Anxiety and Autism Spectrum Disorder
May 6, 2023
Autism spectrum disorder (ASD) is a collective term for a group of neurodevelopmental disorders characterised by persistent deficits in social communication and social interaction, and by repetitive patterns of behaviour and restricted interests. The severity of autism is diagnosed from mild to severe and reflects the degree of support the child needs in relation to these key characteristics.
New learning can be a struggle
Teachers who have autistic children in their class often ask me, how they can engage them in new learning. For example, a Foundation teacher recently explained how distressed a child with autism became when the concept of addition was introduced to the class. The child found the idea of adding up so upsetting that for several weeks he was:
- Upset about addition at home
- Teary at school about the topic
- Finding excuses to opt out of maths, and
- Disruptive and in one instance had a melt-down and cried uncontrollably.
Autistic children have restricted interests, and can have a disinterest in new learning. Hence, a child with autism may have no interest in a topic being introduced , believe they already know the work or answer, or may even find the new learning overwhelming.
Together, the child’s teacher and I brainstormed ways to link new learning to what the child already knows or to one of their special interests. In this case the child had an interest in making things with Lego, so we discussed talking with the child about ‘addition’ by firstly talking about Lego – and the idea of ‘adding’ Lego pieces to each other to create something (like a caterpillar) then noting when Lego is put together piece-by-piece this is a bit like adding numbers together. It eventuated that this was enough to reassure the child that addition was something he already knew about and his anxieties at home and school notably reduced.
This example highlights how children with autism might interpret and respond to the world in unexpected ways. While each autistic child is an individual who has specific needs, interests, passions and talents, many will experience anxiety, with some experiencing intense anxiety depending on the situation or context.
Anxiety and autism
Everyday living and learning can be exhausting for many autistic children. They may face heightened levels of anxiety, worry and stress related to:
- Difficulties with social interactions and communication
- Dealing with change
- Coping with sensory overload
- Self-worth and peer acceptance. Repetitive patterns of play and behaviour and fixated interests can be puzzling, annoying or confronting to peers. This can lead them to avoid engaging with autistic children
- Challenges in learning and/or a disinterest in new learning
- A range of difficulties with verbal and non-verbal communication
- Problems with speech and language
- Mental health issues such as depression, poor self-worth, and loneliness
- Managing ADHD. Difficulty listening and shifting focus are specific issues for autistic children with ADHD.  Fifty to seventy percent of children with autism also have ADHD
- Difficulty with fine and gross motor tasks
- Sleep problems
- Difficulties interpreting and regulating bodily states. Stress, body temperature and muscle tension which might alert the neurotypical child that they are feeling anxious may be misinterpreted.  These body signals, known as interoception, enable neurotypical people to be able to say how they feel and self-regulate to feel more at ease.  Autistic children can be confused by, or unaware of, some feelings and emotional states until their behaviour unexpectedly erupts.
- Unhelpful thoughts and thinking styles.
- Being stuck on a thought and exaggerating or misunderstanding situations and the actions of others.
The new Psych4Schools ebooklet Working with children diagnosed with autism spectrum disorder (ASD) explains the nature of autism and suggests strategies to help understand and minimise challenges, including anxiety, with a focus on a strengths-based approach to teaching and learning.
A strengths-based approach supports autistic children within a safe, inclusive and autism-friendly teaching and learning environment that promotes a respectful acceptance of each child’s capabilities and needs.
Practical strategies are suggested under nine major headings:
- Promote inclusive teaching and learning
- Identify pathways to learning
- Create a safe, autism-friendly learning environment
- Teach social thinking skills
- Build a focus on teaching and learning
- De-escalate distress and manage any dangerous stimming
- Aggressive behaviour
- Final thoughts
The extensive suggestions and practical strategies in the ebooklet aim to assist school staff to support teaching, learning and wellbeing needs of children with autism to help them achieve their personal best. A clear understanding of ASD, a focus on each child’s unique capabilities and/or any challenges can assist teachers to guide peers in accepting, working with and supporting the child.
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Psych4Schools Psychologist/Guidance Officer
 Whitehouse, A, J, O, Evans, K, Eapen, V, Wray, J. A national guideline for the assessment and diagnosis of autism spectrum disorders in Australia. Summary and recommendations. Cooperative Research Centre for Living with Autism, Brisbane, 2018.
 Goodall, E., (2018) Understanding and facilitating the achievement of autistic potential: How to effectively support children on the Autistic Spectrum, Trove, South Australia. https://nla.gov.au/nla.obj-637176994/view
 Hours, C., Recasens, C., and Baleyte, J., (2022) ASD and ADHD Comorbidity: What are we talking about? Front. Psychiatry, 28 February. Sec. Child and Adolescent Psychiatry. Volume 13.
 Flene, L.M., Ireland M.J. and Brownlow, C (2018) The Interoception Sensory Questionnaire (ISQ): A Scale to Measure interoceptive Challenges in Adults, Journal of Autism and Developmental Disorders, 48, 3354-3366
 Kelly Mahler, What is Interoception?