Anxiety affects most of us at various points in our lives, but it can become a big issue for autistic individuals, including children and young people. But what exactly is anxiety? How does it manifest and impact on our children’s lives and behaviour? How can we help our children deal with anxiety and improve their wellbeing and mental health?
What is anxiety?
Anxiety is a feeling of unease, such as worry or fear, that can be mild or severe. Usually anxiety is a normal part of human experience. It would be unusual for a person to never experience anxiety; for example, you may feel worried and anxious about an exam coming up or a job interview. But usually our anxiety disappears in time (until the next anxiety-inducing event comes along!)
However when you are unable to control your anxious feelings and constant worrying affects your everyday life, anxiety can become a problem. Chronic anxiety is a major component to anxiety disorders such as Generalised Anxiety Disorder, phobias, panic disorder, or social anxiety disorder.
According to Research Autism around 40% of individuals on the autistic spectrum suffer from an anxiety disorder.
Why do autistic children experience high levels of anxiety?
There is a lot in the world to be anxious about if you are autistic, more than just important job interviews or exams. Our children get anxious about things that neurotypical (not autistic) children may take in their stride. Sensory overload can make getting out and about a difficult experience, social interactions with other children can be hard to navigate, or any change in routine can make our children feel like they don’t know what is going to happen next.
How do I know if my child is anxious?
It can be harder to tell with autistic children and young adults, as they may not even recognise themselves that what they are feeling is anxiety, or may not be able to communicate what they are feeling to their caregiver as well as neurotypical children can.
When my son, who has PDA, feels anxious, his first response is to hide away. Under a table, behind a curtain, under the duvet, or to go online and game, where it is safer and he has control. If you try and force him out of his safe place, he becomes verbally or physically aggressive. It is only after the anxiety has passed he can identify that he acted that way because something made him anxious, he never says ‘Mum, I feel worried about eating the sandwich you have never given me before’, or ’there is something really major coming up in school’.
Your child may act the same, or they may shut down completely, stim more to soothe themselves, become more rigid in their routines, or become oppositional. Basically, you know your child better than anyone else, and once you start getting an idea of what makes your child anxious and how they react to anxiety-inducing situations, you will start recognising their behaviour for what it is; their way of communicating their difficult feelings.
What can I do to help my child when they feel anxious?
Many of the things you can do in both the short term and long term to help your anxious child are the same whether your child is autistic or neurotypical.
When anyone is anxious what they need from those around them is reassurance and to feel safe. Let them know you understand how they are feeling, explain to them what they are feeling and what anxiety is, and be clear, calm and consistent in your parenting style.
Often, when a child feels anxious, their behaviour can look like they are ‘acting up’, and it can be tempting to discipline them. But that is the exact opposite of what they need at that time; they need calm and understanding to reduce their anxiety.
With autistic children, anxiety can be caused by not knowing what is expected of them, what will happen next, or what will take place at a certain event, for example. Providing very clear information in advance can help with this. See our posts on visual communication and transitions for more information.
What if their anxiety is getting worse and starting to affect their everyday life?
Sometimes our children may need help from professionals if their anxiety has become a major problem. If anxiety gets to the chronic stage, it doesn’t often just go away on it’s own, but will carry on getting worse. If you are worried about the impact anxiety is having on your child’s life you can get further help from their GP, paediatrician, school nurse or SENCO.
What additional help is out there?
CBT (Cognitive Behavioural Therapy) is reported to have very good results at helping autistic people with anxiety, as do other talking therapies with a counsellor. An article on Childmind states, ‘research over more than 20 years has shown that CBT is the most effective treatment for reducing symptoms of severe anxiety…the therapy gives children the tools to manage the anxiety themselves, now and in the future’.
Holistic therapies like massage and acupressure or relaxation techniques like meditation and yoga, tailored to your child’s age and abilities, are also worth exploring.
Occasionally, it may be recommended that your child takes medication like antidepressants or mood stabilisers to help with their anxiety, but because the medications often come with side effects this is only really considered if all other avenues have been exhausted.
Luckily, there is a lot of help out there if your child suffers from anxiety; it is very common. Below you will find a list of some of the online resources out there to help you to help your child.
- We have a list of mental health practitioners with autism experience
- The Mental Health Foundation have an excellent booklet about childhood anxiety you can download for free
- The NHS’s guidance on child anxiety
- The Anna Freud Centre, which deals with children’s mental health
- YoungMinds, a children’s mental health charity
- Off The Record (OTR) provides mental health help for children aged 11-25 in Bristol and South Gloucestershire
Books about autism and anxiety
- Jessica Kingsley Publishing has a huge range on this topic
- The Anxiety Workbook for supporting teens who learn differently by Clare Ward and Jamie Galpin
- 10 steps to reducing your child’s anxiety on the autism spectrum by Michelle Garnett et al
- The Autism Discussion Page on stress, anxiety, shutdowns and meltdowns by Bill Nason
- The Autism Discussion Page on anxiety, behaviour, school and parenting strategies by Bill Nason
- The parents’ guide to managing anxiety in children with autism by Raelene Dundon
- Helping autistic teens to manage their anxiety by Dr Theresa Kidd
- Avoiding anxiety in autistic children by Dr Luke Beardon