OCD and Autism: A Practical Guide for Australians

OCD and autism overlap: how are they connected?

Raising Children Network notes that some conditions occur with autism, and around 10% of autistic children are thought to have OCD (Raising Children Network).

• Is OCD linked to autism? They can occur together, so assessors ask about both, but they are not the same condition.
• Is OCD part of autism? No. OCD is its own diagnosis, even though both can involve repetition.
• Is OCD a type of autism? No. Autism is a lifelong neurotype, while OCD involves unwanted thoughts and repeated actions that cause distress.
• Is OCD on the autism spectrum? It is not, but it can sit alongside autism, as can anxiety.
• OCD and ASD (autism spectrum disorder) can both be present in the same person.

Difference between OCD and autism

Repetition looks similar from outside, but the experience behind it is often different. This table is for reflection only, and only a qualified professional can assess this.

Because the signs can overlap, ask a qualified clinician to help tell them apart.

High-functioning autism and OCD: why labels do not help

Labels such as “high-functioning” explain very little. Raising Children Network says an autism diagnosis gives support levels separately for social communication and for repetitive behaviour, special interests or sensory differences, the levels can differ, and they can change over time.

• An autistic person can need very little support in one area and a lot in another, such as sensory overload or transitions.
• Describe the specific things that are hard rather than relying on a label.
• Our guide to autism and tics shows how other repetitive movements are assessed.

OCD and autism in females

If you are a girl or woman, or supporting one, these steps can help when you talk to a clinician.

• If you mask, which means hiding autistic traits to fit in, mention this to your clinician.
• Tell your GP about patterns that happen at home or in private, such as checking, counting or repeating phrases, not just what others see.
• Ask for an assessor who understands how autism can present in girls and women.
• Explore related conditions in our guides on CPTSD and autism and ADHD and OCD.

TQN Care support workers help with personal care, community access, respite and help around the home across Sydney, Melbourne and surrounding areas (NSW & VIC). Tell us what you need and we will call you back.

Autism obsessive attachment and friendships

Strong attachment to a person, interest or routine can be part of autism and is not automatically a problem.

• Autistic people may form deep, loyal bonds and want frequent contact with a favourite person.
• Intense focus on a friend can be a natural way of connecting, not necessarily OCD.
• Concern is worth raising with a clinician if the focus causes distress, repeated checking or reassurance seeking.
• Help the person practise boundaries, taking turns and flexible plans in a calm, kind way.
• Support workers can help with social outings and community access at the person’s pace.

How to treat OCD in autism

Treatment decisions belong with a qualified clinician, but knowing the usual pathway helps you prepare.

1. 1Book a GP appointment. Describe the thoughts, rituals and distress, and bring notes about what happens at home, school and work.
2. 2Ask for a referral. A psychologist or psychiatrist with autism experience can assess whether OCD is present alongside autism.
3. 3Discuss therapy and medicine options. Ask what suits the person, including adjustments to therapy for autistic communication and sensory needs.
4. 4Involve the family and school. Share the plan so routines, expectations and responses are consistent and kind.
5. 5Review regularly. Never start, stop or change medicine without advice from your GP, paediatrician, psychiatrist or pharmacist.

NDIS and other support for OCD and autism

• The NDIS looks at how a permanent condition affects daily life, so keep clinician reports and a diary of support needs.
• Find out how funding works in our guide to autism funding.
• Autism Connect on 1300 308 699 is a free national helpline run by Amaze, open 8am to 7pm Monday to Friday (Amaze).
• Ask about whether OCD is a disability under the NDIS and other systems.
• Other conditions can occur alongside autism too, such as autism and seizures and autism and psychosis.

When to talk to a GP or specialist

• Rituals or intrusive thoughts take up large parts of the day or stop the person doing things they want to do.
• Distress, anxiety or avoidance are increasing, even if routines look the same to others.
• Sleep, eating, school attendance or relationships are being affected.
• The person has become withdrawn, hopeless or talks about harming themselves; call Lifeline on 13 11 14.
• Someone is in immediate danger: call 000 in an emergency.

TQN Care support workers help with personal care, community access, respite and help around the home across Sydney, Melbourne and surrounding areas (NSW & VIC). Tell us what you need and we will call you back.

Your next step

If OCD and autism make everyday life harder at home or in the community, practical help can lighten the load. TQN Care’s support workers help with personal care, community access, respite and help around the home, never with treatment. See our NDIS services or make a referral, and we will call you back to talk about what you need.