Autism and Anxiety

Children with Autism are known to be more naturally ‘anxious' than their non-ASD peers. The challenges presented by the 5 characteristics of Autism (social impairment, communication impairment, sensory sensitivity, repetitive behaviours and difficulty with change) potentially make their world a confusing and frightening reality. Add anxiety to the mix and you may have a child who is anxious and worried 100% of the time. Anxiety and stress over sustained periods of time is shown to lead to exhaustion, the development of allergies and illness.


Children with Autism demonstrate their anxiety through a variety/combination of behaviours:-

* Physical symptoms (stomach pains; headache; racing heart; sweaty palms; constricted chest; tight muscles; insomnia)
* Avoidance desire
* Inattention and
* Irritability

Anxiety in children with Autism can be triggered unconsciously; when this is coupled with their inability to verbalise effectively it compounds the effects of anxiety – the child with Autism can be extremely anxious, and unable to tell you why (they may not know themselves). They may be able to tell you they have a stomach ache, or don't wish to go to Joey's birthday party, but not know why.

Children with Autism are known to have ‘perfectionist' attitudes towards many areas of their lives, and this can be witnessed through their ‘obsessive/compulsive' behaviours, their repetitive patterns of behaviour and their difficulty coping with change. This self-imposed ‘perfectionist' attitude can contribute to their anxiety and ‘pressure to perform'. In other words, children with Autism usually place extreme/unrealistic demands on themselves. It's important to remember this when dealing with an anxious ASD child.

Some useful techniques for supporting an anxious child with Autism include:

* Redirection/distraction
* Physical energy ‘burn' (physical activity such as running, bike riding, jumping on a trampoline, swimming etc)
* ‘Whole-body' activities (tug-of-war; monkey-bar; rolling on floor/ground)
* Body brushing/massage
* Deep pressure activity (lying under a heavy blanket/cushions/mattress)
* Chewing/sucking (relieves pressure in the jaw)
* Listening (hearing what the child can tell you)

Anxiety levels in children with Autism are ‘cyclic' in nature, making it more difficult for parents/teachers/carers to identify anxiety triggers. Cycles vary from 4-6 weeks (often linking with lunar cycles). What causes the ASD child mild anxiety one week, may cause extreme anxiety ( and/or avoidance desire) the next.

When our son with Autism was 9 he progressed from a child who was slightly more anxious than his peers, to a child who was extremely anxious, paranoid and agitated in the space of 6 months. Various methods of dealing with anxiety were introduced by the many therapists/professionals treating our son, much of them with conflicting advice. All of them failed to acknowledge the physical symptoms our son with Autism experienced, tending to present the attitude that the anxiety was "self-imposed", and "if he's not going to speak about what's causing the anxiety, then we can't help him dispel the physical symptoms of that anxiety".

Our son with Autism is now nearly 16, and in the last year has begun to verbalise much more about his experience of that time. He tells us he was very frightened by his physical symptoms, and most of the time he didn't know what it was about a situation or event that was causing him anxiety, he just knew that the thought of participating sent him into panic. The ‘fight or flight' response occurred almost immediately (before he'd had a chance to process the feeling of panic) and he felt he had no control over his world.

He also says we should've listened to him more. For example, if he said didn't want to go to Joey's birthday party, we should've understood that he:-

a) knew birthday parties were fun
b) liked eating party food
c) liked singing Happy Birthday
d) knew all the other kids were going
e) wanted to be like all the other kids

We should've understood that if there was any way he could've coped with the party, he would go. At that point he'd already tried 100 things in his head to talk himself into going. In saying he didn't want to go, his real message to us was "I can't cope with that today".

As you support your child with Autism to cope with their anxiety be mindful of ‘hearing' them – not all avoidance desire is ‘manipulative' behaviour. Yes, children with Autism can be manipulative, but their desire to not be ‘different' together with their ‘perfectionist' attitudes is a strong, internal force that drives them to be all they can be.

www.autismchild.org
©Nelle Frances 2005