©2020 by Theresa Regan

Autism and Organization: Too Much and Too Little




Have you thought about your New Year's resolutions? Is one of them to "get organized." So many of us spend a lot of energy organizing, re-organizing, or wishing we were organized.


It is very common for clients and family members to describe the ASD individual as both over- and under - organized at the same time! This apparent contrast is very common, and is not something the ASD individual could "just do better" with if he were "more motivated."


We see this contrast of "over" and "under" with many autistic qualities such as how much the individual talks, how she handles personal space, and how she modulates the frequency of eye contact. Other individuals show over-reactivity to some sensory inputs (like light sensitivity) and under-reactivity to other sensory inputs (such as lack of reaction with a broken bone). Over and under, too much and too little.


A core feature of autism is a struggle with executive function. This thinking skill is impacted by the center (subcortical) and front of the brain. One sub-skill of executive function is organization. The interesting thing in autism is that -- although some individuals show either too much organization OR too little organization -- many show both.


What does this look like? One individual may over-organize his sock drawer and stamp collection but under-organize his taxes and work projects. Another individual may over-organize her pantry (with like items stacked and arranged by size, color, and date of expiration) but under-organize her medications and appointments.


Recommendations:

1. Recognize The Contrast as Neurologic

Even though the contrast in over and under-organization doesn't seem logical or intuitive, it does have a neurologic base, and it is common in autism.


2. Hoarding Is Common in ASD

One of the criteria for autism discusses unusual "attachment to objects." This could be an unusual strength of attachment (e.g., melting down if he can't hold his notebook), unusual objects (e.g., stress if unable to keep garbage or piles of boxes, etc), or an unusual amount of objects (e.g., thousands of items in a collection, hoarding).


3. Pick a Battle

Because the brain of the autistic individual feels that certain objects are "very important" and others are "not important," logical arguments about what "should be" important are rarely helpful.


Consider prioritizing what must be addressed and what can be let go in the area of organization. For example, if the individual has a collection that is over-organized, costs too much money to maintain, and takes up too much space, this may need to be addressed. If the individual has garbage, food, and bugs in their living space, this also needs to be addressed. But other parts of the disorganization or clutter may not be a first priority.


4. Try a Step by Step Process

Some ASD individuals can take a "first step" of parting with items by moving them to another floor of the house for "safe keeping." Others might be able to move some items to a storage locker. The goal would be to eventually help the person give away some of the items from storage. Other individuals become extremely distressed at the idea of even moving a loved object off the bed (some sleep on top of piles of possessions) or selling pieces of a collection ("It would feel like a death in the family").


5. Placement of Items

Some on the spectrum may feel very specific about item placement. One person may want her cup to sit on the very edge corner of a table, while people around her may worry the cup will fall. Another person may want all items on the mantle to be spaced evently and facing a certain direction. Others may meltdown if furniture is moved.


Understanding that this is likely to be stressful for some on the spectrum may be a first step in deciding whether changing object placement is really a priority.