Autism and Anxiety-continued

Anxiety is such an innate part of autism and much of the behavior exhibited by individuals with autism is directly related to anxiety. I wish I knew that years ago when I was first working with kids with autism.  Because kids with autism are anxious! Unfortunately, teachers and adults working with these kids just don’t recognize that anxiety. We see the behaviors they exhibit, and react to their behaviors instead of the underlying anxiety which causes their behavior.

Kids with autism don’t understand their feelings of anxiety and don’t even know how to explain how they feel to adults-even parents.  Even if they know enough to explain it, they likely don’t have the specific language to describe exactly what’s going on with their minds and bodies. They just know that they feel bad and upset, and usually don’t even have the words to say what is upsetting them.

Most of us as adults can usually recognize our own anxiety, and we may even know why we feel anxious. But that’s not typically true of kids with autism. I’ve often said that individuals with ASD need to be able to recognize their feelings of anxiety and identify what causes them to be anxious in order to manage their anxiety. We can’t manage what we don’t understand. But unfortunately, I think this is a long, on-going process, which probably takes years, along with much maturity, experience and self-awareness.

With kids with ASD, it’s up to us as teachers, therapists and parents to recognize their anxiety, identify what causes it, and help these kids understand and learn to manage their anxiety, to the best of their ability. In the meantime, we adults need to recognize and manage their anxiety for them.

When I look back on the students with autism that I worked with, I can now see their anxiety and subsequent behavior, often out of control behavior, with a clearer, non-judgmental  eye.  In the moment, we adults typically react to bad, aggressive behavior, thinking only of stopping or controlling the behavior.  We often assume their behavior is a result of task avoidance, temper tantrums over changes or not getting what they want. We don’t usually see the overwhelming anxiety that initiates the behavior.

I once had a student who lashed out at anyone who got too close to him. He would hit with lightning speed and great force, hurting adults and students alike. Needless to say, it was difficult to work  with him. Adults at school didn’t like this student because of his behavior, and would get angry when he attacked people around him-for seemingly no reason.  What we didn’t see was how scared and anxious this boy was all the time.  He had a difficult time understanding what was going on around him. He was easily overwhelmed and didn’t even have the language or speech capability to tell us he was upset.  Instead of attempting to calm him down and explain things in a way he’d understand, he was punished and isolated.  This was a great disservice to this student, and I’m sad to say the story doesn’t have a happy ending.  When this student got older and stronger, and more out of control, public education could no longer deal with him.  He was eventually sent to a residential placement where he was heavily medicated.

This is not an unusual situation. Many kids with ASD, especially those who are at the lower end of the spectrum and have poor cognitive and language skills, end up in residential placements due to out-of-control behavior.  As adults, we need to take a serious look at the anxiety that drives the behavior of these kids.  Because I’m now convinced these kids all have fear and anxiety.  And overwhelming, sensory-filled situations, with added confusion and poor understanding of what’s going on, only causes their anxiety to hit the roof! And then we see out-of-control behaviors. I now know that my students with ASD love school, love the structure, and all want to do a good job. But their sensory integration issues, confusion, and language difficulties just add to their anxiety and prevent them from doing their best in school.

Anxiety in children with ASD can include many different behaviors. learn to recognize the anxieties of your students and children. Here are some:

  • looking anxious, fearful, worried or stressed
  • increased self-stimulation-frequency, intensity, and duration(i.e from subtle rocking to frantic, fast rocking)
  • a change in their self-stimulation, such as a self-stim behavior you haven’t seen before or typically don’t see
  • attempts to block out sensory (i.e: covering their ears, closing eyes, verbalizing or vocalizing loudly)
  • shutting down and not responding at all
  • increased echolalia, including reciting movie scripts
  • increased refusals, negative responses, including negative echolalia, often spoken with agitation
  • attempts to escape the environment, or hide
  • extreme focus on an activity(as if to block everything else out) and not responding to others
  • covering themselves up with blankets, pillows, a jacket or anything
  • walking around in circles, walking aimlessly
  • not letting anyone get near them
  • screaming/yelling or talking loudly
  • self-injurious behavior, including picking at scabs, fingers or pulling out hair
  • aggression toward others or objects

We need to explain to our children and students with ASD just what anxiety is and work with them to figure out what causes them to be extremely anxious.  We need to help them understand that there are ways to decrease anxiety and feel better. We need to start teaching them self-calming strategies from the time they are young in order that they will continue to learn to manage their anxiety as they get older.

Next time I will talk about ways to manage anxiety for people (young and old) who have ASD. Managing anxiety and behavior is the key to helping people with ASD get out of their comfort zone, make friends, learn new things and be successful in the world.

I’d love to hear about your experiences with anxiety and how you have dealt with anxiety when it happens to your children or students. And I’d love to read your comments about my blogs.

Until next time,


Author: autismtherapysite

I'm an SLP and teacher specializing in autism. I've written two books: Taking Care of Myself and Taking Care of Myself2. I've contributed to two other books on autism and have published articles in various autism publications. My first book, Taking Care of Myself, won the ASA award for best literary publication- educational division in 2004, as well as the iParenting Media Award. I have given autism presentations at various autism conferences throughout the US and Canada. My next conference is a day-long presentation on 1/18/18 in Laredo, TX

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