Characterizing subdomains of insistence on sameness in autistic youth.
Insistence on sameness splits into three parts; measure the part that matches your client’s real-life barrier.
01Research in Context
What this study did
Spackman et al. (2023) looked at 1,892 autistic kids and teens. They used a math tool called exploratory graph analysis. The goal was to see if insistence on sameness is one block or splits into smaller parts.
Parents filled out the 44-item Autism Spectrum Quotient. Items about sameness were pulled out and mapped. No extra tests were done on the kids.
What they found
Three clear chunks showed up: ritualistic/sameness, routines, and social IS. Each chunk tied to different day-to-day problems. For example, social IS linked with weaker social skills, while ritualistic IS linked with more sensory issues.
The team says we should score these chunks apart, not as one big score.
How this fits with other research
Park-Cardoso et al. (2023) asked Brazilian autistic adults why they keep food rules. The adults called the rules helpful shields against sensory chaos. Emily’s youth data now show that sensory issues sit mainly with the ritualistic/sameness chunk, not the other two. The studies line up: sensory-linked IS looks like self-protection in both kids and adults.
Grant (1989) first showed that autistic kids struggle with appearance-reality tasks. Emily’s social-IS chunk now maps onto today’s social-cognitive scores, giving an update on where those classic ToM troubles live.
MacFarland et al. (2025) found sensory sensitivity stays high even after pulling out ADHD symptoms. Emily’s ritualistic-IS chunk also clusters with sensory problems, backing the idea that sensory features are a core autism trait, not just co-occurring ADHD.
Why it matters
Stop using one total IS score. Instead, pick the chunk that fits your client’s main struggle. If the child melts over chair placement, track ritualistic/sameness and pair it with sensory supports. If the teen panics over changed conversation topics, track social IS and add social-cognitive coaching. Measuring the right chunk gives you clearer baseline data and cleaner progress lines.
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02At a glance
03Original abstract
Insistence on sameness (IS) encompasses a range of behavioral patterns, including resistance to change, routines, and ritualized behaviors, that can be present across social and non-social contexts. Given the breadth of behaviors encompassed by IS, it is important to determine whether this domain is best conceptualized and measured as uni- or a multi-dimensional construct. Therefore, the current study aimed to characterize the structure of IS and explore potentially distinct of patterns of associations between identified IS factors and relevant correlates, including age, sex, IQ, anxiety, social abilities, emotional and behavioral dysregulation, and sensory hypersensitivity. Exploratory graph analysis was conducted using the dimensional assessment of restricted and repetitive behaviors to examine the structure of IS in a sample 1892 autistic youth (Mage = 10.82, SDage = 4.14; range: 3-18 years; 420 females) recruited from the Simons Foundation Powering Autism Research for Knowledge cohort. Three distinct IS subdomains labeled as IS-Ritualistic/sameness, IS-Routines, and IS-Others (referring to IS behaviors during interactions with others) were identified. Generalized additive models demonstrated that each of the IS subdomains showed a unique pattern of association with key variables. More specifically, while sensory hypersensitivity was significantly associated with IS-Ritualistic/sameness and IS-Routines, it was not associated with IS-Others. Further, while emotional dysregulation was a unique predictor of IS-Ritualistic/sameness (but not IS-Routines or IS-Others), social interaction abilities were a unique predictor of IS-Routines (but not IS-Ritualistic/sameness or IS-Others). Current findings provide preliminary evidence that the IS may encompass several distinct subdomains.
Autism research : official journal of the International Society for Autism Research, 2023 · doi:10.1016/j.tics.2008.07.005