Conform or be ostracised: restricted and repetitive behaviours in non-autistic persons

Abstract

Autism is a neurological disability characterised by a number of ‘deficits’ in multiple areas of functioning and everyday life. Or is it? Damian Milton’s theory of the ‘double empathy problem’ attempts to empirically posit that the socialisation and communication difficulties present in autistic people are due to bidirectional differences in ways of communication between autistic and non-autistic people. This Current Issues piece extends said theory to encompass the restricted and repetitive behaviours that are commonly observed in autistic people, arguing that such behaviours may also be present in non-autistic people, albeit in a less stereotypical, more socially acceptable way. Because autism is characterised in part by the presence of restricted and repetitive behaviours, this piece fundamentally challenges the manner in which autism spectrum conditions are diagnosed in individuals and seen far and wide, ultimately promoting the view of cognitive-behavioural difference in autistic people instead of ‘deficit’.

Keywords:

• Autism
• behaviours
• experiences
• rituals
• rigidity
• double empathy

Introduction

Different diagnostic systems define autism differently. But what many of those definitions have in common is that autism is a neurological condition primarily characterised by persistent ‘deficits’ in social communication skills plus the presence of restricted and repetitive behaviours. The dominant paradigm of autism, the ‘medical model’, has shone quite the unflattering light on autism, positioning it as a pathological disease transforming normative children with bright futures into tragic lost causes that cannot empathise and communicate reciprocally with other people. It is this common rhetoric that has massively perpetuated the marginalisation and stigma that autistic people frequently face from day to day—that they are not enough, and that they are inherently broken. It is not surprising that many autistic people feel isolated in this non-autistic society because of this. Whilst it is not true that everyone is ‘a little autistic’, this article seeks to reinforce the idea of cognitive-behavioural difference in autistic people rather than ‘deficit’ by pointing out that perhaps some ‘autistic traits’ may also be present in non-autistic people.

Double empathy

What if autistic people are enough? What if they are not inherently broken? Recently, academics have started to suggest that the so-called ‘deficits’ in social communication skills seen in autistic people may just be differences in communication style compared to non-autistic people. Damian Milton (2012) masterfully describes this as a ‘double empathy problem’ in which two differently disposed social actors each hold different norms and expectations of the opposing actor and, as a result, both experience a disjuncture in social reciprocity. Several studies in recent times have demonstrated communication effectiveness and reciprocity between autistic people as well as the lack thereof between autistic and non-autistic people (Crompton et al. 2020; Komeda et al. 2014; Morrison et al. 2019). If autistic people inherently lacked communication ability, then a communication between two autistic people would be less effective and reciprocal than one between an autistic and non-autistic person. Because of this, it is reasonable to assume that autistic people do not necessarily lack communication ability, but rather struggle to communicate with non-autistic people, which is amplified by the fact that autistic people are in a steep minority. As for their ability to empathise with one another, the fact that autistic people are frequently bullied by non-autistic people (Schroeder et al. 2014; Weiss and Fardella 2018) speaks volumes about non-autistic people’s lack of empathy and understanding for autistic people.

Restricted and repetitive behaviours in non-autistic persons

So, there is a chance that at least a number of autistic people might not present ‘deficits’ in social communication skills after all. But what about their restricted and repetitive behaviours? Rigidity and inflexibility play a crucial part in the autism diagnostic criteria, which can take place as inflexible adherence to routines, insistence on sameness, as well as the presence of stereotyped or repetitive movements or speech (American Psychiatric Association 2022). These traits may include hand flapping or other ‘stims’ (i.e. repetitive, self-stimulating motions to cope with overwhelming situations or boredom), lining up objects, eating the same foods, having restricted interests, etc., and are all stereotypically seen in autistic people, who are at times mocked, belittled, or punished for having them. But why do autistic people receive poor or harsh treatment for simply exhibiting such traits?

It may perhaps be accurate to acknowledge that non-autistic people are also rigid and inflexible, albeit on a social level. It is this ‘social rigidity’ present in non-autistic people that prevents many of them from accepting autistic traits and behaviours in this non-autistic society. In fact, non-autistic people’s ‘insistence on social sameness’ has forced autistic people to mask their autistic traits and adopt more ‘normal’ traits, simply because such autistic traits are considered to be ‘not normal’. This ‘insistence on social sameness’ is likely a reason why autistic people are regularly abused and ostracised from societies and social circles; their behaviours often bring discomfort for non-autistic people. Indeed, it is why many types of professional therapy for autism focus on replacing autistic traits and behaviours with non-autistic ones in order for the individual to successfully blend in with this society of conformity; it is almost never about the individual, but rather about how those around the individual feels (Shkedy, Shkedy, and Sandoval-Norton 2021). Such approaches can deny autistic people the opportunity to develop their self-understanding and self-advocacy, creating a lasting negative impact on their mental and physiological health in the long run (Kupferstein 2018).

Yet, autistic people are clearly not the only ones displaying repetitive behaviours. The term ‘fidgeting’ is used to describe the periodic, subtle physical activities people engage in that are not relevant or peripheral to ongoing tasks or events. Such activities can be hair twirling, finger twiddling, or leg drumming. Fidgeting as a form of ‘displacement behaviour’ can regulate feelings of stress and anxiety amongst many people (Mohiyeddini and Semple 2012). Many autistic adults feel the same about stimming—it helps contain or control excess emotion (Kapp et al. 2019). However, many autistic adults have reported regularly encountering negative social responses to stimming despite not being detrimental or destructive (Kapp et al. 2019).

Different but the same

But what really are the differences between ‘fidgeting’ and ‘stimming’? Aside from the obvious difference in intensity and noticeability between the two (i.e. hand flapping is more intense and noticeable than hair twirling), I submit that a core difference between ‘fidgeting’ (i.e. hair twirling) and ‘stimming’ (i.e. hand flapping) is that the former is considerably more socially acceptable, whereas latter is considerably less so. Like autistic people, non-autistic people can also present a degree of rigidity in their behaviour, but on a social level that prevents and hinders the existence and tolerance of any difference, such as autistic difference.

Whilst an important point of this article is to highlight how some behaviours associated with being autistic are negatively perceived by non-autistic people despite being present in many non-autistic people in a different manner, it is simply false that everyone is ‘a little autistic’. Autistic people have their own causes of ongoing distress that are not strictly social, such as sensory overload (Kapp et al. 2019) and more frequent gastrointestinal issues (Madra, Ringel, and Margolis 2020). In fact, the reason why many autistic people engage in stimming is to reduce sensory distress (Kapp et al. 2019); hence, the importance of allowing such behaviours and not belittling autistic people for displaying them should never be understated.

As explained, repetitive and rigid behaviours in autistic people just manifest themselves in a different way and are backed by a different motive. This line of thinking could be useful in preventing such stigmatisation and dehumanisation towards autistic people, which are already highly prevalent in autism research (Botha 2021), let alone in society. If the repetitive behaviour does not lead to any destruction or harm to oneself or other people, then it should most likely be tolerated and not stigmatised.

Conclusion

The purpose of this piece is to highlight yet even more cognitive-behavioural differences in autistic people that researchers and professionals may deem to be autism-exclusive traits—ritualistic behaviours in particular. Autism is characterised by a lack of communication ability and the presence of restricted and repetitive behaviours. However, not only may autistic and non-autistic people communicate and empathise differently with one another, but they can both express rigid and repetitive behaviours in their own ways. So, what does it really mean to be on the autism spectrum? Is it a mere difference that society fails to accommodate and accept? Or does it have fundamental ‘deficits’? Perhaps they are both the case, depending on the individual. After all, autism is a broad, complex spectrum with various levels of ability and requirements for support. Whilst this is not to say that everyone has autistic traits, the definition and diagnostic criteria for autism may need to be re-evaluated in order to best support autistic individuals according to their individual needs and reduce any social burden on them that comes with getting an autism spectrum diagnosis. Some may have inherent ‘deficits’ which need to be acknowledged, whereas some may not have them which should not be imposed on the individual.

Furthermore, diversity is important on many levels, and increased diversity leads to an increased chance of survival as a species. It is for this reason that the neurodiversity movement, different ways of thinking and relating to the world, and any non-destructive behaviours and traits, no matter how ‘weird’ they are considered to be by some, commonly associated with autism should perhaps not be suppressed, stigmatised, or discouraged. As an autistic self-advocate, I can only hope the public will be more informed on autistic differences as well as why they should be more tolerant of such differences and how to be more comfortable with them.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.