A study by King et al., 2009, found that effective pharmaceutical treatments for reducing OCD symptoms were not as effective in individuals with autism (King et al., 2009). His diagnosis of autism so many years later was empowering, he says, but it also led to new complications. For example, when talking to clinicians, his autism always seemed to overshadow his other challenges, including an auditory processing disorder. «Once you`ve been diagnosed with autism, doctors say, `Oh, it`s because of autism,` and they don`t look at the nuances,» he says. He found that no one could tell him if a certain behavior was the result of his obsessive-compulsive disorder or autism — or what to do about it. Clinicians have long overlooked Slavin`s obsessive-compulsive disorder and autism, though he is no stranger to a psychologist`s office in the north-west suburbs of London. He did not speak in his first six years and says his memories are peppered with frequent visits to speech-language pathologists and psychiatrists. Even after he started talking, he was socially withdrawn and didn`t like eye contact. He was plagued by anxiety and abdominal pain.
As the case studies show, there are several similarities between OCD and AD, including displacement, incompleteness, emotions, and compulsions. In both diseases, children have strong academic skills. Children with Alzheimer`s disease often exhibit strong reading, numeracy and memory skills (Bauer, 1996). Neziroglu and Yaryura-Tobias (1997) also report that children with OCD tend to have above-average academic ability. Both children will rarely feel relaxed and they will spend most of their day feeling anxious. In AD, this is especially true if the child doesn`t know what to expect next or is overwhelmed by stimuli such as loud noises. In obsessive-compulsive disorder, the child is anxious about his obsessive thoughts and whether or not he executes his compulsions correctly. Unpublished work from another group suggests that rare «de novo mutations» that occur spontaneously can significantly increase the risk of autism or obsessive-compulsive disorder. Some of the genes the researchers linked to both diagnoses are linked to immune function, suggesting that an interaction between environmental factors and the immune system may play a role. Another gene on this common list, CHD8, regulates gene expression. In summary, people with AD or OCD may experience similar symptoms, including postponement, incompleteness, anxiety, compulsions, and adherence to rituals. In general, people with Alzheimer`s disease are more socially deficient and have difficulty establishing relationships with each other.
In AD, individuals may have obsessive thoughts related to a limited area of interest, but these thoughts are unlikely to cause a pronounced level of anxiety or stress as with OCD. Finally, compulsive behavior in obsessive-compulsive disorder is completed with the intention of minimizing anxiety. In AD, individuals enjoy participating in these activities. As with most support group meetings, the call assures its participants that they are not alone. Callers also share updates and tips, such as using a timer to reduce handwashing time. Three of the callers mention CBT, which can help people understand and manage their obsessions and compulsions. However, as with other talking therapies, CBT is not always effective for people with autism. Therapy, for example, didn`t help Slavin.
We also recommend begging for children with autism and OCD. Mendability offers online sensory enrichment therapy (SET). The benefits of SET for children with autism are clinically proven. Boyd BA, McDonough SG, Bodfish JW. Evidence-based behavioural interventions for repetitive behaviours in autism. J autism dev disord. 2012;42(6):1236-1248. doi:10.1007/s10803-011-1284-z A more personalized variant of CBT could also work for people with autism and obsessive-compulsive disorder. Various programs include involving parents in sessions, adapting language to an autistic person`s abilities, using images, and offering rewards to children.
One study compared these adaptations to standard CBT in more than 160 children with both autism and OCD. Unpublished results suggest that standard CBT is beneficial, but that an individualized approach is preferable. OCD is usually characterized by persistent and distressing thoughts.