How does IQ impact 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 IQ is often explored when looking at patterns of rigidity and routine. While insistence on sameness is a recognised feature across the spectrum, research shows that autism and IQ interact in complex ways, shaping how these behaviours appear and how they are managed.

Some studies suggest that cognitive ability in autism may influence both the intensity and expression of sameness behaviours. For example, individuals with higher intellectual skills may channel their routines into structured hobbies or interests, while those with greater support needs may struggle with even small changes in daily life. This helps explain the wide insistence on sameness variation seen across different individuals. Similarly, research into intellectual functioning in autism highlights that flexibility is not solely determined by IQ, but by a mix of coping strategies, environment, and personal differences.

How it may present across IQ levels

Below are some ways sameness behaviours can appear depending on intellectual profile:

Higher IQ profiles

Individuals may create highly structured personal systems, such as detailed schedules or rituals around study and work.

Moderate IQ profiles

Routines may dominate daily life, with visible anxiety if plans are altered or disrupted.

Lower IQ profiles

Even minor changes in environment or caregiving routines may lead to strong emotional reactions or behavioural distress.

Recognising these differences is vital to tailoring support at every level.

Visit providers like Autism Detect for personal consultations and personalised guidance.

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.