OTSLPOtherAutism : the international journal of research and practice2022

Cognitive processes in autism: Repetitive thinking in autistic versus non-autistic adults.

Kate Cooper, Ailsa Russell, Steph Calley and 3 others

PMID 34291680

WHAT IT FOUND

Autistic adults reported more repetitive thinking than non-autistic controls, but their thoughts were not more restricted, negative, or visual.

The study suggests that obsessive thinking, rather than generic repetition, may drive insistence on sameness behaviours.

Key findings

01Autistic participants reported significantly more repeated thoughts than controls.

02There was no significant difference between autistic and control participants in restricted thinking style (number of thought categories).

03In autistic participants, higher insistence on sameness was associated with higher scores on the obsessive-compulsive inventory, but repetitive thinking was not associated with insistence on sameness.

STILL TO COME

How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs

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What it does not show

The sample size for the analysis was smaller than recruited (96 of 120) due to incomplete DES booklets. Researchers coding the thoughts were aware of the hypotheses, which could introduce bias, although double-rating was used. The DES method relied on paper booklets and random alarms, so it is unclear if thoughts were recorded exactly 'in the moment' or reconstructed shortly after. The groups were imbalanced in gender, with a high number of females in both groups. The measure of 'restricted thinking' relied on categories defined by non-autistic researchers, which may not capture idiosyncratic autistic cognitive patterns.

Declared interests

The authors declared no potential conflicts of interest. The research was supported by a National Institute for Health Research (NIHR) Clinical Doctoral Research Fellowship for Kate Cooper.

The easy way to misread this

Do not conclude that autistic adults do not benefit from visual supports. The lack of difference in reported visual thoughts does not prove visual aids are ineffective; it only shows that autistic adults did not report *more* visual thoughts than controls in this specific self-report task.

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