Having the amazing job of being in the company of people who have Autism has provided me the unique opportunity to see into their worlds and the inner workings of their minds, although be it a superficial look at best. I could never fully understand the inner workings of any person mind, as none could fully understand mine, but I have been able to observe things that they do and have then able to see how they rationalize their actions. One big part of this has been how anxiety comes into play in their actions.
Anxiety can look like the traditional traits we see in people with Autism; stimming, the need to exhibit obsessive or ritualistic behaviors (example; lining objects up), or their need for rigidity and inflexibility in their routines and schedules. According to the Resource Center for Autism at Indiana University Bloomington (www.blog.stageslearning.com) among the multiple types of anxiety they have tested in individuals with Autism, there are three that presented as the most common; Specific Phobia, OCD (Obsessive Compulsive Disorder), and Social Anxiety.
They use the following to define these most common types of Anxiety:
Specific Phobia: Occurs rather frequently. It is the fear of a certain object, place, or situation. For example, if a person is afraid of self-flushing toilets then they might avoid public restrooms all together as to not encounter one. Any parent of a small child who has been the stressed out audience to their screaming when a toilet spontaneously flushes in a public restroom can tell you this is very common (Oh, little trick here, put a piece of toilet paper over the sensor on the toilet and it will not flush on it’s own!). Some of us have fears about snakes, spiders, bees....the list can go on, and we haven’t really had an experience that makes these fears a reality. They are just irrational fears. I have never been attacked or even looked sideways by a snake but growing up if I saw one I was absolutely positive it’s main focus was to kill me or at least bite me and leave me for dead. This is a specific phobia that I’ve learned to get over as I got older, sort of like the Boogie Man in the closet or the monster who lives under your bed at night when your a kid.
OCD: People with OCD may often feel that if they don’t participate in obsessive/ritualistic behaviors a certain amount of times something negative will happen. An example of this is lining up objects and being upset if this routine is interrupted. I worked with someone that would have to touch things (like the door knob, chairs, TV) the same amount of times everytime they walked by them or they would have to start all over again. This ritual satiated something in him, and if he didn’t complete it he would focus on it for hours internally he said. We can see this with children with ASD as well, the lining up of their toys for example. This is a specific ritual that satiates something in them and is self soothing. Now, what do you think would happen if I walked by and rearranged their toys from the line they were in? If your child does this then I’m sure your rolling your eyes at me right now because you know that I would have triggered a very aversive reaction in them and it could take hours to calm them. P.S. I would never actually do this but I figured this example was relatable to many parents of children who have Autism.
Social Anxiety: This is the struggle with social interactions, which can include but isn’t limited to eye contact, conversation, social cues, and body language). People with this may avoid social interactions all together and have physical reactions (like sweating, racing heartbeat, and become shaky) when they are presented with these situations. Now we can also see this in people who have Autism. Since it is a challenge for some people with ASD to process information such as social cues, eye contact, if a person is interested in the topic you’ve brought up for example they can start to feel the anxiety build in them. Many of the children I’ve worked with that feel this look to flee the situation, or elope. They want to get as far away from this situation as possible and who could blame them? Think about a time when you’ve had to stand up in front of a bunch of people to speak and you blanked on what you were going to say. Remember how the fear starts to creep up from your toes to your heart, you throat is dry, and you start to get the cold sweats? Well I’d imagine Social Anxiety can feel like that horrible feeling.
So what can we do to help support people with Autism who are dealing with these types of Anxiety? A big part of helping them is teaching them how to identify the changes that occur in their bodies and the feelings that present themselves when anxiety is occurring. To teach this we need to start when they aren’t in the midst of all the turmoil of anxiety but identifying how their bodies feel when they are calm. For one student I would present her with a laminated card every morning that had, “Today my body feels…” and on the back, there was a list of different feelings she could choose from if she wasn’t able to come up with a word by herself. After she was used to this then I would do a “body check in” where I would start by asking how her head felt, her tummy, etc and she would be able to tell me. This helped a lot since she wasn’t able to tell me when she felt sick, but teaching her to scan her body she started to let me know if she was sick and what part of her body hurt. This is just an example of how to start this for a person with Autism who may not be able to relay their physical feelings to you. Another way to help them is to talk to them about what they feel triggers the feelings. Someone who is more verbal may be able to tell you that when they walk into their Math class they start to feel their heartbeat race and their hands get sweaty. With a less verbal person, you can start to take data on when you are noticing they are presenting these feelings and see if your data can find a correlation between a situation that is occurring and their behaviors. Having a drawing of a body, or picture of the person, and having them point to the places on their bodies that are feeling “bad” or “uncomfortable” is also a way to support them.
When you might have a good idea of what is triggering their anxiety you can start on ways to help them decrease these feelings.
Some examples of teaching ways to cope with anxiety are: Guided Meditation Count slowly to 10 Deep breathing exercises Running Deep pressure or skin brushing Jump on a trampoline Go into a quiet, dimly lit room or other “safe space” with little to no interruptions A visual schedule with “break times” incorporated Social Stories Do a “practice run” before the potentially anxiety-producing situation (for example, if it’s the dentist that is causing anxiety see if they will allow you to come earlier to do a practice run and meet everyone there, see where they will be, what is expected, etc.)
There are so many possible strategies to help someone who is dealing with anxiety, and I’d love to hear how you’ve helped or strategies you’ve found have helped! And think about what helps you deal with stress and anxiety. Is it journaling? Is it listening to your favorite music? Reading your favorite book? These are suggestions we can pass along as well!
As always I hope your all having a wonderful week!
Shine On! Ronette Parker, Mindful ABA
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