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What causes anxiety in children with autism and how you can help to reduce it.

Anxiety in children on the autism spectrum

Children on the autism spectrum often suffer from anxietyOne of the things that we often hear from parents of children on the autism spectrum is that their child seems to have particularly high levels of anxiety.

Anxiety and autism can go hand in hand. Causes of anxiety are numerous and not always obvious. This makes it very difficult for parents to know what to do or how to react.

Even if an autistic child is high functioning, they may not be able to verbalise their feelings and worries. They find it difficult to make sense of the world around them, especially when it comes to understanding social rules. This can lead to behaviours like:

  • Tantrums (although because they are coming from a different place to regular tantrums, we might call these ‘meltdowns’), rages, and aggression.
  • Becoming withdrawn and resisting any interaction with others.
  • Becoming distressed and physically lashing out at others, at property, or even themselves

What causes anxiety in children on the autism spectrum?

A boy with ear defendersWe all react to stressful situations in different ways, but the symptoms of anxiety are often similar: fear, panic, increased heart rate, sweating, sickness, confusion, indecision, reduced confidence and obsessive compulsive behaviours. These are all unpleasant and can impact on our mood, energy levels and behaviour. Some children on the spectrum deal with these feelings every single day. They might be caused by things like:

  • Meeting strangers.
  • Hearing too much language.
  • Being given too many instructions or choices.
  • Not being able to communicate their needs.
  • Changes in routine.
  • Experiencing new activities or places.
  • Experiencing unpleasant sensations. These can be particularly stressful because people on the spectrum are more sensitive to things like noise, smell and light: a dog barking, a hand dryer, crowds, the school dining hall, a butcher’s shop, flashing lights, bright sunlight.
  • Transitioning from one activity to another.
  • Unpleasant events like having a haircut, or seeing the dentist or doctor. Even just being asked to repeat these events can make children anxious.

It’s no wonder that children with ASD experience anxiety. It’s also entirely understandable that they become angry and aggressive when they are overwhelmed by anxiety but lack the communication skills needed to express what is wrong. This is one of the main reasons that people on the autism spectrum seek routine, predictability and control.

How can you help your child deal with anxiety?

Always consider anxiety levels when making decisions about how to manage your child’s behaviour or when introducing them to changes in routine or new activities.

  • PECS, or pictograms like these from can be used to make visual schedules.Be empathetic. Remember how it feels when you are anxious.
  • Maintain a neutral and calm tone of voice. Your own anxiety, anger or frustration can make a child more anxious.
  • Keep a diary of your child’s behaviour. You may be able to identify a trigger for their anxiety.
  • Establish routines and stick to them. If you do need to change a routine, provide your child with as much notice as possible.
  • Make sure your child knows what is going to happen. Provide visual support for this change if you can.
  • Allow time between activities whenever you can. Small transitions can be a big deal to a child with ASD. For example taking a bath and then cleaning teeth straight away might cause anxiety.
  • Give one instruction at a time.
  • Give your child time to process information.
  • fidget toys for autismOffer ‘fidget toys’ such as stress balls, hand held sensory toys or play dough. They may help your child lower their anxiety levels.
  • Give your child a non-verbal way to show how they feel. You could use coloured cards, with red for “need time out now” and green for “okay for now”. Alternatively, you could have a verbal code or hand gesture. If your child is older, try teaching them an anxiety scale using number. So 1=calm 2= happy 3=feeling worried 4=very anxious 5=extremely anxious.
  • Provide your child with a time out mechanism for when things are getting too much. Use of a ‘time out’ or ‘break’ card can be useful.
  • Identify a ‘safe place’ that your child can go to when they are feeling anxious. For example their bedroom.
  • Blanket fortSome children enjoy the feeling of being even more enclosed. For example, in a tent in the living room or bedroom.
  • For some children, the feeling of being squeezed can be calming. This can come from things like a weighted blanket or pressure vest (under supervision of an occupational therapist) or just lying under the sofa cushions!
  • Be tolerant of your child’s method of self-calming. They may have a way of dealing with their stress that you find difficult or annoying, liking humming or tapping. They are doing this to reduce the unpleasant feelings they are experiencing.
  • Help your child to understand social rules. Social stories or visual structures can be helpful. If you would like to know how to make these we’d be happy to give you some more information.
  • Learn as much as you can about autism. See the world through their eyes.Autism mural at Toby House - See the world through my eyes