What is insistence on sameness in autism?

PostedDecember 9, 2025

UpdatedDecember 19, 2025

ByMy Patient Advice

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

Insistence on sameness in autism refers to a strong preference for routines, rituals, or familiar environments. It often shows up as resistance to change, even with small daily shifts. This tendency is not about stubbornness; it’s a way some autistic individuals create predictability and safety in a world that can often feel overwhelming or chaotic.

Many autistic people rely on routine to help manage sensory input, anxiety, or social challenges. Unexpected changes like a different route to school or a new teacher can lead to distress, meltdowns, or withdrawal. By sticking to familiar patterns, they reduce the unpredictability that often feels emotionally or physically overwhelming.

How It Might Show Up

These behaviours vary from person to person, but here are a few common ways they can present:

Rigid routines

A person may need to follow the exact same morning sequence, eat the same foods, or wear the same clothes every day.

Repetitive questions or scripts

Some may ask the same question multiple times or repeat set phrases to reassure themselves things are staying the same.

Resistance to change

Even positive changes, like a fun surprise, can cause stress or anxiety if they disrupt expected routines.

What looks like inflexibility is often a deeply rooted need for security. Recognising insistence on sameness in autism helps caregivers and educators better support transitions and adapt environments.

Some call this sameness behaviour in autism, and it sits alongside traits like autism and repetitive behaviours and autism rigidity, forming a pattern many clinicians recognise early in diagnosis.

Visit providers like Autism Detect for personal consultations and practical strategies to support transitions.

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.