Anxiety in children with Autism

Each one of us must have felt anxious at one point or another in our life. Be it
moving to a new place, joining a new school or college, starting a new job or even
when taking an exam. Though this type of anxiety is not so pleasant, it is normal and
can be managed. This anxiety comes and goes now and then but does not interfere
with our day-today life.

But anxiety disorders are intense and they do interfere with our life. They prevent us
from doing things that we enjoy and if left untreated, they become worse brining our
lives to a complete halt. Anxiety disorders are quite common form of emotional
disorders and they can affect anybody at any age. A bout of anxiety kicks in slowly
but gets acute as the stressful event comes close. The worry, distress, fear and
feeling of overwhelming apprehension are the characteristics of an anxiety attack.
However, these attributes may vary greatly in individuals.

An estimated 40% of the children who are diagnosed with Autism Spectrum Disorder
(ASD) fulfil the diagnostic criteria for anxiety disorder (Van Steensen et al., 2009).
According to researchers, as many as 84 % of these children have impairing and
subclinical anxiety symptoms (White et al., 2009). When anxiety co-occurs with
autism, it can cause severe distress, amplify symptoms of the disorder and could
result in behavioural difficulties like tantrums, aggression and sometimes self-injury
(Canitano,2006). However, it is still not clear whether anxiety symptoms exist as a
separate condition or if they form the core part of the ASD. Social withdrawal
symptoms too in ASD are very much similar to that of social avoidance in social
anxiety (Hallett et al., 2013).

But why do children with autism experience anxiety? There could be manifold as
below.
1) Difficulties in sensory processing e.g., being hypo or hypersensitive to lights,
noises, smells and visual distractors.
2) Difficulty in adapting to new situations or a change in daily routines.
3) Problems in interpreting social cues, facial cues and in engaging in
communication.
4) Trying to fit in. Several researchers hypothesise that children or teenagers
with high cognitive functioning usually also have a keen sense of their environment
and the manner they are perceived by others. So, they try extra hard to fit in, which
could lead to anxiety.
So, how can we help these children. First of all, it is necessary to find out the causal
factors that trigger anxiety in the children. Some of the following measures too might
help in managing the anxiety.
1) Find out what triggers anxiety. Parents and teachers can help by talking about
these fears with the child and encouraging them to face these situations under their
guidance. For example, if a child is afraid of going to the toilet, parents or teachers
can pretend going to the toilet and let child see that nothing happened to them. If the
child cooperates, then she or she can be rewarded with e.g., their favourite snack or
a toy.
2) Following a structure in a child’s day can also help reduce the stress. Children
with ASD usually do not appreciate a sudden change in their routine or unexpected
changes in their circumstances. It is best to inform them about the changes in their
routine beforehand by taking help from the visual aids. This way, the children would
know what to expect and so might get ready to face for those.
3) The environment surrounding also matters. Sometimes because of too much
sensory overload, children can experience severe anxiety. And in times like this, it is
crucial to have a safe place for them to go to. Some children like playgrounds, some
like sitting in a corner, some prefer the smaller play area in the school and so on.
Therefore, it is helpful to keep a note of a child’s individual needs and preferences
while choosing a safe area.
4) There are number of calming and sensory tools that also help calm the child.
Calming jars, puzzles, fidget spinners and stress balls help in decreasing the anxiety
in children. Relaxing music such as white noise also helps in reducing the stress and
anxiety.
5) Meditation and yoga might also help. Research on the benefits of meditation
on children with autism began to shed light on the ways to reduce anxiety and bring
a sense of calm in children with autism.

As a parent you know about your child more than anyone else. Hence it is important
that you are aware of the triggers of anxiety in your child and be well-informed on the
subject. When as a parent if you sense that you are unable to cope with the problem,
then it is very important to seek professional help. Clinical Psychologists are those
trained professionals that treat such disorders. They provide counselling and therapy
as per the requirements of the child.

Vasavi Yellamraju