Does insistence on sameness decrease over time in autism?

PostedDecember 10, 2025

UpdatedDecember 19, 2025

ByMy Patient Advice

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

The question of insistence on sameness over time is one that families and professionals often ask. Some individuals show greater flexibility as they grow, while others maintain strong preferences for routine well into adulthood. Understanding insistence on sameness over time means recognising that changes depend on personality, environment, and support strategies.

Research into developmental changes in autism suggests that sameness behaviours may shift with age. For some, coping skills improve, making it easier to handle unexpected changes. Others, however, continue to find disruptions very distressing, showing that sameness is not simply something people “grow out of.” Studies of routine rigidity during lifespan show that while the outward intensity may reduce the underlying need for predictability often remains. Similarly, sameness progression in autism depends heavily on individual experiences: supportive environments can encourage flexibility, while stressful or unpredictable ones may reinforce rigidity.

How sameness may shift over time

Here are a few ways insistence on sameness can change with age:

Childhood

Children may react strongly to small disruptions, such as a favourite toy being moved.

Adolescence

Teenagers may develop coping skills, but stress from school or social life can still make flexibility difficult.

Adulthood

Adults often adapt rituals into structured habits that fit work or home life, though rigidity may still appear under pressure.

Recognising these patterns helps families plan support across different life stages.

Visit providers like Autism Detect for personal consultations and guidance.

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.