Thoughtful Adjustments
Autistic people are more likely to experience mental health challenges than their non-autistic (allistic) peers.
Research suggests that between 9% and 20% of autistic individuals also have OCD, around 20% experience anxiety disorders, and about 11.4% live with ARFID (Avoidant/Restrictive Food Intake Disorder).[1]
But here’s the important part: with the right understanding and thoughtful adjustments, it is possible to navigate these challenges in a way that feels manageable and supportive.
If you or someone you care about is autistic while also dealing with anxiety, OCD, or ARFID, here are five key areas worth paying attention to.
1. Meet sensory needs first
Many autistic people experience the world differently on a sensory level.
Sounds, textures, lights, and even smells can feel either overwhelming (hypersensitivity) or not noticeable enough (hyposensitivity). This may require accommodations to either increase or decrease sensory input such as noise-canceling headphones or fidget tools. Planning ahead to meet sensory needs can mean that an autistic person is more regulated and more easily able to do hard things
For example:
Imagine an autistic person with ARFID trying a new food at a restaurant. If they are hypersensitive to sound, the noise of clinking dishes and overlapping conversations is likely overwhelming, making trying the new food impossible. But wearing headphones or choosing takeout in a quieter space could make trying that new food approachable.
2. Prioritize Clear Communication
Autistic people communicate differently than allistic people.
Autistic people may need more direct communication, more time for processing, and space to ask clarifying questions. Implied meanings and reliance on social norms and understanding often lead to misunderstanding and confusion for autistic people. Additionally, autistic people usually see asking clarifying questions an attempt to enhance understanding and even increase interpersonal connection, not rudeness or defiance.
For example:
If an autistic person is planning to go to a new museum with a family member, they may ask questions like “What time does it open?”, “What time will we get there?”, “How will we get there and how long will it take?” “How long will we spend there?” and “Which exhibits will we see?” This could look like anxiety and an attempt to control the situation, but it may simply be the autistic person attempting to understand the expectations and be prepared.
3. Special Interests Are Powerful Tools
Autistic people may also have special interests that they find very meaningful and significant.
These are not just hobbies. They can be essential parts of an autistic person’s wellbeing, bringing joy and comfort. Special interests are also multipurpose when dealing with anxiety, OCD or ARFID; they can be motivators and way to recharge.
For example:
An autistic person with social anxiety might struggle to leave the house. But if they have a special interest in dogs, leaving the house to walk a dog might be an approachable starting point. Or being able to meet and pet more dogs might be an important motivator to engage in new social situations. Or watching a favorite dog could be a good way to decompress after a stressful social interaction.
4. Understanding Rigidity: Routine vs. Fear
“Rigidity” is on one of the main areas of overlap between autism and OCD, anxiety or ARFID.
In autism, routines are comforting and improve functioning. In anxiety, OCD, or ARFID rigid behaviors are often driven by fear. Understanding why a rigid behavior occurs will often clarify if it is autism related or driven by OCD, anxiety or ARIFID. When a rigid behavior provides comfort and improves functioning, it may not be anxiety, OCD, or ARFID, and it may not need to change.
For example:
An autistic person with OCD might follow the exact same bedtime routine every night. If that routine is not related to an obsessional worry (e.g., “If I miss a step something bad will happen while I’m asleep”) and makes it easier to fall asleep, the routine is probably autism related and supportive.
5. Consistency, Consistency, Consistency
Another way that rigidity can show up in the intersection of autism and OCD, anxiety, or ARFID is in the difficulty that an autistic individual can have with change.
Worrying about what will happen in the future can be key part of anxiety, but, for autistic people, the difficulty is often not in the anticipation but in the need to adapt. Knowing what to expect and having things stick to the plan as much as possible can allow autistic people to more comfortably push outside their comfort zones.
For example:
Imagine an autistic person with ARFID has agreed to try steamed carrots but only raw carrots are available. They will likely refuse to try the carrots. This could look like avoidance and unwillingness to try new foods. However, it is more likely difficulty adjusting to the unexpected change. If the same person knows to expect raw carrots for the exposure the next day, they may be much more willing to challenge themselves.
Looking for Support?
Looking for Support That Truly Understands the Whole Picture?
When autism and anxiety, OCD, or ARFID overlap, the right approach can make all the difference. We specialize in individualized, evidence-based care that meets each person where they are—honoring neurodiversity while helping clients build confidence and resilience.
If you’re wondering what the right next step might look like for you or your child, we’re here to help. Contact us for a complimentary consultation or connect with our team to learn more about our programs. (844) 881-1846