Raelene Dundon - The Parents Guide to Managing Anxiety in Children with Autism

The Parents Guide
to Managing Anxiety in
Children with Autism

Raelene Dundon

Jessica Kingsley Publishers
London and Philadelphia

Contents

A Note to Readers

T hroughout this book, you will notice that I have used both identity-first and person-first language when referring to autistic children. I have done this for two reasons. First, because there does not seem to be a consensus regarding the most appropriate language to use to describe autistic individuals. Second, as this book is aimed primarily at parents, my experience is that person-first language is often their preferred way of discussing their child. However, I am aware that many autistic adults prefer identity-first language as they feel that person-first language implies a defect or disability which they do not relate to.

Please be assured that when I have used person-first language in this book, it is in no way meant to be offensive or derogatory. Rather, it is a way to describe the children that this book is about in a reader-friendly way. Conversely, my use of identity-first language does not imply that any individual is wholly defined by their autism, but instead that autism represents a part of who they are.

I hope that in reading this book you will see past the language to the true intention of my words, which are to educate and empower parents to support their autistic children to manage their anxiety in the most effective way possible.

Disclaimer

The information contained in this book is not intended to replace the services of trained medical professionals or to be a substitute for medical advice. You are advised to consult a doctor on any matters relating to your health, and in particular on any matters that may require diagnosis or medical attention.

Introduction

W hen I first started my work as a psychologist, many years ago, it quickly became evident that a large proportion of the autistic children I was working with experienced significant levels of anxiety. I saw children who would not go into a public toilet due to the possibility of hand dryers being present; children who would cry and scream and refuse to separate from their mum or dad to enter preschool; children who would hide under a table when it was time to leave their classroom to go to art; children who became aggressive and distressed when asked to do something they found difficult; and children who would have a meltdown as soon as they came home from school after having a great day. These were children that experienced challenges associated with their autism diagnosis, but seemed to be more adversely affected by the level of anxiety they were experiencing on a day-to-day basis. However, at the time, anxiety was not always recognized in children with autism, as their difficulties were attributed to being part of their autistic characteristics rather than being an additional difficulty requiring treatment.

As many of you reading this book will be aware, autism is a neurodevelopmental condition that is present from birth and is characterized by difficulties with social communication and interaction, and the presence of restricted and repetitive interests and behaviors. It is a condition that is reported to impact as many as 1 in 59 individuals worldwide, with considerable variability in the way that it presents in children and adults, and between men and women. The presence of sensory sensitivities in many children with autism, along with comorbid disorders such as intellectual disability, made it difficult for professionals in the past to determine which symptoms were specifically part of an autism spectrum disorder and which were related to autism but ultimately separate conditions, such as anxiety.

In recent years, mental health in autistic individuals has been the focus of growing concern for the autistic community, their families, and the professionals who support them. As a consequence of this increased interest, anxiety has become much more widely recognized as a problem that requires intervention and support. In my private practice, the majority of autistic clients I currently work with experience levels of anxiety that impact on their daily lives in many different ways. Anxiety can affect their capacity to learn, their social interactions and relationships, their ability to function across different settings, and their overall sense of happiness and security. In children, the negative impact of anxiety often affects the whole family, as they struggle to carry out their day-to-day activities while trying to support their autistic child in managing what can often be extreme and uncontrollable distress.

The good news is that anxiety can be treated, and children with autism can develop skills to assist them to reduce their experience of anxiety and manage their symptoms effectively. In this book I will help you develop an understanding of anxiety and how it relates to autism, describe the types of anxiety that children with autism may experience, and provide you with strategies for supporting your child to manage their anxiety effectively. I will also give you information regarding where to seek additional support if your child needs further assistance from a professional, and how to communicate your childs needs to their school or preschool.

While anxiety is a persistent condition that is likely to remain in some form through the lifespan, with the right support and guidance from parents, teachers, and health professionals, autistic children can develop the skills they need to effectively manage their anxiety now and into the future.

PART 1

Understanding
Anxiety and Autism

CHAPTER 1

What Is Anxiety?

A nxiety can be described as feelings of apprehension, worry, or nervousness that are accompanied by physical symptoms.

When we think of anxiety, we often think of something negative and upsetting, but it is really important to remember that for most of us, anxiety can actually be quite helpful and is a normal experience. The bodys response to threat is hardwired into us and is designed to get us out of danger. For example, if we perceive a threat in our home, such as an intruder or a fire, we need our body to respond in a way that will get us out of that situation as quickly as possible in order to protect ourselves. So, anxiety can actually be something thats very helpful in terms of keeping us safe.

The fight, flight, or freeze response, which is often what people talk about in terms of a reaction to a threat, is quite a natural, almost primal, response to danger. The idea is that when a threat is perceived our body will react, either with a burst of energy to fight off that threat (fight), or to run from it (flight). If neither of those options is available to us, then we might shut down and become nonresponsive (freeze).

In terms of the way that our body reacts, and what its supposed to do, we perceive a threat, and that fight or flight response in our nervous system is activated. Adrenaline, noradrenaline, and cortisol are released, which are designed to get our body going. In response to these neurochemicals, heart rate and breathing increases, and blood flow is diverted from our brain to our muscles, so we are primed to act. Then, when the threat is removed, our body also reacts to that by releasing another wave of neurochemicals, and calms everything down again.

While our brains are still hardwired for this intense reaction, our everyday experiences in modern society rarely warrant a full fight or flight response. We may feel apprehension or nervousness about a major event in our lives, such as starting a new job, getting married, having an operation, or performing in front of an audience, but these feelings subside quickly and do not usually prevent us from functioning day to day.