How does autism affect deciding which task to do first?
Deciding which task to do first can be difficult for many autistic people because this skill relies on executive functioning, including planning, organisation, sequencing, working memory, and cognitive flexibility. According to the NHS, these differences can make it harder to start tasks, understand what is most important, or shift between activities during the day.
Why prioritising tasks can be challenging
Executive functioning differences play a major role in these difficulties. The National Autistic Society explains that many autistic people find it easier to work with clear, predictable routines and struggle when tasks have unclear order. Reduced cognitive flexibility can make it difficult to change plans, while working memory challenges can lead to losing track of steps or forgetting what needs to happen next. Sensory overload and anxiety, particularly around uncertainty, can further complicate decision-making.
A 2024 study published in Autism Research found that executive functioning, including prioritising and sequencing tasks, strongly predicts daily-living independence in autistic adults.
Impact across home, school, and work
At home, difficulties deciding what to do first may affect self-care routines or managing multiple chores. In school settings, challenges with planning and sequencing can make it harder to organise assignments or prepare for exams. According to NICE CG170, these executive functioning differences can also affect transitions between activities and managing workloads. In work environments, prioritising tasks may become stressful when demands shift quickly or instructions lack clarity.
Evidence-based supports
NHS, NICE, and the National Autistic Society recommend several strategies to support prioritisation:
- Visual schedules and diaries: making the order of tasks visible helps “externalise” the plan.
- Step-by-step lists or checklists: breaking tasks into smaller stages supports task initiation.
- Colour-coding or decision matrices: highlighting urgent vs important tasks helps guide choices.
- Written instructions and reminders: providing clarity and supporting working memory.
- Environmental adjustments: such as decluttering, reducing distractions, or labelling work areas.
Occupational therapists often use task analysis, modelling, and external prompts to build prioritisation skills. The SPELL framework also emphasises structure, predictability, and clear communication to reduce anxiety around decision-making.
A 2025 systematic review published on PubMed reported that structured visual supports and OT-led interventions significantly improve task prioritisation and reduce anxiety in autistic adolescents and adults.
Takeaway
Autism can affect how easily someone decides what to do first because of differences in executive functioning, sensory processing, and uncertainty. With the right supports, including visual tools, step-by-step structures, and predictable routines, many autistic people can navigate task prioritisation more confidently and independently.
