Extreme distress at small changes is most closely associated with which behavior feature?

The feature most closely associated with extreme distress at small changes is insistence on sameness. Individuals who exhibit this behavior often find comfort and security in familiar routines and environments, leading to significant anxiety or distress when even minor alterations occur. This can manifest in various settings, such as disruptions in daily routines, changes in expected activities, or variations in surroundings.

Insistence on sameness indicates a strong preference for predictability and a resistance to change, which can be particularly pronounced in individuals with autism spectrum disorder and other behavioral conditions. This feature highlights how critical consistency is to the individual's emotional well-being.

On the other hand, stereotyped or repetitive behavior typically refers to repetitive actions or movements that serve to self-regulate or express discomfort but might not necessarily involve distress regarding changes in environment or routine. Highly restricted interests focus on intense fixation on specific topics or activities, but they do not inherently involve distress at changes outside those interests. Hyper or hyporeactivity pertains to unusual responses to sensory input, which may be stressful but is not directly about the need for sameness.