Why do ASD kids get Anxious ? 6 Core Strategies


14-year old Jack diagnosed with Asperger’s Syndrome came to attend Occupational Therapy (OT)  session in school's OT room. Jack loves OT as he feels that he doesn’t have to study in this lesson and he can learn and do fun activities. However, this time, when he came to attend a lesson, he was seen worried and unfocused while carrying out tasks. On being asked,the reason of consistent worry, it was found that he has to come to school by public transport (bus) whole next week along with his class friend, as his father has gone on an official tour and mother doesn't know driving.

A thought of travelling in the bus made Jack extremely anxious because of which he couldn’t focus even on tasks he like. Waiting for the bus, getting on it, asking for a ticket from bus driver (new person), standing along with new unknown people, being touched by people which creates defensiveness while bus is moving, hearing different sounds (people talking, vehicles on road, baby crying, music), smell of various deodorants, are some of challenges which made Jack so nervous! 

Above mentioned experiences are just so normal for anyone of us and do not affect any typically growing adolescent, however, for a child like Jack they are big reasons of worry!

Children with or without autism display anxiety during the day to day situations. Getting separated from the parents (separation anxiety) is most common cause of nervousness among typically and atypically developing children. Recent research at the University of Amsterdam suggests that 40% of children and adolescents with ASD have anxiety issues.

Every day most of us face situations that can cause anxiety or nervousness such as getting late for school or office, getting stuck in traffic jam, before examination or interview or even not being able to understand a simple joke that others find funny. 
We simply know how to cope with such situations, either by informing office staff that we are running late or ignoring joke that we do not understand. However, for autistic or learning disabled adult and child coping with stress, anxiety or frustration can be a great challenge.

“My 5-year old son with Autism gets nervous easily in school and public places. He often starts crying in malls and I feel embarrassed. Is there anything I can do to help him?"

This is a common question heard from parents of children diagnosed with Autism Spectrum Disorder (ASD), Sensory Processing Disorder (SPD), Learning Disabled (LD) and ADHD. Anxiety is not uncommon to anyone of us, however, atypically developing children display extreme nervousness in ordinary situations too.
As per anecdote reports, many children with autism will receive the another diagnosis at some point of development. The additional diagnosis is mostly related to (Simonoff, et al). 

So what triggers anxiety in children?             Dr Chuck Edington (2010) suggested common triggers of anxiety at home and school setting are, Unstructured Timing, Academic situations, sensory issues, social situations and Routines. Other factors of anxiety can be homework, examination, meeting a new person, fear of rejection from peers, or health concerns. 

Children with autism commonly display self-stimulatory behaviours (stemming) such as hand flapping, finger flicking (hand mannerisms), chewing and mouthing things, watching spinning objects, rocking body back and forth while sitting, nail biting or hand biting which, if not stopped can be self-injurious in nature.
Stemming helps them to calm down and reduce anxiety. Children having under-responsiveness (hypo-sensitivity) towards touch or hearing lack danger awareness which can lead to self-harming behaviour. 

For highly anxious children sensory stimulation (stimming) as a way of shutting down their thoughts, anxiety and related stress. It works as a medium of shifting one's own attention to physical stimulatory behaviour that is more engaging.

There is no causal relationship between anxiety and over-responsiveness (hyper-sensitivity) established through researchers, however, it is commonly observed, that children with over-sensitivity often react negatively to noisy and visually complex environments. 

Shutting their ears in public places, displaying temper tantrums, meltdowns during recess, trying to avoid hair cutting or dental check-ups by any means, being avoidant to bathing or tooth-brushing are some of the behavioural patterns of ASD child with anxiety.

To resolve the problem, parents need to be carried out some ‘detective’ work to find out possible reasons for anxiety.