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Research suggests that a high number of autistic people experience poor mental health with anxiety and depression being the most commonly reported difficulties. Anxiety is described by the NHS as a feeling of unease, such as worry or fear, that can be mild or severe, which can often lead to issues with our mental or physical well-being. Everyone experiences anxiety at some point in their life and a small amount of anxiety can be beneficial in some circumstances, for example before you are about to sit an exam or attend a job interview. It makes us more aware of our surroundings and more capable of handling atypical circumstances. On the other hand, anxiety can sometimes become overwhelming and persistent, which can significantly interfere with our daily lives – this can be referred to as an ‘anxiety disorder’.
Understanding anxiety in autism
Research suggests anxiety is more prevalent in autistic people than in non-autistic people and it’s estimated that as many as 40% of autistic children, adolescents, and adults may be recognised as having ‘anxiety disorders’ [1]. According to the National Autistic Society, being in social circumstances where one must give conscious effort to understanding what other people are thinking or feeling or worry about wanting to fit in can be a contributing factor in anxiety among autistic people [2]. For some autistic people the world can feel anxiety provoking as it is often unpredictable and confusing, and not appropriately adapted for their needs. Some have suggested anxiety may stem from a fear of having their routines or their ability to engage in things that bring them comfort and safety disrupted. Other reasons may include a fear of the unknown, such as getting in a lift for the first time.
Some autistic children can also be sensitive to certain sensory input, perhaps most commonly unexpected or loud noises, such as the bursting of a balloon or the passing of an ambulance with its sirens on. In situations like these, autistic children may experience sensory overload or a meltdown. When a meltdown occurs, it can appear like a tantrum to those unfamiliar with witnessing an autistic meltdown; however, these are quite different. When an event triggers an overpowering feeling, stimming (or self-stimulatory) activities such as hand flapping, spinning, or rocking back and forth can be used as a calming mechanism.
During a meltdown, some autistic children might run or hide in a small, enclosed area to withdraw from the overwhelming experience. These behaviours are all strategies that might support regulation [3], and where possible should be supported and encouraged by those around them.
Top tips for supporting autistic children and young people who experience anxiety
- Maintaining a calm and quiet voice and trying to be a consistent, safe presence can support those around us to remain calm and relaxed.
- Using visual timetables/schedules and social stories can support children’s understanding of what to expect in novel situations, thereby reducing uncertainty and providing more predictability. Where possible collaborative development of timetables and plans can also support a child’s sense of agency.
- If an individual has a particular repetitive or self-stimulatory behaviour (e.g. hand flapping, rocking, jumping, spinning) that helps them to calm, this behaviour should be supported where possible. Such behaviours often support regulation and self-soothing and are therefore an important coping strategy for individuals. Where stimming behaviours may cause injury or are dangerous (e.g. head banging), you may need to seek professional support to understand the needs underlying the behaviour and work to find an alternative way to self-soothe.
- Sensory aids such as fidget toys, vibrating items, weighted toys or visual toys can be effective in reducing immediate anxiety. These need to be tailored to the needs and preferences of the individual.
For more information about Caudwell Children’s Autism Services please click here.
References
[1] Gaigg, B., Crawford, J., & Cottell, H. (2018). An Evidence Based Guide to Anxiety in Autism. Retrieved January 29, 2024, from https://www.oxfordshire.gov.uk/sites/default/files/file/special-educational-needs/anxiety-in-autism-a5-guide.pdf
[2] Anxiety. (2024). Retrieved January 29, 2024, from https://www.autism.org.uk/advice-and-guidance/topics/mental-health/anxiety
[3] Rudy, L. J. (2023, November 8). How autistic meltdowns differ from ordinary temper tantrums. Verywell Health. https://www.verywellhealth.com/what-is-an-autistic-meltdown-260154