Like a vinyl record stuck in a groove, the mind of someone with autism can sometimes replay the same track, revealing the fascinating phenomenon of perseveration. This unique aspect of autism spectrum disorder (ASD) offers a window into the complex workings of the autistic brain and highlights the challenges faced by individuals on the spectrum in their daily lives.
What is Perseveration?
Perseveration is the repetition of a particular response (such as a word, phrase, or gesture) regardless of the absence or cessation of a stimulus - the continuation of an activity or thought without an ending point.
Perseverative behavior is simply a repetitive behavior, an action that a person keeps repeating without meaning to. Some examples include saying the same words, moving in the same pattern, or even thinking the same unhelpful thought, long after whatever initially prompted the activity has passed. Or as described by Danielle Sullivan in Neurodivirging.com, "To perseverate is to feel that involuntary fixation, that feeling of being “stuck.” The speech, movement, or perseverative thinking repeats over and over, without the person consciously deciding to make it happen.
Perseveration or Interest?
According to Lisa Jo Rudy, author of “Get out, Explore, and Have Fun! How Families of Children with Autism or Asperger Syndrome Can Get the Most out of Community Activities,” many children with autism have passionate interests. In some cases, these are true interests which can lead to many fascinating adventures in the community. In other cases, the “interest” was in fact a perseveration.
She continues to explain the difference between an interest and a perseveration:
- An interest is flexible. A child who is interested in dogs may be interested in learning about different breeds, attending a dog show, joining a 4-H dog club, or taking care of a pet dog.
- A perseveration is inflexible. A child who perseverates on dogs may simply want to collect and hoard figurines of dogs and recite the names of the breeds – but he or she will have no real interest in better understanding or caring for dogs.
- An interest can be shared. A child who is fascinated by football may want to watch a game with a family member, discuss stats with a friend, or join a fantasy league.
- A perseveration is individual. A child who perseverates on football may stash hundreds of trading cards, but will rarely want to trade them, play with them, or even discuss them – except by reciting a memorized “script.”
- A person can grow with an interest. A child’s interest in finger painting can become a tween’s interest in acrylic painting and a teen’s interest in oil painting – each medium being a progressively more difficult and richer tool.
- A person is “stuck” in a perseveration. The child who perseverates on finger painting isn’t interested in painting. He or she may love the texture, smell or colour of the paint, but the interest is in the thing itself and not in its usefulness as an artistic tool.
Types of Perseveration
Danielle Sullivan in Neurodivirging.com note that there are three categories of perseveration:
- verbal perseveration,
- motor perseveration
- perseverative thinking (sometimes called cognitive perseveration).
Some people with autism show signs of all three types, and some people just present one type. Let’s look at some examples for each of these categories.
What is verbal perseveration in autism?
Perseverated speech, also called verbal perseveration, is repetitive speech or other sounds that are not voluntary or serving a social function. In autism, we especially see this in the (commonly stereotyped) autistic behaviour of repeated info-dumping.
Think of the little kid who can only talk about cars, only wants to talk about cars, and who repeats the same facts about cars every time you see him. He is repeating information past the point of utility or value. That child is perseverating on the topic of cars.
What is motor perseveration?
The second category of perseveration that applies to autism is motor perseveration. This is defined as a repetitive movement of the body that is not fully voluntary. The most common movements seem to depend on the age of the individual.
In autistic children under 3 years-old, it is identified as common repetitive behaviors such as banging objects on a surface, moving objects stereotypically, repetitively swiping objects, and trying to spin objects. Stiffening of the posture, rubbing oneself, and banging on surfaces are also common.
The most common motor perseveration in adults with autism are grimacing and other facial movements, as well as flapping arms and hands.
What is thought perseveration?
Thought perseveration is sometimes called cognitive or thought perseveration, and it refers to, you guessed it, a repetitive thought! But what exactly does that mean?
Repetitive cognition is a tendency to perseverate on particular thoughts, often accompanied by difficulty disengaging with these thoughts; repetitive cognition ranges from fixation on favorite topics or activities (whether actually doing these activities or merely thinking about them) to rumination, which is a perseveration on negative thoughts noted in typically-developing individuals with depression.
In children, cognitive perseveration often stems from some kind of anxiety or worry. Maybe a dog barked at them or a door slammed, and it scared them very much, and now they feel like they can’t stop thinking about it, and how it could happen again. This is rumination, one particular negative kind of thought perseveration.
As an autistic adult, the kind of thought perseveration I catch myself doing most often is repeating conversations I’ve already had with other people in my mind. Sometimes I am actively analyzing these conversations to try to figure out what I might be able to do better next time, but often they’re just looping through my mind for no particular reason other than my own anxiety about being socially awkward.
Example of perseverative thinking in autism
Here are some traits and tendencies of perseverative thinking from Autism Parenting Magazine:
- Obsession: When your child is highly fixated on a topic, they have an interest in it and will not move to other ideas and interests. Our children may ask the same question over and over or have repeating behaviors.
- Loop thinking: When working with clients, we discuss how thoughts and behaviors may appear like a “Tasmanian devil” or “swirling water in a drain.” Typically, when a topic comes up, the individual may go over and over the topic while the details become very intertwined. Looping thinking may also come across as giving the same answer to different questions, even if the answers have nothing to do with the topic.
- “What ifs”: This may look like repetitive thinking of details for upcoming events. Your child may “what if” every single detail before making a decision or acting. They may also “what if” a situation based on historical situations that occurred long ago.
- Fears, stress, and anxiety of the unknown: Your child may express feelings based on not knowing all the details. They may not take any action until they have uncovered all the information to lessen these emotions. This may cause delayed action or no action at all.
- Conflict avoidance: To avoid conflict, your child may dodge all topics and situations where a dispute could arise. They may avoid people and situations to limit the need to navigate the conflict.
- Concerned about what others will think: A child may get hyper-focused on what others think, creating an emotional reaction for themselves. This thinking could cause an increase in their emotions, thus not acting.
Why does perseveration happen?
There could be a number of reasons why an individual perseverates. First, stress and anxiety can cause and prolong this behavior. Sometimes, when your sensory system is under stress or they are more sensitive, repetitive actions and behaviors could increase to help them cope with the environment.
According to the Canadian training organization, Autism Awareness Centre Inc, some of these reasons why autistic people perseverate include:
- not knowing how to calm the mind and body
- difficulty with flexible thinking
- slow processing speed which means a person needs a lot of time to take in, make sense of, and respond to information
- not understanding social cues
- a lack of impulse control
- being hyperfocused on things a person is interested in
How to get “unstuck”?
Autism Awareness Centre Inc, suggest that to help a person become unstuck with their thinking, we have to figure out why it is happening and how to address those reasons.
Sensory Overload
Sensory overload will not only affect sensory regulation, but also emotional and cognitive regulation. Emotional regulation lets a person respond to social rules with a range of emotions through initiating, inhibiting, or modulating their behavior in a given situation to ensure social acceptance. Cognitive regulation allows a person to use cognitive (mental) processes necessary for problem solving and related abilities in order to demonstrate attention and persistence to tasks.
Understanding a person’s sensory profile and the activities which support calmness and regulation can really help when a person feels overwhelmed and out of control. Engaging people in sensory experiences on a regular schedule can support focus, attentiveness, and interaction. Individuals tend to feel less anxious when they feel comfortable and in control.
Reducing Anxiety
Anxiety is a complex subject because there is no one cause for its occurrence. When an autistic person feels anxious, perseverative thoughts can start. There can be a number of reasons for anxiety such as:
- difficulty with social situations
- unpredictability
- loss or change of routine
- not being able to identify, understand and manage emotions
- sensory overload/unfriendly sensory environment
- feeling misunderstood and wanting to fit in by masking or camouflaging autistic traits
Some tips for managing anxiety are:
- Know the anxiety triggers. Triggers can be identified through keeping a journal or observational notes.
- Monitor and manage energy levels. Develop an awareness of energy levels after events and activities such as school or work. Allow for breaks, periods of rest, and the chance to engage in enjoyable interests that can recharge the batteries.
- Make accommodations to the environment – Altering the environment can help with sensory overload. Have quiet spaces, soft lighting, wear noise cancelling headphones.
- Reduce demands. If a person is struggling, stop talking, allow for personal space, and reduce the demands on that person.
- Use sensory tools to calm and soothe. Examples are fidgets, items that provide deep pressure, stress balls to squeeze etc.
- Use relaxation and calming activities. Examples of these could be meditation, yoga, listening to music, and physical activity.
- Visual schedules and routines. Visual schedules and routines provide structure and predictability.
- Consider using an anxiety app. Molehill Mountain was designed specifically for autistic people to help with anxiety and executive function support.
Parking Perseverative Thoughts
Judy Endow, autistic adult and visual thinker, wrote an excellent blog post on this topic and how she helps her clients park those repetitive thoughts. Judy says, “Sometimes the perseveration is happening because the individual is thinking about something they do not want to forget and haven’t yet figured out another way to hold onto their visual thought.”
Some of Judy’s ideas for parking perseverative thoughts are:
- Create a parking garage or parking lot in your mind. Park the picture of that thought into the garage for access at a later time. To first practice this concept, it may be helpful to draw the garage, build a 3 dimensional structure, or use a box. Draw the visual thought that needs to park and put in the garage. This lets a person know the thought is still there for later retrieval but it doesn’t need to be kept by repeating it.
- Write out the visual thought or draw it so that there is a concrete record of it. Direct instruction and repetitious practice will have to happen before the seemingly simple idea of writing it down becomes a viable everyday strategy.
- Visually pull up a future scene of when you need to remember your current thought. Again, this can be done through drawings or pictures.
Do we want to stop autistic perseveration?
Neurolaunch reiterates that perseveration in autism is a complex phenomenon that significantly impacts the lives of individuals on the spectrum. By understanding its characteristics, causes, and manifestations, we can develop more effective strategies to support those affected by this aspect of autism.
Understanding and supporting individuals with autism who experience perseveration is crucial for their overall well-being and development. By recognizing the unique challenges they face, we can create more inclusive and accommodating environments that allow them to thrive.
A balanced approach to managing perseveration is essential. While it’s important to address problematic behaviors, we must also recognize and nurture the positive aspects of intense focus and dedication often associated with autism. This approach can help individuals harness their strengths while developing the skills needed to navigate a neurotypical world.
But we are also reminded by Danielle Sullivan in Neurodivirging.com that if a person’s perseveration is annoying you, but not harming them or anybody else, please don’t consider intervention. An autistic child should be allowed to talk about their favorite subject, just like anybody else would, even if the behavior seems excessive to you. In this case, the problem is your perception of the behavior, not the behavior itself. Try ignoring it, and remembering that there’s no harm in perseveration in and of itself.