Anxiety

Anxiety is a normal part of all children’s development, but research confirms that young people with autism experience elevated levels of anxiety in comparison to their typically developing peers.1 An extensive review of the literature by White et al (2009) revealed that up to 84% of individuals with autism meet the criteria for clinically diagnosed anxiety disorders.2

Anxiety during the middle years

All young people may experience heightened levels of anxiety during adolescence.  This is especially true for children with autism as a result of their social environment becoming increasingly complex and a possible increasing self-awareness of their differences and interpersonal difficulties.

Due to characteristic communication difficulties, a young person with autism may have severe anxiety issues but have a decreased ability to express it. As noted by Howlin (1997), “…the inability of people with autism to communicate feelings of disturbance, anxiety or distress can also mean that it is often very difficult to diagnose depressive or anxiety states.” 3

Ways anxiety might manifest itself in a young person with autism:

• social phobia
• excessive worry/rumination
• obsessive compulsive behaviour
• hyper-vigilance, or seeming “shell shocked”
• phobias
• avoidance behaviours
• rigid routines and resistance to change
• stimming and/or self injurious behaviour
• controlling behaviours – oppositional defiance
• meltdowns
• shut down

Stress at school

The Queensland Government Department of Education has collated information for educators of students with autism on their website. The article, Managing Stress and Anxiety lists several ways in which high levels of stress and anxiety may present itself in a young person with anxiety including:

• fatigue, irritability, difficulty attending and/or a reduced ability to concentrate
• constant questioning or the increased need for reassurance and predictability
• an increase in repetitive or controlling actions and an inflexible approach to activities
• fear of new or unfamiliar situations, activities or environments
• physiological symptoms such as sleep disturbance, headaches, changes to bowel and dietary habits, difficulties maintaining a calm state, and muscle tension

Further information which may be useful in addressing, minimising and managing stress and anxiety including sensory triggers in students on the autism spectrum can be obtained from the Queensland Government Department of Education website.