OCD & Autism — Understanding the Difference (and the Overlap)

OCD (Obsessive Compulsive Disorder) and autism can sometimes look similar, but they are not the same thing. Understanding the difference helps ensure children receive the right kind of support.

In autism, routines, repetition, and sameness are often:

    •    Comforting

    •    Regulating

    •    Enjoyable or grounding

    •    Related to sensory needs or predictability

These behaviors usually help the child feel calm, safe, and organized.

In OCD, behaviors are driven by:

    •    Intrusive or distressing thoughts (obsessions)

    •    Fear that something bad will happen if a behavior isn’t completed

    •    Anxiety relief that is temporary

    •    A strong internal pressure of “I have to,” rather than “I want to”

The key difference is the emotional experience:

    •    Autism-related routines are typically calming or neutral

    •    OCD-related behaviors are often distressing and anxiety-driven

Important reminder:

A child can be autistic and have OCD. When both are present, support should be individualized and thoughtful, focusing on reducing distress while respecting the child’s neurodiversity.

If a behavior appears to bring comfort and regulation, it may be serving an important purpose. If it causes distress, fear, or interferes with daily life, it may be worth exploring further.

Understanding the why behind behavior is always the first step.

Disclaimer:

This information is for educational purposes only. We do not diagnose medical or mental health conditions.