Catatonia in autistic disorder: a sign of comorbidity or variable expression?

Davison et al. (1991) looked at a small group of autistic people who also showed catatonia. They wanted to know if the catatonia was part of the autism or a separate illness.

The team wrote short stories about each person. They noted medical and mood problems that could explain the frozen or slowed behavior.

The authors saw that catatonia often appeared with bipolar mood swings or hidden medical issues. They warned: do not blame autism alone.

They said treat the mood or medical problem first, then the catatonia may ease.

Hare et al. (2004) later coined the term 'autistic catatonia' and called it a built-in part of autism. This seems to clash with the 1991 view, but both papers used single cases, not large groups. The difference is mostly words, not proof.

Walley et al. (2005) and Petkova et al. (2022) took the 1991 advice and tried real treatments. One teen improved after ECT; two adults improved on clozapine. These later studies extend the 1991 warning into action: screen, then treat.

Hasan et al. (2025) mapped six catatonia symptom clusters in autism. Their wide list supports the 1991 idea that many things can look like catatonia, so check for each cause.

When your autistic client suddenly stops moving, speaking, or eating, pause before writing it off as 'autism behavior.' Ask about recent mood swings, medications, or illness. Request a psychiatric or medical consult if needed. Target the treatable cause first; the catatonia may lift and your ABA program can resume.