Does insistence on sameness manifest differently in different autistic people?

PostedDecember 9, 2025

UpdatedDecember 9, 2025

ByMy Patient Advice

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

Sameness and variation in autism is a key concept for understanding how diverse the autistic experience can be. While many autistic individuals show signs of preferring routine, the way these preferences show up varies greatly. The phrase sameness and variation in autism captures how one person’s strict bedtime sequence may be another’s reliance on repeating a single phrase for comfort.

This difference reflects individual differences in autism more broadly. While some may resist even the smallest change in their environment, others may only become distressed when social or emotional patterns shift. There’s no universal rule and that’s what makes recognising sameness across the spectrum so important during diagnosis and support planning. It also relates to variability in autism behaviours, which can shift over time, especially as children develop coping strategies or face new demands.

Examples Across Individuals

Here are a few ways sameness can present differently:

Strict routines

One child may insist on the exact same breakfast every morning.

Social repetition

Another might only talk about one topic or repeat specific questions in every conversation.

Sensory-based patterns

Some may engage in repetitive movements, like flapping or tapping, to create predictability in sensory input.

Acknowledging these differences helps families and professionals tailor support with greater empathy.

Visit providers like Autism Detect for personal consultations and guidance built around individual experiences.

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.