OCD vs. Autism: Similarities & Differences

While OCD and autism are distinct conditions, there are certain features that can overlap between the two.

Ruben Kesherim
November 16, 2023

OCD vs. Autism: Similarities & Differences

Understanding OCD and Autism

To differentiate between Obsessive-Compulsive Disorder (OCD) and Autism Spectrum Disorder (Autism), it is essential to have a clear understanding of each condition independently. By defining OCD and Autism and exploring their differences, we can gain insight into their distinct characteristics.

Defining OCD

OCD is a mental health disorder characterized by recurring intrusive thoughts, images, or urges (known as obsessions) that cause distress and anxiety. Individuals with OCD often engage in repetitive behaviors or mental acts (known as compulsions) as a means to alleviate the distress caused by their obsessions. OCD can significantly impact daily functioning and quality of life.

Defining Autism

Autism, or Autism Spectrum Disorder (ASD), is a neurodevelopmental disorder that affects social interaction, communication, and behavior. It is a spectrum disorder, meaning that it manifests differently in each individual. People with Autism may have challenges with social skills, communication, and may engage in restricted, repetitive patterns of behavior, interests, or activities.

How They Differ?

While there may be overlapping features between OCD and Autism, there are key differences that distinguish the two conditions.

Feature OCD Autism
Nature of Symptoms OCD primarily involves distressing obsessions and compulsions. Autism primarily involves challenges with social communication and interaction, as well as restricted and repetitive behaviors.
Focus of Symptoms OCD symptoms typically revolve around specific thoughts or fears, leading to compulsive behaviors. Autism symptoms involve difficulties in social communication and interaction, along with repetitive behaviors and interests.
Onset and Development OCD usually develops in late childhood, adolescence, or early adulthood. Autism symptoms are typically present in early childhood and persist throughout life.
Prevalence OCD affects approximately 1-3% of the population. Autism is estimated to affect around 1 in 36 children.
Diagnostic Criteria OCD is diagnosed based on specific criteria outlined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). Autism is diagnosed based on specific criteria outlined in the DSM-5.

It is important to note that individuals can have a dual diagnosis of OCD and Autism, as there can be overlapping features and co-occurring symptoms.

By understanding the distinctions between OCD and Autism, individuals and caregivers can gain a clearer understanding of the conditions and seek appropriate support and interventions tailored to their specific needs.

Common Symptoms of OCD

To better understand the differences between OCD and autism, it's important to delve into the common symptoms associated with each condition. In this section, we will explore the obsessions and compulsions typically seen in individuals with OCD.


Obsessions in OCD refer to intrusive and unwanted thoughts, images, or urges that cause significant distress and anxiety. These obsessions are recurrent, persistent, and difficult to control. Common obsessions include:

  • Contamination: Excessive fear of germs, dirt, or illness, leading to repeated handwashing or avoidance of certain places or objects.
  • Symmetry and Order: Intense need for things to be arranged in a specific and orderly manner, often spending excessive time organizing or arranging objects.
  • Intrusive Thoughts: Involuntary, distressing thoughts or mental images of harming oneself or others, engaging in taboo behaviors, or other irrational fears.
  • Forbidden or Taboo Thoughts: Unwanted thoughts related to religious, sexual, or aggressive content that go against personal values or beliefs.

These obsessions can consume a significant amount of time and energy, interfering with daily activities and causing distress.


Compulsions, also known as rituals, are repetitive behaviors or mental acts that individuals with OCD feel driven to perform in response to their obsessions. Compulsions are aimed at reducing anxiety or preventing a feared outcome. Common compulsions include:

  • Cleaning and Washing: Excessive cleaning, handwashing, or sanitizing due to an overwhelming fear of contamination.
  • Checking: Repeatedly checking doors, locks, appliances, or other items to ensure they are secure or in the "right" position.
  • Counting and Repeating: Engaging in repetitive counting, tapping, or repeating certain words or phrases to reduce anxiety or prevent harm.
  • Ordering and Arranging: Constantly arranging objects or items in a specific way, striving for symmetry and order.
  • Mental Rituals: Engaging in mental rituals such as silently repeating prayers or phrases to neutralize intrusive thoughts.

Compulsions may provide temporary relief from anxiety, but this relief is short-lived, leading to a cycle of repetitive behaviors.

Understanding the common symptoms of OCD is essential for distinguishing it from autism. While both conditions may exhibit overlapping features, it's crucial to recognize the specific characteristics of each.

Common Symptoms of Autism

Autism is a neurodevelopmental disorder that is characterized by a wide range of symptoms and behaviors. While each individual with autism is unique, there are some common symptoms that are often observed. Understanding these symptoms can help differentiate autism from other conditions such as OCD.

In this section, we will explore two common symptoms of autism: social communication and interaction difficulties and restricted and repetitive behaviors.

Social Communication and Interaction

One of the hallmark features of autism is difficulties in social communication and interaction. Individuals with autism may exhibit challenges in various aspects of social interaction, including:

  • Social Skills: They may struggle with understanding social cues, such as body language, facial expressions, and tone of voice. This can make it difficult for them to interpret the emotions and intentions of others, leading to misunderstandings or miscommunications.
  • Initiating and Maintaining Conversations: Individuals with autism may find it challenging to initiate conversations or keep them going. They may struggle with reciprocal conversation skills, such as taking turns, listening actively, and providing appropriate responses.
  • Theory of Mind: Theory of Mind refers to the ability to understand and attribute mental states, such as beliefs, intentions, and emotions, to oneself and others. People with autism may have difficulty with Theory of Mind, which can impact their understanding of others' perspectives and motivations.

Restricted and Repetitive Behaviors

Another common symptom of autism is the presence of restricted and repetitive behaviors. These behaviors often manifest in various ways, including:

  • Stereotyped or Repetitive Movements: People with autism may engage in repetitive motor movements or gestures, such as hand flapping, rocking, or spinning. These behaviors may serve as self-soothing mechanisms or a way to cope with sensory overload.
  • Rigid Adherence to Routine: Individuals with autism often have a strong preference for routine and predictability. They may become distressed or anxious when there are changes to their established routines or when faced with unexpected events.
  • Narrow Interests and Specialized Topics: It is common for individuals with autism to develop intense interests in specific subjects or objects. They may spend a significant amount of time focused on these interests, often acquiring in-depth knowledge in their chosen areas.

Understanding these common symptoms of autism can help differentiate it from conditions such as OCD. It is important to note that while there may be some overlapping features between autism and OCD, they are distinct disorders with unique diagnostic criteria.

Overlapping Features

While OCD and autism are distinct conditions, there are certain features that can overlap between the two. Understanding these overlapping aspects can help in identifying and differentiating between OCD and autism. Two areas where these conditions share similarities are sensory issues and anxiety and emotional regulation.

Sensory Issues

Both individuals with OCD and those with autism may experience sensory issues that affect their daily lives. Sensory issues refer to difficulties in processing and responding to sensory information from the environment. This can manifest in various ways, such as hypersensitivity or hyposensitivity to certain sensory stimuli, including sounds, lights, textures, or smells.

In individuals with OCD, sensory issues can be related to specific obsessions or compulsions. For example, someone with OCD may experience extreme discomfort or distress when touching certain objects or substances due to sensory sensitivity. These sensory issues are directly linked to their obsessive thoughts or the need to engage in compulsive behaviors.

Similarly, individuals with autism often exhibit sensory sensitivities that can impact their daily functioning. They may be overwhelmed or distressed by certain sounds, textures, or visual stimuli. For instance, bright lights or loud noises may cause discomfort or anxiety. Sensory issues can also contribute to restricted and repetitive behaviors commonly seen in autism.

Anxiety and Emotional Regulation

Anxiety and difficulties with emotional regulation are common features that can be present in both OCD and autism. Both conditions are associated with heightened levels of anxiety, although the underlying causes may differ.

In OCD, anxiety arises from obsessions and the accompanying urge to perform compulsions. Individuals with OCD often experience intense fear or distress when their obsessions are triggered, and engaging in compulsions temporarily alleviates this anxiety. However, the relief is short-lived, leading to a cycle of obsessions and compulsions.

Similarly, individuals with autism may experience high levels of anxiety, often related to difficulties with social interactions or changes in routine. The challenges they face in understanding and interpreting social cues can contribute to feelings of anxiety and emotional dysregulation. It's important to note that anxiety can manifest differently in individuals with autism compared to those with OCD.

Understanding the overlapping features of sensory issues and anxiety and emotional regulation in OCD and autism is crucial for accurate diagnosis and appropriate treatment. Additionally, specific strategies and interventions tailored to address these overlapping features can be implemented to support individuals with OCD or autism in managing these challenges effectively.

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Diagnosing OCD vs Autism

Diagnosing OCD and Autism requires a careful evaluation of the individual's symptoms and behaviors. While there may be overlapping features between the two conditions, distinct diagnostic criteria help differentiate between them.

Diagnostic Criteria for OCD

To diagnose OCD, mental health professionals refer to the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 provides the following criteria for diagnosing OCD:

  1. Presence of obsessions, compulsions, or both:
  • Obsessions are recurrent and persistent thoughts, urges, or images that are intrusive and cause distress.
  • Compulsions are repetitive behaviors or mental acts that individuals feel driven to perform in response to an obsession or according to rigid rules.
  1. The obsessions or compulsions are time-consuming (taking more than one hour per day) or cause significant distress or impairment in daily functioning.
  2. The obsessions or compulsions are not attributable to the physiological effects of a substance or other medical condition.
  3. The symptoms are not better explained by the symptoms of another mental disorder.

Meeting these criteria is essential for a diagnosis of OCD. It's important to note that individuals with Autism may also exhibit obsessive or repetitive behaviors, but these behaviors alone do not necessarily indicate a diagnosis of OCD.

Diagnostic Criteria for Autism

Autism is diagnosed using the criteria outlined in the DSM-5 as well. The diagnostic criteria for Autism Spectrum Disorder (ASD) include the following:

  1. Persistent deficits in social communication and social interaction across multiple contexts:
  • Challenges in social-emotional reciprocity (e.g., difficulty initiating or maintaining conversations).
  • Deficits in nonverbal communication (e.g., limited eye contact or gestures).
  • Difficulties in developing and maintaining relationships.
  1. Restricted, repetitive patterns of behavior, interests, or activities:
  • Stereotyped or repetitive motor movements, use of objects, or speech.
  • Insistence on sameness, inflexible adherence to routines, or ritualized patterns.
  • Highly restricted, fixated interests that are abnormal in intensity or focus.
  1. Symptoms must be present in the early developmental period.
  2. Symptoms cause clinically significant impairment in social, occupational, or other important areas of functioning.
  3. These disturbances are not better explained by intellectual disability or global developmental delay.

Meeting these criteria is necessary for a diagnosis of Autism. It's worth noting that individuals with Autism may also experience symptoms that resemble OCD, such as obsessive interests or repetitive behaviors. Understanding the unique patterns and combinations of symptoms is essential for an accurate diagnosis.

Accurate diagnosis is important in order to provide appropriate support and interventions tailored to the individual's specific needs. Consulting with healthcare professionals who specialize in neurodevelopmental disorders can help in determining the most appropriate diagnosis and guiding treatment approaches.

Treatment Approaches

When it comes to addressing the challenges associated with OCD and autism, there are specific treatment approaches that can be beneficial for each condition.

These approaches aim to improve symptoms, enhance daily functioning, and enhance the overall quality of life for individuals with OCD or autism. Let's explore two common treatment approaches: Cognitive-Behavioral Therapy (CBT) for OCD and Applied Behavior Analysis (ABA) for autism.

Cognitive-Behavioral Therapy for OCD

Cognitive-Behavioral Therapy (CBT) has been widely recognized as an effective treatment for OCD. CBT for OCD focuses on identifying and modifying the thought patterns and behaviors that contribute to obsessive-compulsive symptoms. The therapy typically involves two main components: exposure and response prevention.

During exposure, individuals are gradually exposed to situations or objects that trigger their obsessions. The goal is to help them confront their fears in a controlled and safe environment. Through repeated exposure, individuals learn to tolerate the anxiety associated with their obsessions without engaging in compulsive behaviors.

Response prevention involves resisting the urge to perform compulsive behaviors in response to obsessions. Therapists work with individuals to develop strategies to manage and reduce their anxiety without resorting to compulsions. By gradually reducing and eliminating compulsive behaviors, individuals can gain a sense of control over their obsessions and reduce their impact on daily life.

It's important to note that CBT for OCD should be conducted by a trained mental health professional with experience in treating OCD.

Applied Behavior Analysis for Autism

Applied Behavior Analysis (ABA) is a widely recognized and evidence-based treatment approach for autism. ABA focuses on understanding and modifying behaviors to improve social, communication, and daily living skills. The therapy is tailored to the individual needs of each person with autism and is typically delivered by trained behavior analysts or therapists.

ABA uses various techniques to teach new skills and reduce challenging behaviors. These techniques include prompting, modeling, reinforcement, and generalization. The therapy utilizes positive reinforcement to motivate and reward desired behaviors, while also addressing problem behaviors through strategies such as functional behavior assessments and behavior intervention plans.

Through targeted interventions, ABA aims to enhance communication skills, social interactions, adaptive behaviors, and reduce behaviors that may interfere with learning and daily functioning. It is important to note that ABA programs are individualized and may vary based on the specific needs and goals of each person with autism.

By utilizing these treatment approaches, individuals with OCD or autism can receive targeted interventions to help manage their symptoms, enhance their quality of life, and reach their full potential. It's important to work with qualified professionals who can tailor the treatment to the specific needs of each individual.


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