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Anxiety is common in Autism, with 40-50 per cent of autistic people thought to have a severe level of anxiety on a regular basis.  

Anxiety is a feeling of unease, which may present as worry, restlessness, fast heartbeat or breathing, hot flushes, even panic attacks. For autistic people it may be brought on by difficulty negotiating social or sensory situations, being misunderstood and identifying and managing their emotions. Anxiety has many forms, which impact on the individual’s school performance. At an extreme level it can result in meltdowns or autistic burnout. 

The signs of anxiety 

  • Avoiding tasks 
  • Need to have very high levels of control of people, routines and environment 
  • Obsessive, repetitive or intrusive thoughts 
  • Meltdowns at the end of the day that last for hours. 
  • Emotional dysregulation, eating disorder or self-harming. 
  • Depression 

Strategies for working with high levels of anxiety 

  • Identifying situations that lead to anxiety. 
  • Talking through any planned changes in advance. 
  • Talking about how their body feels when they are anxious, as it is possible that they will not have connected the physical sensation (for example of feeling nauseous) with the emotion of anxiety. 
  • Teaching calming strategies. This can be anything from concentrating on breathing, to fiddling with a gadget, to wearing ear-defenders to block out noise. 
  • If something has gone wrong, talking about how it could be different next time, and making a plan for it to be different. 
  • Asking 'what is the worst thing that can happen?' and then discussing fears, putting them into perspective and context. 
  • Try using cards with ‘big deal’ on one side and ‘not a big deal’ on the other. Ask the young person to categorise which the issue would be, and then talk through reasons why it might be less of a big deal than they think. 
  • Celebrating difference. Everyone has things that they find difficult and things that they find easier. Build the young person’s confidence and self-esteem, so that they believe in themselves, and develop their resilience. 
  • Talking Mats TM provides a programme that helps the child identify needs and prioritise things that matter. 

A high level of anxiety is not unusual in girls with Autism. Read our article, Autism in girls, to learn more.

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