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What role does behaviour therapy play in managing insistence on sameness? 

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

When it comes to autism and behaviour therapy, one of its key roles is helping individuals become more flexible with routines and expectations. Many autistic children rely heavily on predictable patterns to feel safe, but with guidance from autism and behaviour therapy, it’s possible to build tolerance for change over time. 

One well-established method is applied behaviour analysis in autism, which focuses on teaching alternative ways to respond when routines are disrupted. This might include gradually exposing the child to small changes, using rewards for flexibility, and modelling calm responses. These approaches are often central to insistence on sameness management, especially when rigidity affects learning or social interaction. 

Therapists aim not to remove routines altogether but to reduce stress when things don’t go exactly as planned. Through repetition and reinforcement, individuals learn to adapt without distress. This process is part of broader behavioural interventions that improve everyday functioning at home and school. 

What Progress May Look Like 

Below are signs that behaviour therapy is helping reduce insistence on sameness: 

Improved reaction to change 

The child remains calm when routines shift unexpectedly. 

Flexible task completion 

They can complete familiar tasks in different ways or settings. 

Decreased reliance on rituals 

Less insistence on repeating the same steps or using specific items. 

Greater emotional control 

Fewer meltdowns or shutdowns during transitions or surprises. 

When personalised and consistent, behaviour therapy can make daily life smoother.  

Visit providers like Autism Detect for consultations on customised strategies and family-based support. 

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to Insistence on Sameness.  

Beatrice Holloway, MSc
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
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. 

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