How does insistence on sameness make transitions between routines difficult in autism?

PostedDecember 10, 2025

UpdatedDecember 10, 2025

ByMy Patient Advice

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

The connection between autism and routine transitions is crucial in understanding why moving from one activity to another can be so challenging. Many autistic individuals rely on predictability for comfort, and when routines shift, stress levels often rise. By looking closely at autism and routine transitions, we can see how insistence on sameness adds extra barriers to flexibility.

Researchers note that transition challenges in autism are often tied to the need for structure. A sudden switch such as leaving playtime for dinner can feel abrupt and overwhelming. This highlights the role of insistence on sameness barriers, where even minor shifts may be experienced as a loss of control. While routines provide stability, they can also make adaptation harder, contributing to difficulty with change in autism in school, work, and family life.

How transitions may be affected

Here are some ways insistence on sameness can make moving between routines more difficult:

Emotional reactions

Transitions may trigger frustration, resistance, or anxiety when expected patterns are disrupted.

Behavioural responses

Meltdowns, withdrawal, or repeated questioning may occur when the new activity feels unpredictable.

Need for preparation

Many individuals cope better when changes are explained in advance, often with visual cues or time warnings.

Understanding these responses helps families and professionals plan smoother transitions with empathy and support.

Visit providers like Autism Detect for personal consultations and practical guidance tailored to individual needs.

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.