Is insistence on sameness linked to executive function differences in autism?

PostedDecember 9, 2025

UpdatedDecember 9, 2025

ByMy Patient Advice

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

Yes, executive function and sameness in autism are closely related. Executive function is the brain’s ability to plan, shift focus, manage time, and handle new information. When these processes are challenged, routines become a protective strategy. That’s why executive function and sameness in autism often go hand in hand, especially when navigating uncertainty or unexpected change.

Autistic individuals may struggle with transitions, flexible thinking, or managing multiple tasks. These traits align with autism executive dysfunction, where difficulties in organising and adjusting behaviour can lead to a strong preference for predictability. What may look like stubbornness is often rooted in neurological processing differences. For example, rigid thinking in autism can make it hard to consider alternatives or accept changes, reinforcing sameness-seeking behaviour. Additionally, challenges with planning organisation in autism can mean a structured routine reduces the cognitive load, making daily life feel more manageable.

What This Might Look Like Day to Day

Some common signs linked to executive function challenges:

Trouble with transitions

Difficulty stopping one task and starting another without distress.

Fixation on routines

Needing to perform steps in the exact same order to feel calm.

Avoiding new tasks

Hesitation or refusal to try unfamiliar activities due to fear of unpredictability.

Recognising the executive function link helps reframe sameness not as resistance, but as support.

Visit providers like Autism Detect for personal consultations and executive-support 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.