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Autism and Anxiety

What is anxiety?

Anxiety is a feeling of unease, fear or worry that we experience when we believe something bad will happen. Most of the time, feelings of anxiety are completely normal and important. Everyone will experience anxiety in their lifetimes. However, for some people, anxiety can come about so often and with such intensity that it gets in the way of everyday life. For example, being so worried about failing a test that you stop going to school all together.

What causes anxiety in autism?

Many autistic children and young people experience high levels of stress and anxiety in a range of circumstances:-

  • Feeling overwhelmed and out of control in social situations. Neurotypical people can be very unpredictable as they react and emote in different ways that cannot always be anticipated by an autistic person. Autistic people can find it challenging to pick up on social signals and the underlying meaning and emotions that go alongside. This can also include unwanted social attention, being teased and geliophobia (a fear of being laughed at).
  • Change and uncertainty but also anxiety for known upcoming events and the possibility of ‘catastrophising’ – always focusing on the worst possible outcome and believing it to be likely even when it isn’t.
  • Sensory processing differences which can make the world a very unpredictable place.
  • Differences in identifying and expressing emotions.

Consistent exposure to these situations creates a build-up of stress, resulting in the CYP being in a constant state of hyper-arousal. This is often referred to as being in the ‘fight or flight’ mode.

This can lead to autistic people experiencing meltdowns or shutdowns as a result of being completely overwhelmed (National Autistic Society, www.autism.org.uk ).

How to help an autistic young person with anxiety

Allow for the neurodivergence

Characteristics such as heavy reliance on routines, rituals, and stimming are commonly used by autistic/ neurodivergent people to make everyday life more predictable.  They also have a calming influence if a young person starts to feel anxious.

Thought Blockers

Video games and special interests can also be used to soothe anxiety by acting as ‘thought blockers’. By being overly engaged in the activity the young person cannot focus on anxious thoughts. Often, young people have meltdowns when the activity ends – this may be because of the anxious thoughts flooding back into their mind.  This will need to be carefully managed by parents and carers.

Emotions wheel

Autistic and other neurodivergent young people often find it challenging to talk about and identify their feelings.  For an older teenager, using an emotions wheel may help.  The wheel works by supporting the young person to talk about and identify their feelings.  Start by identifying your core feeling (at the centre of the wheel).  Then move slowly to the outer circles to pinpoint a more specific emotion. You can see an example of a ‘Feelings Wheel’ here by Gloria Wilcox with Addendums by Ken Smith, www.caass.online.

Monitoring heart rate

Use a smartwatch to monitor your heart rate and begin to understand how a higher heart rate could indicate intense emotions such as fear or anxiety.

Sensory processing toolbox

Creating a personalised sensory toolbox can help reduce anxiety in stressful situations.

Consider your child’s sensory preferences and choose some resources from the list below.  You may also wish to include your own ideas.

Wheel detailing 8 sesnses
  • Visual resources including blowing bubbles, kaleidoscopes, reflective/ transparent / shiny materials.
  • Tactile resources including PlayDoh, Blu Tack, putty, slime, shaving foam, soft and/or rough fabrics/materials, sensory chew necklaces and fiddle/fidget toys.
  • Auditory resources including access to music or other sounds via headphones; noisy toys; musical instruments.
  • Taste and smell resources including aromatherapy oils, foods, herbs and spices.
  • Proprioceptive activities including rolling over an exercise ball, jumping on a trampette, carrying heavy books, using a weighted blanket or vest, pushing against walls.
  • Vestibular resources including climbing equipment that allows hanging upside down, swinging or equipment that provides balancing opportunities.

For further information on sensory processing and strategies for reducing sensory overload, please visit our sensory processing.

Mindfulness

Practising mindfulness means to focus your awareness on the present moment, while calmly accepting your passing feelings, thoughts, and bodily sensations without judgement.  Recent research suggests that it could bring significant benefits to autistic young people.  These techniques are also thought to improve parent-child relationships and parental wellbeing.

Simple mindfulness practices to try:

  • Bell listening: using a real bell or one from a phone app, ask your child to close their eyes and listen to the sound of the bell. Ask them to raise their hands once the ringing stops, getting them to pay attention to any other sounds that they can hear for the next minute or so.
  • Bedtime mindfulness: ask your child to lie down and close their eyes. Starting with their toes, move up to the head and ask your child to bring their attention to the various parts of their body.
  • Mindfulness walks: walk with your child in the local area or sit in a garden space and ask them to pay attention to all the sounds that they can hear. You can draw their attention to sensations e.g., the sun on their face or the sound of their footsteps.  If your child is energetic then you might draw their attention to their heartbeat or breath after exercise.
  • Mindful breathing: encourage your child to sit and close their eyes; focus their attention on the sensation of breathing in and out. Ask your child to place their hands on their stomach and feel it rise and fall as they breathe.  You can guide them to any present feelings or thoughts.
  • Glitter jar: fill a clear jar with water, glitter and baby oil (you could also use a snow globe); ask your child to shake the jar and watch the glitter as it swirls and falls back to the bottom. This activity can be a useful metaphor that relates to the thoughts that swirl in our mind.
  • Counting to ten: close your eyes and begin to count to ten slowly.  Breathe in and out slowly after saying each number.

You can find some useful further links, including podcasts, here.

Coping with uncertainty

  • As uncertainty can be a big source of anxiety, it’s useful to make life more predictable where possible. Visual supports, like timetables or checklists which use photos or symbols, can help with this.
  • It can be helpful for young people to be exposed to some uncertainty as life isn’t always perfect or predictable. Thinking tools can also be used to help young people cope with uncertainty. Parents can talk through scenarios to problem solve and manage anxiety-inducing situations, such as losing their keys or missing the bus.