International OCD Foundation | OCD and Autism Resource Center

This resource center includes information and resources about when OCD and autism happen together, treatment options, information for family members, and stories from autistic individuals living with OCD.

Please explore the resources and information available, and know that this is a growing and developing Resource Center. Make sure to check back as more resources about OCD and autism become available.

And remember, your voice is vital! If you are an autistic individual with OCD, you can contribute to the conversation by sharing your personal journey or a message of hope with the IOCDF community.

NOTE: While the term “autism spectrum disorder” (ASD) is utilized in the most widely used professional diagnostic manual, the DSM-5, we consider the differences associated with autism as an aspect of the individual’s identity rather than inherently being a disorder. Accordingly, identity-first language such as “autistic” is used throughout this writing, as preferred by many with lived experience.

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OCD and Autism

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Treatment

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Information for Families

Stories from Lived Experiences

Read stories from those who have been impacted by OCD and autism, including a conversation with Dr. Rebecca Sachs and Dr. Yael Clark, and a personal story from Andy as he looks back on his life with OCD and Asperger syndrome.

Plus, learn how to share your story!

Read the Stories

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Summary, References, and Resources

Certainly, this is a time of progress, as our understanding of how OCD and autism interact continues to grow. OCD in autistic individuals is challenging and there are no easy answers, but it is now regarded as both understandable and treatable with the proper modifications. Guiding research in this area is continuing to emerge, but more is clearly needed. The same may be said of clinicians: there seems to be more interest in this crucial subject, but it needs to be reflected in increased educational and training opportunities. With such developments, autistic persons as well as family members will be more likely to receive an accurate diagnosis of OCD in a timely way and access properly modified evidence-supported OCD treatments.

Our knowledge of how to help autistic people with OCD can only increase over time. We can already see this area of treatment receiving increased concern and interest on the part of mental health professionals. Another powerful impetus for meaningful change in the treatment of OCD in autistic individuals has been the increasing input from the voices of autistic individuals. Indeed, the posting of this article, itself, is proof of this growing attention, as such resources did not even exist until recently. There will certainly be more articles and information about treatment and resources in the future. The next steps will involve encouraging the research community to devote even more time and resources to growing our knowledge of how to best help members of the autism community and their families. These efforts will continue as long as there are autistic people out there who contend with OCD, in addition to their other challenges. As they say, "Every journey starts with the first step."

This material was informed by the references, books, and resources pertaining to OCD and autism that are listed below.

Books

Attwood, T. (2015). The complete guide to Asperger's syndrome. Jessica Kingsley Publishers.

Baker, J. (2008). No more meltdowns: Positive strategies for managing and preventing out-of-control behavior. Future Horizons.

Ballou, E.P., daVanport, S., & Onaiwu, M.G. (Eds.) (2021). Sincerely, your autistic child: What people on the autism spectrum wish their parents knew about growing up, acceptance, and identity. Beacon Press.

Brown, J.F. (2015). The emotion regulation skills system for cognitively challenged clients: A DBT-informed approach (1st ed.). The Guilford Press.

Cook, B. & Garnett, M. (Eds.) (2018). Spectrum women: Walking to the beat of autism. Jessica Kingsley Publishers.

Cornoldi, C., Mammarella, I.C., & Fine, J.G. (2016). Nonverbal learning disabilities. The Guilford Press.

Dawson, P. & Guare, R. (2009). Smart but scattered: The revolutionary "executive skills" approach to helping kids reach their potential (1st ed.). The Guilford Press.

Gallagher, R., Spira, E.G., & Rosenblatt, J.L. (2018). The organized child: An effective program to maximize your kid's potential – in school and in life. The Guilford Press.

Gaus, V.L. (2011). Living well on the spectrum: How to use your strengths to meet the challenges of Asperger syndrome/high-functioning autism. Guilford Press.

Gaus, V.L. (2018). Cognitive-behavioral therapy for adults with autism spectrum disorder (2nd ed.). The Guilford Press.

Golomb, R.G. & Mouton-Odum, S. (2016). Psychological interventions for children with sensory dysregulation. The Guilford Press.

Hoffman, J. (2012). Stuck: Asperger's syndrome and obsessive-compulsive behaviors. Weston Press.

Hoopmann, K. (2006). All cats have Asperger syndrome. Jessica Kingsley Publishers.

Meeks, L. & Masterson, T.L. (2016). Parties, dorms and social norms: A crash course in safe living for young adults on the autism spectrum. Jessica Kingsley Publishers.

Miller, J. (2014). Decoding dating: A guide to the unwritten social rules of dating for men with Asperger syndrome (autism spectrum disorder). Jessica Kingsley Publishers.

Myles, B.S., Trautman, M., & Schelvan, R.L. (2013). The hidden curriculum for understanding unstated rules in social situations for adolescents and young adults. AAPC Publishing.

Nichols, S., Moravcik, G.M., & Tetenbaum, S.P. (2009). Girls growing up on the autism spectrum: What parents and professionals should know about the pre-teen and teenage years. Jessica Kingsley Publishers.

Penzel, F. (2016). Obsessive-compulsive disorders: A complete guide to getting well and staying well (2nd ed.). Oxford University Press.

Prizant, B. M. & Fields-Meyer, T. (2022). Uniquely human: A different way of seeing autism. Simon & Schuster.

Scarpa, A., White, S.W., & Attwood, T. (Eds.) (2016). CBT for children and adolescents with high-functioning autism spectrum disorders. The Guilford Press.

Sparrow, M. (Ed.) (2020). Spectrums: Autistic transgender people in their own words. Jessica Kingsley Publishers.

Steward, R. (2019). The autism-friendly guide to periods. Jessica Kingsley Publishers.

Winner, M. G. & Crooke, P. (2016). Good intentions are not good enough. Social Thinking.

Additional Online Resources

Below are a variety of additional online resources for those impacted by OCD and autism:

Autism Mental Status Exam - An assessment tool for clinicians
Carol Gray Social Stories - A social learning tool that supports the safe and meaningful exchange of information between parents, professionals, and people with autism of all ages.
Association for Contextual Behavioral Science (ACBS) - ACBS is dedicated to the alleviation of human suffering and the advancement of human well-being through research and practice grounded in contextual behavioral science.
Autism Research Centre - A UK-based research center for autism
Social Thinking - Online resources for social-emotional learning
Spectrum News - Information on updates in autism research
Autistic Self Advocacy Network (ASAN) - ASAN works to empower autistic people across the world to take control of their own lives and the future of their common community, and seek to organize the autistic community to ensure their voices are heard in the national conversation about them.

Academic References for the OCD & Autism Resource Center

Bedford, S.A., Hunsche, M.C., & Kerns, C.M. (2020). Co-occurrence, assessment and treatment of obsessive compulsive disorder in children and adults with autism spectrum disorder. Current Psychiatry Reports, 22(53). https://doi.org/10.1007/s11920-020-01176-x

Boyd, B.A., McDonough, S.G., & Bodfish, J.W. (2012). Evidence-based behavioral interventions for repetitive behaviors in autism. Journal of Autism and Developmental Disorders, 42, 1236–1248. https://doi.org/10.1007/s10803-011-1284-z

Cadman, T., Spain, D., Johnston, P., Russell, A., Mataix-Cols, D., Craig, M., …, & Murphy, D. (2015). Obsessive-compulsive disorder in adults with high-functioning autism spectrum disorder: What does self-report with the OCI-R tell us? Autism Research, 8(5), 477-485. https://doi.org/10.1002/aur.1461

Elliott, S.J., McMahon, B.M., & Leech, A.M. (2018). Behavioural and cognitive behavioural therapy for obsessive compulsive disorder (OCD) in individuals with autism spectrum disorder (ASD). Cochrane Database of Systematic Reviews,11, CD013173. https://doi.org/10.1002/14651858.CD013173

Griffiths, D.L., Farrell, L.J., Waters, A.M., & White, S.W. (2017). Clinical correlates of obsessive compulsive disorder and comorbid autism spectrum disorder in youth. Journal of Obsessive-Compulsive and Related Disorders, 14, 90-98. https://doi.org/10.1016/j.jocrd.2017.06.006

Iniesta-Sepúlveda, M., Nadeau, J.M., Ramos, A., Kay, B., Riemann, B.C., & Storch, E.A. (2017). An initial case series of intensive cognitive–behavioral therapy for obsessive–compulsive disorder in adolescents with autism spectrum disorder. Child Psychiatry & Human Development, 49, 9-19. https://doi.org/10.1007/s10578-017-0724-1

Hoffman, J. & Hudak, R. (2022). Understanding and treating obsessive-compulsive disorder in adults with autism spectrum disorder. Journal of Therapeutic Schools and Programs, 14, 38-73.

Jassi, A., Fernández de la Cruz, L., Russell, A., & Krebs, G. (2021). An evaluation of a new autism-adapted cognitive behaviour therapy manual for adolescents with obsessive–compulsive disorder. Child Psychiatry & Human Development, 52, 916-927. https://doi.org/10.1007/s10578-020-01066-6

Jiujias, M., Kelly, E., & Hall, L. (2017). Restricted, repetitive behaviors in autism spectrum disorder and obsessive-compulsive disorder: A comparative review. Child Psychiatry & Human Development, 48, 944-959. https://doi.org/10.1007/s10578-017-0717-0

Kerns, C. & Kendall, P. (2014). Autism and anxiety: Overlap, similarities, and differences. In Davis III, T.E, White, S.W., & Ollendick, T.H (Eds.) Handbook of autism and anxiety (pp. 75-89). Springer, Cham.

Kerns, C.M., Roux, A.M., Connell, J.E., & Shattuck, P.T. (2016). Adapting cognitive behavioral techniques to address anxiety and depression in cognitively-able emerging adults on the autism spectrum. Cognitive Behavioral Practice, 23(3), 329-340. https://doi.org/10.1016/j.cbpra.2016.06.002

Kerns, C.M., Wood, J.J., Kendall, P.C., Renno, P., Crawford, E.A., Mercado, R.J., Fujii, C., Collier, A., Hoff, A., Kagan, E.R., Small, B.J., Lewin, A.B., & Storch, E.A. (2016). The treatment of anxiety in autism spectrum disorder (TAASD) study: Rationale, design and methods. Journal of Child and Family Studies, 25, 1889-1902. https://doi.org/10.1007/s10826-016-0372-2

Kose, L. K., Fox, L., & Storch, E. A. (2017). Effectiveness of cognitive behavioral therapy for individuals with autism spectrum disorders and comorbid obsessive-ompulsive disorder: A review of the research. Journal of Developmental and Physical Disabilities, 30, 69-87. https://doi.org/10.1007/s10882-017-9559-8

Krebs, G., Murray, K., & Jassi, A. (2016). Modified cognitive behavior therapy for severe, treatment-resistant obsessive-compulsive disorder in an adolescent with autism spectrum disorder. Journal of Clinical Psychology, 72(11), 1162–1173. https://doi.org/10.1002/jclp.22396

Leyfer, O.T., Folstein, S.E., Bacalman, S., Davis, N.O., Dinh, E., Morgan, J., Tager-Flusberg, H., & Lainhart, J. E. (2006). Comorbid psychiatric disorders in children with autism: Interview development and rates of disorders. Journal of Autism and Developmental Disorders, 36(7), 849-861. https://doi.org/10.1007/s10803-006-0123-0

Lehmkuhl, H. D., Storch, E. A., Bodfish, J. W., & Geffken, G. R. (2008). Brief report: Exposure and response prevention for obsessive compulsive disorder in a 12-year-old with autism. Journal of Autism and Developmental Disorders, 38(5), 977–981. https://doi.org/10.1007/s10803-007-0457-2

Martin, A.F., Jassi, A., Cullen, A.E., Broadbent, M., Downs, J., & Krebs, G. (2020). Co-occurring obsessive-compulsive disorder and autism spectrum disorder in young people: Prevalence, clinical characteristics and outcomes. European Child & Adolescent Psychiatry, 29, 1603-1611. https://doi.org/10.1007/s00787-020-01478-8

Meier, S.M., Petersen, L., Schendel, D.E., Mattheisen, M., Mortensen, P.B., & Mors, O. (2015). Obsessive-compulsive disorder and autism spectrum disorders: Longitudinal and offspring risk. PLOS One, 10(11): e0141703. https://doi.org/10.1371/journal.pone.0141703

Nadeau, J.M., Tan, S.Y., McAndrews, J., Park, J., Bergman, R.L., Andrews, J., Leonard, R.C., Ramos, A., Eken, S., Young, P.R., Franklin, M.E., & Riemann, B.C. (2021). Anxiety and depression recovery in ASD: Level 2 patient workbook. Oconomowoc, WI: Rogers Behavioral Health.

Neil, N. & Sturmey, P. (2014). Assessment and treatment of obsessions and compulsions in individuals with autism spectrum disorders: A systematic review. Review Journal of Autism and Developmental Disorders,1, 62-79. https://doi.org/10.1007/s40489-013-0006-1

Nakagawa, A., Olsson, N.C., Hiraoka, Y., Nishinaka, H., Miyazaki, T., Kato, N., Nakatani, E., Tomita, M., Yoshioka, K., Murakami, S., & Aoki, S. (2019). Long-term outcome of CBT in adults with OCD and comorbid ASD: A naturalistic follow-up study. (2019). Current Psychology, 38, 1763–1771. https://doi.org/10.1007/s12144-018-9952-1

Pazuniak, M., & Pekrul, S. R. (2020). Obsessive–compulsive disorder in autism spectrum disorder across the lifespan. Child and Adolescent Psychiatric Clinics of North America, 29(2), 419-432. https://doi.org/10.1016/j.chc.2019.12.003

Postorino, V., Kerns, C.M., Vivanti, G., Bradshaw. J., Siracusano, M., & Mazzone, L. (2017). Anxiety disorders and obsessive-compulsive disorder in individuals with autism spectrum disorder. Current Psychiatry Reports, 19(92). https://doi.org/10.1007/s11920-017-0846-y

Rosen, T.E., Connell, J. E. & Kerns, C.M. (2016). A review of behavioral interventions for anxiety-related behaviors in lower functioning individuals with autism. Behavioral Interventions, 31(2), 120-143. https://doi.org/10.1002/bin.1442

Russell, A.J., Jassi, A.., Fullana, M.A., Mack, H., Johnston, K., Heyman, I., Murphy, D.G., & Mataix-Cols, D. (2013). Cognitive behavior therapy for comorbid obsessive-compulsive disorder in high-functioning autism spectrum disorders: A randomized controlled trial. Depression & Anxiety, 30, 697-708. https://doi.org/10.1002/da.22053

Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child & Adolescent Psychiatry, 47(8), 921-929. https://doi.org/10.1097/CHI.0b013e318179964f

Ung, D., Selles, R., Small, B.J., & Storch, E.A. (2015). A systematic review and meta-nalysis of cognitive-behavioral therapy for anxiety in youth with high-functioning autism spectrum disorders. Child Psychiatry & Human Development, 46, 533-547. https://doi.org/10.1007/s10578-014-0494-y

Wikramanayake, W.N.M., Mandy, W., Shahper, S., Kaur, S., Kolli, S., Osman, S., Reid, J., Jefferies-Sewell, K., & Fineberg, N.A. (2018). Autism spectrum disorders in adult outpatients with obsessive compulsive disorder in the UK. International Journal of Psychiatry in Clinical Practice, 22(1), 54-62. https://doi.org/10.1080/13651501.2017.1354029

Wood, J.J., Ehrenreich-May, J., Alessandri, M., Fujii, C., Renno, P., Laugeson, E., Piacentini, J.C., De Nadai, A.S., Arnold, E., Lewin, A.B., Murphy, T.K., & Storch, E.A. (2015). Cognitive behavioral therapy for early adolescents with autism spectrum disorders and clinical anxiety: A randomized, controlled trial. Behavior Therapy, 46(1), 7-19. https://doi.org/10.1016/j.beth.2014.01.002

Wolters, L.H., de Haan, E., Hogendoorn, S.M., Boer, F., & Prins, P.J.M. (2016). Severe pediatric obsessive compulsive disorder and co-morbid autistic symptoms: Effectiveness of cognitive behavioral therapy. Journal of Obsessive-Compulsive and Related Disorders, 69–77. https://doi.org/10.1016/j.jocrd.2016.06.002

Special thanks to the leadership of the IOCDF's OCD and Autism Special Interest Group (SIG) for their contributions to the OCD & Autism Resource Center - Jonathan Hoffman, PhD; Robert Hudak, MD; Josh Nadeau, PhD; Fred Penzel, PhD; and Rebecca Sachs, PhD.

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