Catatonia & Autism

A significant change from a person’s usual movement, communication, behavior or independence deserves attention.

Catatonia is a serious but treatable condition that affects movement, communication, behavior, and daily functioning.

Catatonia & Autism

THE MOST IMPORTANT QUESTION

Is this new or significantly
different for this person?

Look for change from the individual’s own baseline, rather than comparing them with someone else.

RECOGNIZING CHANGE

What Changes Might You Notice?

One alone does not diagnose catatonia. What matters is a noticeable change in the person’s usual functioning, particularly when several appear together or get worse over time.

Movement or Behavior Changes

Movement or Behavior Changes

A noticeable slowing of movement, responses, or everyday activities.

Freezing or Getting ‘Stuck’

Difficulty starting, continuing, or completing movements and familiar activities.

Changes in Speech

Changes in Speech

Speaking much less, taking longer to respond, or stopping speech that was previously used.

Needing More Prompts

Needing More Prompts

A new or significant increase in prompting for activities the person previously managed more independently.

Changes in Daily Living

Changes in Daily Living

New difficulty with eating, drinking, dressing, hygiene, toileting, or other self-care.

Movement or Behavior Changes

New or increased repetitive movements, unusual postures, imitation, agitation, withdrawal, or other marked changes.

What Is Catatonia?

Catatonia is a serious but treatable condition that affects movement, communication, behavior, and daily functioning. It can occur in individuals with Autism and other neurodevelopmental disabilities and may develop gradually over weeks or months or appear suddenly.

Some people become unusually withdrawn, move more slowly, or become less responsive. Others may become increasingly restless, agitated, or exhibit repetitive movements. Some individuals move between both states.

The most important thing to look for is a noticeable change from a person’s usual abilities, behavior, or level of independence.

Needing More Prompts

Help the Clinician See the Change

Families and caregivers may notice changes that are difficult to see during a short medical appointment.

  • Write down when changes began and how they progressed.
  • Track changes in movement, speech, sleep, eating, drinking, toileting, self-care, and independence.
  • Note medication changes, illness, stressors, or other changes around the same time.
  • When appropriate and respectful, short videos may help demonstrate a change in movement or functioning.

LEARN MORE

Understanding Catatonia

Keep the essential warning signs visible. Use toggles for the deeper medical information so families can choose how much they want to read.

Catatonia

Families often notice a change before they know what catatonia is. They may say:

“My daughter stopped talking.”

“Why is he moving so slowly?”

“She seems stuck.”

“He can’t do things he used to do.”

“Something just doesn’t seem right.”

If these changes represent a decline from your loved one’s usual abilities, it may be worth discussing catatonia with a healthcare professional. Catatonia is often overlooked because many symptoms can resemble Autism itself. The key is identifying changes from the person’s typical pattern of functioning.

Catatonia often looks like a loss of previously learned skills or a significant change in how a person moves, communicates, or engages with others. It may develop gradually, making it easy to mistake it for stress, burnout, depression, or changes related to Autism.

You may notice:

  • Moving slower than usual
  • Freezing or getting “stuck”
  • Difficulty starting or completing activities
  • Increased dependence on prompts
  • Reduced speech or communication
  • Withdrawal from family, friends, or favorite activities
  • Changes in eating, drinking, or self-care
  • Increased repetitive movements
  • Repeating words or actions of others
  • Unusual body positions or posture changes
  • New or worsening urinary incontinence

Some individuals may develop a stooped or hunched posture, look downward more often, or show noticeable changes in how they walk and move. The key question is whether these changes are new or represent a decline from previous abilities.

If you are concerned about significant changes in your loved one’s movement, communication, behavior, or daily living skills:

Document What You’re Seeing

Keep notes about:

  • When symptoms started
  • What has changed
  • Changes in eating, sleeping, communication, mobility, and self-care
  • Triggers that seem to make symptoms better or worse

Take Videos

Videos can help healthcare providers compare current abilities with previous functioning and may provide valuable information during an evaluation.

Diagnosis & Treatments

A psychiatrist most commonly diagnoses and treats catatonia, often in collaboration with neurologists, developmental specialists, and other healthcare professionals. Because catatonia can resemble Autism characteristics, it is helpful to seek evaluation from a provider who has experience working with Autistic individuals and recognizes changes from a person’s typical level of functioning.

Treatment may include:

  • Lorazepam (a benzodiazepine medication)
  • A Lorazepam Challenge Test to help support diagnosis
  • Environmental support and structured routines
  • Electroconvulsive Therapy (ECT) for severe or treatment-resistant cases

Catatonia is treatable, and many individuals improve significantly when it is recognized and addressed appropriately.

There Is Hope

Catatonia can be frightening for individuals and families, especially when symptoms develop gradually and go unrecognized.

The good news is that catatonia is often treatable. Many individuals experience meaningful improvement when the condition is identified early and treated appropriately. Increased awareness, persistence, and partnership with knowledgeable healthcare providers can make a significant difference.

Trust your instincts. If something feels different, don’t ignore it. You know your loved one best.

Resources for Families

A short, curated collection of clinical screening, assessment, and treatment resources can help clinicians who are unfamiliar with catatonia in autistic and neurodevelopmentally disabled patients.

Autism Spectrum Disorder and
Catatonia (ASAT)

A straightforward overview explaining how catatonia may present in autistic individuals, common warning signs, and available treatments.

Autism Science Foundation: Catatonia Resources

The Autism Science Foundation has developed family education materials, podcasts, and clinical resources focused on recognizing catatonia in autistic individuals. Their resources help families understand symptoms, diagnosis, and treatment options.

National Council on Severe Autism:

Catatonia in Autism Family Guide
Resources and a webinar series featuring leading experts, including Dr. Joshua Smith, Dr. Kelli Dominick, Dr. Lee Wachtel, and others. Includes practical information families can bring to healthcare appointments.

The Catatonia Foundation

One of the most comprehensive family-focused resources available. Their Autism & Catatonia section explains warning signs, diagnosis, treatment options, family stories, and advocacy tools in plain language. They also provide downloadable resources families can share with healthcare professionals.

Resources for Medical Professionals

Clinical Practice Guideline

British Association for Psychopharmacology: Evidence-Based Consensus Guidelines for the Management of Catatonia

Peer-Reviewed Review Article

Catatonia in Autism and Neurodevelopmental Disorders: A Scoping Review

Peer-Reviewed Systematic Review

Catatonia in Autism Spectrum Disorders: A Systematic Review and Meta-Analysis

You Can Also See

Medical Disclaimer

The information on this page is intended for educational purposes only and should not be considered medical advice, diagnosis, or treatment. Catatonia can have many causes, and symptoms may overlap with those of Autism and other medical, neurological, or mental health conditions.

If you are concerned about changes in your loved one’s movement, communication, behavior, or daily functioning, please consult a qualified healthcare professional. If symptoms involve difficulty breathing, inability to eat or drink, high fever, severe immobility, or unresponsiveness, seek immediate medical attention