How does age affect insistence on sameness in autism?

PostedDecember 10, 2025

UpdatedDecember 10, 2025

ByMy Patient Advice

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

The relationship between autism and age is particularly important when looking at how individuals respond to change. Many autistic people show a preference for routine, but the strength and visibility of this can shift over time. Understanding autism and age gives families and professionals better insight into how needs evolve and how support can adapt.

During early years, routines often provide security. Predictable activities help children make sense of their environment. Yet as development continues, the picture becomes more complex. Research on the developmental stages of autism suggests that insistence on sameness may ease for some as coping skills improve, while others continue to experience challenges well into adulthood. The insistence on sameness across lifespan can therefore look very different depending on the individual, highlighting the need for flexible approaches. Subtle age-related differences of autism also affect how rigidity is noticed: what may be seen as quirky in childhood can become more problematic in adolescence or the workplace.

How it shows up at different ages

Below are some common ways sameness behaviours can appear at various life stages:

Childhood:

Children may become distressed when daily routines are altered, such as bedtime rituals or school schedules.

Adolescence:

Teenagers often struggle when social expectations or academic demands disrupt established patterns.

Adulthood:

Adults may stick rigidly to habits around work, meals, or leisure, sometimes clashing with the flexibility expected in professional or social settings.

Recognising these changes helps in planning tailored strategies.

Visit providers like Autism Detect for personal consultations and guidance across age groups.

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.