How do unpredictable situations trigger insistence on sameness in autism?

PostedDecember 9, 2025

UpdatedDecember 9, 2025

ByMy Patient Advice

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

Unpredictability and sameness in autism are tightly connected. When routines are disrupted or events unfold without warning, many autistic individuals turn to sameness as a way to regain control. The unpredictability and sameness in autism link reflects how hard it can be to process change in real-time, especially when sensory, emotional, or social demands increase quickly.

This response is often tied to change intolerance in autism, where even small, unexpected shifts like a substitute teacher or a delayed meal can spark anxiety. The brain’s natural drive to find patterns and predict outcomes becomes overworked. That’s why sameness can be such a reliable fallback. During transitions in autism sameness, individuals may rely on repeated behaviours, phrases, or routines to restore a sense of calm. It’s also a keyway of managing uncertainty in autism, especially in new or chaotic environments.

How It Might Present

Here are examples of how this plays out in everyday life:

Repeated questions

Asking the same thing repeatedly when plans change.

Fixation on routine

Needing daily activities in the same order, especially during stressful times.

Resistance to surprises

Reacting with distress when spontaneous events or visitors appear.

Recognising these behaviours as responses to unpredictability helps families and educators support transitions more gently and with understanding.

Visit providers like Autism Detect for personal consultations and practical tools for reducing anxiety during change.

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.