Anxiety and Autism: Triggers and Calming Strategies to Help your Autistic Kid / Teen

Anxiety and stress management skills are a concern for autistic kids. In the clinical setting, anxiety-related concerns are some of the most common problems for children and adolescents with a diagnosis of autism spectrum disorders (ASD). Some of the reasons often attributed to these increased anxiety levels in autistic children are:

•  difficulties understanding:
  • social situations and expectations
  • social communication
• difficulties dealing with new situations- as they are not clear how these situations work, what rules apply, and they don’t have a clear routine in place
• sensory issues
• a need for longer times to process information, which may not be the case in their everyday interactions.

Anxiety may worsen during adolescence as

• the social context grows increasingly complex
• autistic kids may become more aware of their differences and interpersonal difficulties

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What is Anxiety?

Let´s step back and look briefly at anxiety. Anxiety is an emotion that triggers an activation of the autonomic nervous system in the presence of stimuli that are considered a threat. In other words, anxiety is a feeling that turns on our body’s “alert system” when we face something that seems scary or threatening. In the context of a threatening situation, it fulfills an adaptive function. However, it becomes a problem when its intensity is too high, or it is triggered by everyday situations where there should be no alarm. Everyday situations that feel absolutely harmless to most of us may be perceived as threatening by our autistic kids.

Anxiety Triggers for Autistic Teens

I’ve been attending a series of workshops designed to guide parents of autistic children through all the changes that may occur when their kids become teens. One of the topics we touched upon was anxiety and stress in autistic teens. We brainstormed about stressful situations and anxiety triggers for our kids.  I’m sharing below the long list of anxiety triggers that we came up with. It may help you become more aware of a number of situations you may need to consider in the future. Understanding these triggers and anxiety situations will help you be better prepared to deal with them.

24 Anxiety Triggers for Autistic Kids / Teens

Sensory-Triggered Anxiety:

• Specific sounds (wind blowing, whistles, fireworks)
• Getting startled by something
• Crowded spaces
• Loud places
• Sensory overload

Autism and Social Anxiety:

• Performance anxiety / Speaking in front of their peers
• Being in a group of people
• Getting a strong reaction from another person
• Not understanding what you are expected to do
• Being addressed by a stranger
• Talking on the phone
• Being asked questions
• New social events
• Using public transport

Note: even if social interaction may be an anxiety trigger, it does not mean your child lacks interest. They may still want to participate in social events but find them overwhelming.

Other Anxiety Triggers:

• Sensing stress or big emotions in others
• Not being able to complete a task or activity that he/she had started
• Making mistakes
• Changes / Unexpected changes / Changes in their routines
• Not receiving immediate attention
• Not being acknowledged
• Criticism
• Demands (even the most simple ones)
• Feeling unprepared
• New places

Autism and Social Anxiety

If you re-read the anxiety triggers list, you will see a clear and important theme: socially related triggers. Even some of the triggers I’ve mentioned as “others” could well fall under the social denomination (criticism, feeling unprepared, not being acknowledged, sensing stress, or big emotions in others). Social anxiety commonly co-occurs with autism spectrum disorders (ASD). Many autistic teens are aware of their social difficulties and experience social anxiety. Keep this in mind as your kids become teenagers. Related content: Anxiety Games, Toys and Books: 12 Super Fun Ways to Help an Anxious Kid

Calming Strategies for Autistic Teens

Understanding your Autistic child’s support needs will help you identify activities, strategies, and ways of communication that will prevent high stress levels. Let me share below some of the strategies and tactics that we came up with during our brainstorming session in our workshop.

26 Calming Down Strategies for Autistic Teens

• Creating a calming room / relaxing room / thinking space / quiet space, where your kid can go to wind down
• Creating routines at home that minimize stress
• A calming box
• Time alone (“Do you think you need a moment on your own?”)
• Adapting communication: express yourself calmly and allow extra processing time
• Listening to music
• Drawing activities for anxiety
• Reading a book
• Audiobooks
• Relaxation audio
• Pacing while talking out loud to yourself
• Sensory strategies like a weighted vest or lying under a weighted blanket (you may wish to read what I did wrong and avoid my mistake ⇒ in my post about weighted blankets)
• Tracing a shape with a finger on a card (check out our free finger tracing calming cards)
• Thinking putty
• Talking through the stuff that is bothering them
• Listening to stories
• Writing worries on a piece of paper and disposing of it
• Passing worries to a favorite soft toy
• Physical activity
• Playing games they like (so many of the kids in our group loved Minecraft!)
• Watching T.V.
• Meditation
• Anxiety affirmations
• Preparing “exit strategies” for social situations. Your kid may be eager to participate in social situations (like a birthday party) but feel anxious about what to do if it gets too overwhelming. You can agree for example on a short-time attendance, a “secret code” to let you know your kid wants to leave or agree on a phone call to be picked up.
• Organizing social activities that don’t require too much “socializing”, like watching a movie or a favorite show.
• Identifying a person who will be responsible for checking regularly on your kid as to make sure the social situations is not overwhelming
• Identifying a room or space where your kid will be able to go if the social situation becomes too difficult or demanding. Just an example from somebody we know well: when D. goes over to her friend’s house for a social event, her friend organizes a comfortable corner in the house with a laptop, so that she can escape if she feels overwhelmed.
• Energy accounting. (I´ve left this one for the very end because it was a new one for most of us, and I will get into more detail below)

Last important tip: be aware of your own stress levels to make sure you are not a source of over-arousal. Related reading: 43 Anxiety Activities and Tips for Kids

Energy Accounting

Professor Tony Attwood uses an “energy bank account” concept to propose a strategy that may help autistic kids (or adults) cope better with the high-stress levels that simple everyday activities and tasks may induce. This analogy is great because it provides you with a tool to explain to your kid:

• why he/she is feeling drained
• how to find a solution to fix this situation.

Everyday activities and tasks can be a real energy drain on autistic people. These are the withdrawals from the “energy bank account”. Brainstorming with your kid, you may be able to come up with a number of planned activities that will help him/her replenish the energy levels. These activities are the deposits in his/her “energy bank account”. There are a couple of things I really like about this approach:

• it provides you with an age-appropriate explanation to discuss a situation that may be an issue in their lives. A bank analogy for a teenage with good cognitive abilities can be a nice approach
• it allows you to plan solutions with your kid. And we all know how important predictability and feeling in control are.

Further reading: Research: Anxiety in Children and Adolescents with Autism Spectrum Disorders (Susan W. White,  Donald Oswald,  Thomas Ollendick, and Lawrence Scahillc) Read this research here. I understand there are other stressors and calming activities. I’ve just shared with you all the ideas we came up with, but I will be very happy to hear from you and your personal experience. Please leave me your comments below and share your experience with us.

Other Anxiety Resources

• Anxiety Workbooks:
  • No Worries Journal for Kids (up to 11 y.o.)
• Anxiety Affirmation Cards
• 43 Anxiety Tips & Activities for Kids
• 50 Stress-Relief Games & Activities for Students
• How to Create a Calm-Down Corner
• 18 Anxiety Drawing Ideas for Kids (and Adults!)
• Thoughts-Feelings–Behaviors Worksheets
• 12 Unhelpful Thinking Styles (with examples)
• Best Children’s Books for Anxiety

Other Autism-Related Resources

• Autistic Elopement: 35 Tips to Help Prevent Wandering (Free PDF)
• Autism & Head Banging: 25 Strategies to Help your Kid or Student with Head Banging
• 31 Social Skills Activities and Games for Kids (Young Children, Teens, Autism & Group Activities)
• How to Teach Kids to Wait: 15 Useful Ideas to Learn Waiting Skills
• Autism Explained by An Autistic Teen
• Music Therapy & Autism: How to Improve 18 Valuable Skills