Are Hyper-Fixations and Special Interests Always Pathological?

Why are these more common in neurodivergent children?

So let’s begin with: what are hyperfixations or special interests?

Typically, they are some form of strong attachment and investment in a certain topic, concept, object, person, or activity. In the book Uniquely Human, Dr. Barry Prizant refers to special interests as “enthusiasms”, influenced by the Professor Clara Park and her journey with her own autistic child. As it stands, restricted interests are part of the criteria of autism in the DSM-5. Traditionally, special or restricted interests were seen as disabling, interfering, and problematic. And while in same cases, they can restrict adaptive functioning or goal attainment for some, this is often not the case. In fact, the ICD-11 has moved towards a more humanistic as opposed to a medical model for mental health and neurodivergence.

Why do neurodivergent people have a propensity for hyperfixations? Perhaps because they often provide order, predictability, instructions, sequence, and logic. For many, there is a strong desire to know and to master. For some, it is reassuring that there is no limit obtaining knowledge or possession of their special interests, as it an infinite escape, and a place where opinions and ambiguity are essentially futile. Studies have shown that those with special interests spend an average of 40 hours per week engaged with their hyper fixation and more often than not were engaging with at least one other person. For those who take time to observe and understand an particular autistic individual, you would learn that their special interests or enthusiasms make perfect sense in terms of who they are and what makes them “tick”, so to speak. Special interests are actually often logically-based, given that persons strengths and needs.

Historically, since restricted interests or hyperfixations were largely observed as problematic and pathological by both the medical community and general society, there were a number of negative effects of children who engaged in their special interests. As Dr. Devon Price points out in Unmasking Autism, during early ABA, even talking about special interests were “punished” or “ignored” in an attempt to stop distraction and hyper-focusing and so the children could “fit in.” Of note, many of the autistic people interviewed in research as well as anecdotally reported experiencing bullying and/or rejection at some point for their special interest. Many teens/young adults with autism, especially females, expressed feeling they had to hide or mask their hyperfixations or specialized interests, and they would resort to enjoying their interests in private and try to show interest in more popular topics. Many expressed that it was difficult to connect with others on a deeper level and to accept themselves or feel accepted by others. In present day, the potential danger to these hyperfixations or obsessions is when the topic turns negative. For example, there is a large number of autistic people who have become quite entrenched and active within the “incel” communities and tend to cling to concepts or injustices that may or may not have credibility or rationality.

On the other hand, in listening to and seeking feedback from neurodivergent people with the lived experience of special interest, we have a deeper and more accurate understanding of the function of special interests and why they are so crucial to many children and young adults with autism and/or ADHD. For many, hyperfixations are a way to connect to others, especially other neurodivergent individuals. Many have explained that it is easier to learn facts and develop emotional connections about rote or specific topics or with sequence/sets/collections. Interestingly, studies have shown that for many autistic people, when they are conversing about a special interest, they used more sophisticated and complicated grammar, vocabulary, and overall language. Additionally, there is plenty of research to show that special interests both foster social connections and provide significant meaning and joy to many autistics lives. In fact, several autistic people explained that thinking about, talking about, or researching their current hyper fixation provided a sense of safety and order they don’t normally experience as well as providing relief from expectations and required reciprocity. Many are able to understand complex social situations and emotions in the context of their special interest and serves to motivation them to expand their knowledge and skill sets.

Per the Autistic Self-Advocacy Network, “special interests are really important to most autistic people.” In fact, the concept of a “special interest week” was born out of an idea by Jersey Noah and execution by Dr. Devon Price to reflect on the journey, of joy, self-discovery, and pleasure of one’s own special interests. Many added that they felt time spent engaged in special interests were protective of autistic burnout. Further, some autistics have explained that, for those who are neurodivergent, special interests have a different quality and personal value, than they might for most neurotypical people.

And the irony of the history of attempting to suppress special interests is that hyperfixations can be very adaptive in an occupational sense, whether it be a traditional job and/or as a content creator, especially when it comes to understanding and executing within complex situations. In fact, many autistics have expressed their primary motivation for seeking employment was secondary to their special interest. For example, Dr. Temple Grandin has explained that her hyper fixation on livestock and ability to understand relationships through animals is responsible for her discoveries and advancements within the livestock equipment field. Moreover, many autistic people have reported that their special interests are a core part of their identity and have significantly improved their quality of life. More concerning for social and occupational functioning is actually emotional well-being and self-concept, as those with depression and anxiety tend to struggle most with maintaining relationships and employment.

So knowing all this, brings into question the efficacy of our autism assessments; rethinking the pathology of restricted interests or behaviors as a core feature of the “disorder” of autism. I want to also qualify this to say that hyperfixations and repetitive behaviors can look EXTREMELY different in autistic people with higher support needs, as opposed to lower support needs, and can certainly be much more disabling, and at times, even disruptive; however, it continues to be important to understand the function of such behaviors as well as the relationship to the underlying neurobehavioral differences that actually constitute autism.

Recently, the Survey Of Autistic Strengths, Skills, and Interests (SASSI) was developed, which may be beneficial both as part of the assessment and psychoeducation for the families. For example, the SASSI asks questions related to ability to focus on topics of interest for extended period of time, motivations, and functional benefits of these interests, and whether the interests promote social connections. So we are not only assessing the frequency and nature of these special interests, but actually gauging their functionality and adaptability in a more global context. Moreover, new developments in machine learning and artificial intelligence, in an effort to identify diagnostic biomarkers through deep learning video analysis, natural language processing, brain imaging, and biodata integration, have led to other methods of potential diagnosis in order to diagnose effectively between 70 and 90% of the time, which may lead to a more objective and neurobiological basis for diagnosis; however, there are still many ethical considerations to be worked out.

All in all, special interests can be serve as both a boundary and protector from society as well as a connector and unifier. Similarly, special interests can serve both as a barrier and a strength within the workplace and in relationships. For clinicians and professionals, special interests can also be a significantly beneficial tool to building rapport in therapy and within the school environment. And the truth is, many neurotypical people have similarly intense interests; however, they don’t necessarily allow themselves to fully embrace them and/or they replace them with more maladaptive and socially acceptable coping mechanisms like social media, food, or drug addictions- for a similar dopamine rush. Many neurotypical people are motivated by social rewards, which often undermines their motivation for their interests, free time, hobbies, and even careers. For those who may not value the social hierarchy in the same way, their ability to be overly pragmatic may allow for genuine self-exploration and healthy selfishness. Now of course, if a special interest becomes all-consuming or inappropriate, then it is no longer beneficial or functional; however, that is actually not very common for most autistic people. Someone’s special interest can be the context and background for which they learn and develop across areas of their life: socially, academically, communicatively, and occupationally. And ultimately, part of child’s  “therapy” may include psycho-education for the neurotypical or caregivers in the child’s life.