Does autism severity relate to how intense insistence on sameness is?

PostedDecember 10, 2025

UpdatedDecember 10, 2025

ByMy Patient Advice

Author: Beatrice Holloway, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

The link between autism severity and rigidity around routines is well recognised. Many studies suggest that the stronger the challenges, the more noticeable the drive for sameness becomes. Exploring autism severity in this context helps us understand why some individuals show mild discomfort with change while others experience overwhelming distress.

Researchers note that insistence on sameness intensity often increases when broader difficulties such as communication struggles or sensory sensitivities are present. This doesn’t mean every person with greater needs will always react more strongly, but patterns do emerge. Looking at autism spectrum levels provides a useful framework, as people at different points may display varying strengths and vulnerabilities. Similarly, symptom severity in autism can shape how flexible someone feels able to be, influencing both daily life and long-term wellbeing.

How it can present at different levels

Below are some common ways intensity may appear, depending on severity:

Milder presentations

A person may show discomfort when plans change but can recover with reassurance or coping strategies.

Moderate presentations

Rigid rituals may dominate daily routines, and disruption can cause heightened anxiety or distress.

Higher support needs

Even small changes may trigger strong reactions, sometimes making daily transitions very challenging.

Understanding these differences highlights the importance of tailored strategies.

Visit providers like Autism Detect for personal consultations and guidance suited to individual needs.

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to Insistence on Sameness.

Beatrice Holloway, MSc

Author

Beatrice Holloway is a clinical psychologist with a Master’s in Clinical Psychology and a BS in Applied Psychology. She specialises in CBT, psychological testing, and applied behaviour therapy, working with children with autism spectrum disorder (ASD), developmental delays, and learning disabilities, as well as adults with bipolar disorder, schizophrenia, anxiety, OCD, and substance use disorders. Holloway creates personalised treatment plans to support emotional regulation, social skills, and academic progress in children, and delivers evidence-based therapy to improve mental health and well-being across all ages.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.