism Spectrum), we often notice that the longer these children are permitted to talk about or play with their special interest activity, the greater the likelihood that they will become uncomfortable and irritated when their pattern is disrupted. For many of these children, playing or talking at great length about these special interests results in further isolation from their peers, who tend to share more common interests or engage in activities that can be enjoyed together.
Many professionals who work with children in the Autism Spectrum see value in permitting these youngsters to play their own way when they are at home, away from social experiences. For those children who become much more rigid in their play and engage in more repetitive type of play, however, it is noteworthy to mention that such behaviours will likely continue to create more anxiety than the stresses they initially reduce in these children. We therefore recommend that parents and professionals keep their eyes open to the possibility that these intense fascinations have a risk of becoming problematic for their child. As such, we believe that it is important to intervene, likely through the use of reward systems, to teach these children more appropriate ways of playing and interacting. We also believe that traditional treatment approaches geared to individuals with OCD (that go well beyond the scope of the current article), such as thought delaying procedures and variations of Exposure Plus Response Prevention, will likely be of benefit at some point in the lifespan of an individual with Asperger’s Syndrome or the Autism Spectrum in general.
References: Attwood, T. (2007). The Complete Guide to Asperger’s Syndrome. Philadelphia, PA: Jessica Kingsley Publishers.