By Kelley Yost Abrams, PhD

About the Author: Dr. Yost Abrams received her PhD from the University of California, Berkeley and is a fellow with ZERO TO THREE. She is a parenting expert and early childhood researcher. Dr. Abrams specializes in parent-child attachment relationships, social-emotional development, and infant mental health.

Autism and Anxiety: Helping Neurodivergent Children Cope and Thrive

Prioritizing mental health is important for adults and children alike. However, mental health prioritization looks different for everyone–whether that includes taking a brisk walk at the end of the day to clear the head or an afternoon spent reading in a beloved chair.

For children on the spectrum, learning to live alongside anxiety struggles can be particularly challenging. Luckily, there are some very effective tools that can help children and parents cope and thrive through everyday triggers. 

What Is Generalized Anxiety Disorder (GAD)?

According to the Cleveland Clinic, generalized anxiety disorder is a mental health condition that causes excessive worrying. The disorder can affect both children and adults. An estimated 5.7% of the population have some form of GAD, ranging from mild to severe. So, if GAD is relatively predominant in the population, what are the symptoms and how do you identify anxiety triggers?

The symptoms of anxiety vary from person to person and can manifest differently in those who are neurodivergent versus those who are neurotypical. Some of the most common signs of anxiety include:

  • Restlessness
  • Irritability or feeling on edge
  • Fatigue
  • Difficulty concentrating
  • Difficulty sleeping
  • Tension (muscle tension, headaches, etc.)
  • Shortness of breath
  • Heart palpitations

It can be difficult for those with generalized anxiety to nail down their triggers, but discovering triggers is essential to managing the disorder. Common triggers of GAD for adults include worries about money, health, and work; however, for children, some common sources of generalized anxiety can include—but are not limited to—family matters (“What if my parents die?”), school performance (“What if I fail one of my courses at school?”), social acceptance (“What if nobody likes me?”), and perceived personal weaknesses (“I feel dumb”).

It’s not uncommon for children and adults to have these fears, but the inability to shut them off can present difficulties for people. Fortunately, with the right treatment and intervention, it is possible for those with anxiety to live wonderful lives.

How Can Anxiety Manifest in Children With Autism Spectrum Disorder?

Children on the spectrum can be prone to anxiety and anxiety disorders. According to the ADAA, 40 to 50% of people on the spectrum are diagnosed with anxiety at some point in their lives. This is a pretty remarkable number, considering it can be difficult to diagnose anxiety in neurodivergent people.

One of the reasons neurodivergent anxiety is so difficult to diagnose is due to the fact that some of the signs of autism can resemble those of an anxiety disorder. For instance, people on the spectrum may have sensory sensitivities similar to someone’s anxiety triggers, such as a sensitivity to loud noise. That’s why, if your child is presenting possible symptoms, it’s essential to work with an experienced diagnostician to reach a formal autism diagnosis and develop the best treatment and intervention for them.

If your child is on the spectrum, neurodivergent anxiety can manifest differently depending on different environmental demands. For example, autism and anxiety may cause an extreme response to normal stimuli—such as a balloon popping, the school bell, or the toilet flushing—and develop into a specific fear or phobia.

In ASD, anxiety can also present itself as other comorbidities, like obsessive compulsive disorder (OCD). Children on the spectrum will engage in repetitive actions, like stimming, in an effort to cope with excessive anxiety. Additionally, sensory anxiety can present itself in environments that lack certain stimuli (in the form of separation anxiety), or social settings that overwhelm the child (in the form of social anxiety).

Why Are Children on the Spectrum More Likely to Experience Anxiety?

There are a number of reasons researchers believe children on the spectrum are more likely to experience symptoms of anxiety. While the neurobiology of anxiety and autism isn’t fully understood, a 2020 study in the National Library of Medicine posited that the accelerated growth of the amygdala in autistic children from ages 6 to 12 might hold a connection to the prevalence of anxiety for those on the spectrum.

Furthermore, researchers believe that delays in communication could contribute to a child feeling overwhelmed in certain environments like school. Other contributing factors—like difficulties interpreting social cues and distress around routine changes—can make small, everyday interactions and tasks more difficult and overwhelming for a child on the spectrum. 

How Can Parents and Guardians Support Autistic Children With Anxiety?

The best place to start with neurodivergent anxiety is getting a formal autism diagnosis. As children develop through different milestones, it’s important to routinely screen your child for the early signs of autism. Jigsaw offers a highly comprehensive online diagnostic process, starting with a free online consultation. If your family receives a diagnosis, the next step is early intervention to help teach the child new skills for managing their anxiety.

Environmental Strategies

For children with particularly severe sensory issues and anxiety, learning how to cope in different environments is very important. In a school setting, for instance, giving a child a tool like an “out” can give them control over classroom-specific triggers. Teaching a child to raise their hand or show their teacher a special signal asking to be excused can allow them to remove themselves from an uncomfortable situation and bring down their anxiety.

In a social setting outside of the home, children with an anxiety disorder can try a breathing technique like square breathing (also known as box breathing) or deep breathing to mitigate physiological symptoms like increased heart rate and hyperventilation. This strategy, as well as learning to ask to be excused when they feel overwhelmed and finding a quiet place, can help a child on the spectrum manage their anxiety.

Behavioral Strategies

While parents, guardians, and caregivers may be the most in tune with an autistic child’s triggers, as well as what is most comforting to them, additional intervention may be necessary in order to address all of the child’s needs. This is when therapies like applied behavioral analysis (ABA), occupational therapy, or cognitive behavior therapy (CBT) can help children learn emotional regulation as well as improve sensitivities to certain sounds, tastes, and other stimuli. 

Personal Strategies

Sometimes the best medicine for mental health struggles is relaxation and fun. For children on the spectrum, using tools like a beloved toy, a trip to their favorite place, or a safe and secure hug from a family member can help bring anxiety levels down when other techniques fail. Additionally, supporting your child through their favorite hobbies and activities can teach them self-care, a valuable skill for managing anxiety later in life.

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