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How To Reduce Anxiety In Autism

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Enforce The One And Done Technique

Talking through feelings of anxiety can be helpful, but if your child has a tendency to fixate on something that is causing her anxiety, and you find that her anxiety increases the more you discuss it, consider a one and done approach whereby you discuss the issue once, and then table it for a later time. This ensures your child is able to express her feelings, and that she knows she can talk about it again if her anxiety elevates, while also limiting her ability to obsess over it.

What Do The Findings Of This Review Mean

The findings provide evidence in support of interventions, particularly CBTs, designed to reduce anxiety symptoms in school-aged children with ASD.

These findings accord with and build upon the findings of previous systematic reviews into the effectiveness of interventions to reduce anxiety in children and youth with ASD. However, because of the risk of bias in current findings, it would be useful to have further studies with larger sample sizes and to reduce potential biases where possible.

Classroom Ideas To Reduce Anxiety

Teachers often have students with ASD in their classrooms who appear anxious throughout their school day. These students can have such intense anxiety that it can disrupt the entire classroom , or even the cafeteria or an all school assembly. No teacher, parent or student for that matter wants to experience those anxious moments. Teachers would always rather see their students having successful, meaningful and fun experiences at school and want to provide their students with ASD the proper supports. There is much that can be done pro-actively to enable students to feel more in control and safe in their learning environments. Simple steps can be taken to increase positive learning.

The Children’s Center on OCD and Anxiety believes that students with ASD do their best work in a classroom that is calm, supportive, and organized. Some sample classroom accommodations for students who are anxious can include:

How To Deal With Anxiety And Autism And Strategies To Help Your Child Cope

Making a plan to manage your childs anxiety might include medication and therapy as well as changes to your childs routine at home and school. Including planned relaxation times in your childs schedule will help promote his/her emotional wellbeing and encourage him/her to prioritize mental health. Implementing time for yoga, reading a favorite book, going for a walk, or taking a handful of deep breaths can be helpful. During these brain breaks, it is important to make sure your childs triggers are not present to the best of your ability. For example, a child with social anxiety would not find a crowded yoga class relaxing, but creating a comfortable space in your home for him/her to stretch and take deep breaths might help.

Check-in times where your child can let you know how he/she is feeling with no judgment might be helpful. This might look like a short verbal exchange, a thumbs up or thumbs down, a picture is drawn, or any way your child prefers to communicate.

Above all, when you are making a plan to help children deal with anxiety, meet them where they are. Do not expect them to respond to treatments at any particular pace. Allow your child time to figure out what works for him/her. Anxiety and its triggers can seem trivial or downright strange to others but are very real for the person suffering. Patience and encouragement are key to supporting your child.

Try The Molehill Mountain App

Reducing Anxiety While Homebound with Children with Autism ...

Molehill Mountain is an app specially designed to help autistic people understand their anxiety. You can use Molehill Mountain to explore the causes and symptoms of your anxiety. The app lets you track your worries and the situations that trigger your anxiety, get evidence-based daily tips to understand more about anxiety and learn about techniques to try. Find out more about the app and how to download it from the App Store.

Helping Doctors Spot Anxiety In Youth With Autism

To help primary care doctors, Vasa and doctors in the Autism Treatment Network published recommendations for diagnosing and treating anxiety in youth who have autism.1 They recommend that doctors:

  • Look for physical signs, such as tremors, restlessness, sweating, body aches, and sleep problems.
  • Ask the child, parents, and teachers about possible signs of anxiety. Does the childs behavior change in certain situations?
  • Address school and home problems that trigger anxiety. Bullying, learning and speech problems, and inadequate help at school may be fueling anxiety. Families under stress may need help finding respite care and behavioral therapy for their child.
  • Address medical conditions, such as insomnia, or medications that may fuel anxiety.
  • Consider how much anxiety interferes with daily life, and whether it occurs in different places.

Never Reinforce Their Fears

One of the most important steps to protect children with ASD is to avoid reinforcing their fears as much as you can. Parents can accidentally pass their own anxieties on to their children and that can make matters worse. They can pick up on your mannerisms, tone of voice, body language, and the overall energy around you. It will inadvertently let them absorb your anxiousness and stress, even though you dont directly show it. The key is to never send any messages to your child that they must worry or fear something, even if they have had bad experiences. Let them have experiences and explore things themselves with your supervision, but dont catastrophize or hold them back at every step because of your own fears. For example, if they fell off their bike once, dont remind them they may fall again. Its normal for children to fall, but its your job to help them back up and assure them that its okay.

Investigating Anxiety And Autism

Anxiety is one of the most common psychiatric disorders affecting people with autism. About 40 percent of youth and up to half of adults meet the clinical criteria of an anxiety disorder, such as social anxiety, phobia, panic disorder, or generalized anxiety, or obsessive-compulsive disorder.3-9 By comparison, the anxiety rates in adults and children who do not have autism is 18 and 25 percent, respectively, according to the U.S. National Institute of Mental Health.

A few years ago, a group of researchers working with the Autism Treatment Network wanted to see what science had to say about anxiety treatment for children and teens with autism. The group, led by child psychiatrist Roma A. Vasa, became medical detectives, scouring online libraries to find out. Unfortunately, they could not find a clear answer because little rock-solid research existed. Large, long-term studies the kind that can provide definitive proof of a treatment’s effectiveness were “sorely needed,” they concluded.10

Since that 2014 article, a few more studies have been published, with “promising results” for two school-based behavioral therapies for anxiety in autism. But there is still little research on anxiety in adults with ASD, or in people who have both autism and intellectual disability.11

What Are The Signs Of Anxiety

Signs of anxiety include: 

  • catastrophising 
  • self-harm. 

These are signs that the anxiety has become a significant and debilitating issue in your life. Recognising this early can help you get the right support, therapy and medication.  

Autistic people may experience anxiety for a range of reasons such as: 

  • differences in sensory processing for example, being over or under-sensitive to noises, lights and smells 
  • finding it hard to predict or adapt to certain sensory situations 
  • difficulties with communication and social interactions 
  • having alexithymia – it is more difficult to regulate emotions if you cannot identify what you are feeling 
  • worrying about uncertainty and change or transitions, which comes with a fear of the unknown. You may like predictability and routines, and experience high levels of anxiety if things change 
  • trying to fit in or attempt to appear normal by changing your behaviour and internalising any stress/anxiety you feel in certain situations 
  • performance anxiety particularly at school or in the workplace. 

Summary Of Main Results

Eighteen RCTs and six quasi-experimental studies evaluating the effects of interventions targeting anxiety for individuals of mainstream school ageâwith participants in some study also involving slightly younger and slightly older young peopleâwith ASD were included in this review. The results of the meta-analyses provide some evidence that psychoeducational interventions for anxiety, predominantly CBT, may improve anxiety symptoms for mainstream school-aged children with ASD, ultimately reducing the number of diagnoses of anxiety disorders for some participants. More favorable outcomes for the treatment group compared to the control groups were recorded across the majority of studies, with an overall moderate effect size. Outcomes varied by respondent group, however, with larger effect sizes recorded when outcome measures were based on clinician reports , compared to parent reports . Difference between treatment and control groups were smaller again, although still significant, when the participants reported outcomes themselves . These differences between respondents have been noted elsewhere, and may introduce bias to the results . Moderators indicated larger effects for treatments that involved parents than for student-only interventions . Treatments that were administered individually one-on-one , indicated larger effects than for treatments delivered at a group-level .

Give Your Child A Scented Bandana To Wear Or A Scented Handkerchief For His Or Her Pocket

You will not be there to remind to your child to take a moment to stop and smell, but if your child wears a bandana with a scent on it, he or she will notice the smell from time to time during the day. If your child will be irritated by wearing a bandana, then you can put the scent directly onto the shoulder of his or her t-shirt or sweater.

Identifying Anxious Behavior In Children With Autism

Most children with autism have the same concerns, fears, and anxious feelings as other children. The only difference is that expressing these concerns and troubling thoughts does not come easily to children with autism. As a result, their anxiety manifests in the form of challenging behaviors generally associated with autism. These behaviors may include unexpected temper tantrums, frequent meltdowns, obsessive behavior, or resisting change in the routine and surroundings.

Keep an eye out for changes in behavior. If you notice an increase in the intensity or frequency of autistic behavior, your child may be experiencing anxiety. Some other behaviors associated with anxiety in children with autism include the following:

  • Avoiding social interaction
  • Exhibiting self-harming behavior, like banging their head, scratching, or biting
  • Spinning, rocking, or flapping hands excessively
  • Sleeping difficulty

Provide Reassurance That Worry Is Normal


Autism and anxiety can be intense and challenging to deal with, and we sometimes forget to put ourselves in our childs shoes. We fail to remember that our child probably recognizes and worries that shes different from her friends and classmates as a result of her anxiety and autism, and that worry probably does nothing but make her symptoms worse. Remind her that everyone experiences anxiety in their lives, and give her examples of things that cause you worry and what coping strategies you use to make yourself feel better so that she feels less alone.

Research Yields Tips For Easing Anxiety In Nonverbal Kids With Autism

October 23, 2015

This weeks Got Questions response is by psychologist Jeffrey Wood, of the University of California, Los Angeles , and Autism Speaks Weatherstone Fellow John Danial. An Autism Speaks research grant helped support

Dr. Woods pioneering work on developing behavioral treatments for school children with autism and anxiety. Under Dr. Woods guidance, Dr. Danials Weatherstone research project involves adapting these highly effective anxiety therapy techniques for children severely affected by autism complicated by intellectual disability.

I have a nonverbal 6-year-old grandson with severe autism. Going to the lake had been his one great love. He would wade for hours. But on the last of many boat rides, he suddenly reacted badly to the sound of the engine. 

Since then, hes become extremely frightened of any boat engine noise and wont go near the shore. As soon as he hears even the faintest boat sound , he dashes to the cottage or car where he feels safe.

What can we do to help?

The following information is not meant to diagnose or treat and should not take the place of personal consultation, as appropriate, with a qualified healthcare professional and/or behavioral therapist.

Thank you for your question. It reflects many that we have heard concerning new fears that have put an end to once-beloved activities such as watching trains or airplanes or even birds. Research has confirmed that anxiety is very common among children and adults who have autism.

Session 1 Introduction To Anxiety

Anxiety can cause physical, psychological, emotional and behavioural symptoms such as:

  • nausea, headaches, sweating, muscle tension, fatigue
  • feelings of fear, worry, dread or irritability
  • catastrophic predictions and expectations of failure to cope
  • avoidance or hypervigilance and checking
  • increased repetitive or obsessive behaviours.

The cause or causes of anxiety can be difficult to pinpoint. Anxiety UK suggest imagining anxiety as a bucket of water; an accumulation of small everyday stresses or something very stressful will fill the bucket or even make it overflow. Therefore, it is essential to invest time figuring out the personal causes of anxiety and identifying strategies to effectively relieve, reduce or avoid the rush of anxiety. As part of the session, parents discussed some of the difficulties their children experienced because of anxiety such as:

  • avoiding or withdrawing from school
  • dictating family activities
  • engaging in self-harm. 

Parents were encouraged to take note of any incidents of behaviours such as anger outbursts, withdrawal, increased self-stimulatory behaviour and general indicators of anxiety and to think about the events leading up to such behaviours. 

Impact Of Anxiety And The Need For Balance

For instance, if Kayla stays in a stressful situation too long, it increases her anxiety.  So lets say we push her to stay in a situation thats hard in the morning. In the afternoon, she makes a mistake on her paper .  The previous anxiety makes that little mistake seem much bigger. Its hard to remember this as we push students to extend their boundaries and do new things.  Balance is always the most important thing to strive for.

So, having begun to teach students how to identify when they feel stress, the next step is to help them figure out what to do about it.  Some of that is up to us and things we can put in place. Some are skills we need to teach them to cope with stress.  

I would say coping with stress is a huge life skill for all students; some individuals just need more help with it than others.

Implications For Practice And Policy

CBT in various forms is one of the most widely used psychoeducational interventions to improve the anxiety symptoms of mainstream school-aged children with ASD. The results of the meta-analyses in this review suggest that children who participate in interventions based on CBT, whether modified specifically for those with ASD or not, may make significant gains in terms of reduction of anxiety symptoms, in some cases no longer meeting criteria for a primary anxiety diagnosis or comorbid diagnoses of other anxiety disorders. Evidence in support of other psychoeducational interventions, such as massage and theater therapy to address social anxiety, is more limited, not just due to the popularity of CBT but also due to the quality of the smaller number of non-CBT studies available.

About Anxiety In Autistic Children And Teenagers

Autistic children feel many of the same worries and fears as other children.

But autistic children might also worry or feel stressed about things that are less worrying for typically developing children. These include things like:

  • small disruptions to their routines or new sensations they feel in their bodies
  • unfamiliar or unpredictable social situations
  • situations where its hard to know what other people are thinking or feeling
  • their own thoughts and feelings, especially unfamiliar or unpleasant physical symptoms that are related to worried thoughts and feelings.

Reducing a childs anxiety might reduce the behaviour associated with the core characteristics of autism, but it wont get rid of the characteristics or behaviour.

Looking For Treatment Providers

If you suspect an anxiety disorder in yourself, or your child with autism, how do you find treatment? You can start by talking with your primary health care provider, who may refer you to a specialist. Dr. Vasa recommended taking children to a psychiatrist or psychologist, with experience or training in autism, if possible. But she noted that can be difficult due to a shortage of those providers in many parts of the United States. “We need to increase the number of mental health providers trained in working with individuals on the spectrum,” she said. She and others are working to increase training in autism and intellectual disability for physicians.

Similarly, many U.S. communities do not have therapists trained in CBT for children or adults with autism.

Minimally Verbal People With Autism Have Just As Much Anxiety As Others

Anxiety in autism can wreak havoc on functioning. It can be challenging under the best of circumstances, but downright nightmarish for someone who cannot use language.

Although we still have a long way to go, the role of anxiety in autism is increasingly being recognized and therapies have been developed or adapted to meet this need. .

While interventions have been found to be effective, much of the work that has been done on helping people with autism deal with anxiety has been geared toward those who are verbal. But anxiety management for nonverbal people with autism is often limited to medication and/or behavioral approaches. The target of intervention, in many of these cases, is more on behaviors that result from anxiety rather than on the anxiety itself.

This lack of attention for those who are minimally verbal is unfortunate given the amount of distress anxiety can cause and the impact that it can have on personal growth.

To help rectify this situation, I offer six steps to address anxiety for nonverbal people with autism. Modify the specifics to match the age, developmental level, and preferences of the person you are supporting.

Step 1: Do Your Detective Work.

Step 2: Make Use of Augmentative and Alternative Communication

Nonverbal does not mean noncommunicative. Those who are minimally verbal can communicate in other ways.

Step 3: Provide a Relaxing Environment

How To Manage Autism Mom Stress

Helping your Child with Autism Spectrum Disorder be ...

Did you know that mothers of children with autism experience the stress levels of combat soldiers? Today Ill be addressing this serious issue of autism mom stress and giving some strategies on how to deal with stress for autism moms.

Each week I provide you with some of my ideas about turning autism around. So, if you havent subscribed to my YouTube channel, you can do that now.

Anxiety And Autism: Triggers And Calming Strategies To Help Your Kid / Teen

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Anxiety and lack of stress management skills are a concern in kids with autism. In the clinical setting, anxiety-related concerns are some of the most common problems for children and adolescents with autism spectrum disorders .

Some of the reasons often attributed to these increased anxiety levels in children with ASD are:

  •  difficulties understanding:
  • social situations and expectations
  • social communication
  • difficulties dealing with new situations- as they are not clear how these situations work, what rules apply and they dont have a clear routine in place
  • sensory issues
  • a need for longer times to process information, which may not be the case in their everyday interactions.
  • Anxiety may worsen during adolescence as

    • the social context grows increasingly complex
    • kids with autism may become more aware of their differences and interpersonal difficulties

    Table of Contents:

    Use Visual Aids And Social Stories

    Most children with autism are visual learners. Hence, visual aids, like picture cards, photographs, and storybooks, are an excellent way to prepare your child. You can also use social stories to tell them what to expect during a particular situation. They are likely to experience less or no anxiety once they know what to expect!

    These five techniques can help you reduce anxiety in children with autism. However, if nothing helps, it is best to consult a therapist for professional help.

    Help Your Child Relax At School With Music And Art

    At times your child with autism may need to have some space away from the busy activities of the classroom. If you provide the teacher with headphones that your child will wear and a device that can play your childs favorite instrumental music, then your child can recharge his or her emotional batteries for a few minutes by sitting in a quiet area and listening to music. Even better still would be a device that can display some art as a slideshow whilst playing music. If you can share a slideshow and some music with your teacher on a thumb drive or by providing website links, then your child may be able to access this activity on a school computer.

    Get Your Child To Notice Anxious Feelings

    The first thing you need to do is help the child understand that what is happening to them is normal. Anxiety often leads to elevated heart rate, sweaty palms, and a tight feeling in the chest. One technique is to draw an outline of a persons body on a paper and use colors to show how anxiety feels in the body. Simply knowing what anxiety is and what it feels like can help the child manage it.

    Ten Ways To Stay Calm

    Once you recognize the signs of anxiousness, overload, or upset, try some of these ideas to keep a person calm.

  • Offer an escape plan. We talk about this a lot in our Low Arousal Approach trainings. A person may just need to leave the area in order to regain their control and reduce stimulation. In the home, this could be a bedroom. My sons classroom used to have a one man tent. My son listens to classical music when he needs a break or reads aloud to himself.
  • Have a sensory basket or box. Ours has things in it like a fidget spinner, squeeze ball, Tangle toy, and Fidget for your Digit. Some kids like to chew, others needs deep pressure. If you need some ideas for fidgets, have a look at this article.
  • Develop some simple exercises or routines that are calming. I really like the book Active Imagination because it has many calming exercises/games in it. The illustrations provide clear instruction and there are no complicated materials required. There is also a series of books for children written by occupational therapist Lauren Brukner that teaches how to recognize anxious feelings and then instructs what to do to feel calm and back in control. Most of her books are geared for ages 7 14, but are for ages 4 7.
  • Teach how to self-regulate. Kari Dunn Buron wrote a great childrens book called When My Worries Get Too Big which teaches techniques like deep breathing and counting. She also created a around the book which is well worth watching.
  • Your Role As A Parent Of A Child With Autism

    Your role as the parent of a child with autism and anxiety is to identify resources to help your child work through his/her anxiety and to exercise patience and love with your child even if you do not understand the struggles. You are your childs greatest support and your dedication to his/her wellbeing is so important. As your child begins the hard work of unpacking his/her anxiety, the triggers, and practicing coping skills, he/she will need someone who is a safe and calming presence.

    Take the time to ask questions and listen with an open mind. If you dont understand why something triggers your child, thats okay. Anxiety is perplexing, and often the person managing anxiety wont have all the answers either. Showing up, validating your child, helping him/her to challenge his/her fears, and encouraging him/her to persist in the hard work involved with therapy is an invaluable gift.

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