ASD or OCD? An evidence-based differentiation of repetitive behaviors

While distinct diagnoses, the behavioral presentation of ritualistic/repetitive behaviors seen in obsessive compulsive disorder (OCD) and autism spectrum disorder (ASD) can present similarly. This results in difficulty with accurate diagnosis and implementation of evidence-based treatments. OCD is characterized by prolonged and recurrent unwanted thoughts, known as obsessions, which cause a feeling of intense anxiety or distress. As a result, people with OCD perform repetitive behaviors known as compulsions to help alleviate distress. ASD is characterized as a developmental disorder causing persistent challenges associated with social communication, restricted and repetitive behaviors (RRB), and impairment in functioning. While the definitions are distinct, accurate conceptualization is not always clear. The picture can become even more complex with comorbidities. To parse these behaviors apart, we can consider the course of the behavior and assess the function. With better ability to differentiate, we can have a clearer picture of how to support the youth and family.