How can I support my autistic child with anxiety?

It is normal for children and young people to experience some anxiety as they grow up. Children and young people with Autism Spectrum Disorder (ASD) may experience this more intensely. As a parent or carer, it is helpful to know the signs of anxiety and some strategies to support your child.

• Anxiety is the feeling of fear or worry.
• This feeling can be mild at times, and severe at others. It can become intense and hard to control.
• Most of us will have anxious feelings at some point in our lives. Exams or job interviews can make us feel anxious.
• Some people find it hard to control these feelings. The anxiety is more constant and can affect their daily life.
• Autistic people are more susceptible to certain mental health difficulties, including anxiety.

Anxiety can come from:

• Communication difficulties and misunderstanding social cues;
• A lack of emotional literacy. Children with ASD may not be able to understand what they are feeling. This makes it hard to find a strategy to help them calm;
• Worrying about transitions and change;
• Sensory processing difficulties. Children with ASD might be over- or under-sensitive to sensory experiences. This includes sounds, smells, and bright lights;
• Masking to ‘fit in’. This is when autistic people learn and practice certain behaviours, and hide others. This is so they can hide their autism;
• Performance anxiety at school.

• Stimming:
  – Stimming is self-stimulating behaviours that people (particularly those with ASD) may show. They might use stimming when experiencing a sensory overload or suffering anxiety.
  Stimming actions can include: rocking, hand flapping, spinning, or repeating words. Sometimes, it is a repeated movement of an object or objects. The fidget spinners which became popular a few years ago are tools which some might use for stimming.
  – Stimming can be a natural way to calm down in a period of anxiety which is a positive thing.
  – Stimming may become an issue when anxiety becomes too much to handle. The stimming may become more concerning. Examples could be pulling hair, head banging, or biting, or other repetitive behaviours that could result in injury.
• Sleep issues. Autistic children and young people are more likely to have sleep disturbances or insomnia. These might be more noticeable if they are feeling anxious.
• Resistance to change and the need for routine;
• Obsessive compulsions, and ritualistic behaviour;
• Eating disorders;
• Self harm.
• Panic attacks;
• Negative thoughts.

• Keep a diary to help them to explore their anxiety. Log what makes them feel anxious so that you can understand the triggers.
• Use visuals and plans to help your child’s understanding of their feelings. This can lessen the impact of transitions and reduce uncertainty.
• Look at your child’s environment. Are there ways that you could adapt it together to make it less stressful?
• Think about calming strategies and activities that your child can use. You could try using a fidget spinner or watching animal videos. Some children might find yoga, meditation or colouring can help. Others might benefit from physical exercise.
• Use apps. Molehill Mountain is an app to help people with ASD to understand and self-manage anxiety. Brain in Hand is not specific to any condition. It is for anyone who finds anxiety or unexpected events can disrupt their day.
• Access counselling or CAMHS services. Talk to your GP about whether this would be a helpful route to take. They may be able to direct you to extra support and refer you to mental health services.