How do developmental changes affect insistence on sameness over time?

PostedDecember 9, 2025

UpdatedDecember 9, 2025

ByMy Patient Advice

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

The developmental changes of sameness in autism reflect how this trait can shift across age, environment, and experience. In early childhood, sameness may be highly visible: rigid routines, meltdowns over small changes, or repeating the same phrases. However, the developmental changes of sameness in autism often involve changes in how that need for predictability is expressed, not whether it exists.

During adolescence and autism sameness, changes in social settings, educational demands, and emotional awareness can make these behaviours more internalised. A teen might no longer line up toys but may still need exact routines before school or struggle when a familiar teacher is replaced. Across the lifespan and autism behaviours, coping strategies and support can help reduce the impact of sameness-driven stress but the underlying need often remains. In adulthood and sameness in autism, preference for routine might look like choosing the same brand of clothing, following structured schedules, or avoiding spontaneous plans.

How It Might Evolve

Examples of how sameness shifts with development:

Childhood

Loud distress when a bedtime story is skipped or altered.

Teen years

Withdrawal or irritability when school timetables change unexpectedly.

Adulthood

Reluctance to switch jobs, try new foods, or alter long-standing routines.

Recognising how sameness matures with the person helps build more sensitive, adaptive support over time.

Visit providers like Autism Detect for personal consultations and age-specific strategies.

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.