Herman & Associates

Autistic Spectrum Disorders: Self-Maintenance Behavior

This section contains anecdotal information collected through our clinical experience in working with many individuals on the Autistic Spectrum.  This is not research based scientific evidence.  Herman & Associates offers these observations only as points for discussion and as possible research topics in the future. 

Poor Grooming

Individuals with ASD often struggle with egocentrism and the ability to observe themselves and their behaviors (e.g., taking the perspective of others).  Consequently, they tend to inadvertently ignore the basic grooming standards of their culture.  For example, individuals with ASD often leave the house in the morning without looking in a mirror, taking a shower, combing their hair, or brushing their teeth.  When the basic grooming standards of our culture are brought to their attention, they are commonly unconcerned about it, or the impact it has on others around them. 

Poor hygiene

Another related area of concern for many parents and partners living with individuals with ASD involves their generally poor kitchen and bathroom hygiene (e.g., not washing their hands prior to engaging in kitchen activities, ignoring the dirty dishes and letting them accumulate on the counter, not flushing the toilet, urinating on toilet seat or floor).  They struggle to see the problems and, consequently, do not consistently clean up after themselves.  They often leave a room in greater disarray than when they entered.

Unusual Dress

A closely related issue often needing discussion with individuals with ASD is a lack of conformity in dress and hairstyle.  Individuals with ASD often dress for comfort regardless of the environment.  Sensory sensitivity to clothing and labels may be a contributing factor as they often prefer softer clothing such as sweatpants and tee-shirts.  However, they tend to wear their favorite clothing nearly everywhere, regardless of appropriateness to the situation. 

Sexual Behavior

One difficult, but important topic to discuss with many individuals with ASD, involves the use of masturbation to relieve anxiety.  Many individuals with anxiety disorders (e.g., Generalized Anxiety Disorder, Obsessive-Compulsive Disorder) also use masturbation as a way to relieve anxiety.  Since we are sexual beings from birth, masturbation behaviors can be observed in children, teenagers, and adults.  Individuals with ASD commonly experience spikes of anxiety throughout their day.  Unable to relieve the anxiety in other commonly practiced ways (e.g., self-soothing inner dialogue, exercise, verbal sharing with a friend), they often engage in compulsive masturbation.  While this method of anxiety reduction is effective in the short term, it can be highly distracting, time consuming, and interfere with work production.  Because the adult with ASD is not always aware of their social context, they may engage in masturbation in inappropriate settings.  This is particularly problematic in children in school settings.

Restricted Diet

Many individuals with ASD are extremely picky eaters.  This is also attributable to sensory sensitivity.  Many foods may contain textures or tastes experienced as unpleasant by people with ASD.  Consequently, many individuals on the autistic spectrum have a very restricted diet.