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Anxiety and Autism

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Anxiety does not discriminate.

Anyone can experience it. 

It’s the most prevalent mental health issue in the United States. An estimated 18% of Americans suffer from anxiety 

But there’s a group with significantly higher anxiety levels than the general population: children with autism spectrum disorder.

40% of young people with autism spectrum disorder have either an anxiety disorder or suffer from elevated anxiety levels.

Although anxiety is not a symptom doctors use to diagnose a child with autism, it seems autism and anxiety go hand-in-hand.

Many of the children that we work with at Heartlinks have anxiety. 

We recognize the importance of treating a child’s anxiety because it affects many different elements of autism, including worsening repetitive behaviors and social withdrawal.

Fortunately, many different approaches can positively impact a child’s anxiety, from medication to ABA therapy.

It’s time to redefine the relationship between anxiety and autism differently, and Heartlinks can help.

What is Anxiety?

Anxiety is the body’s natural response to a stressor or a threat. It is often described as a feeling of worry, fear, or unease. 

If that feeling persists even though the stressor has been removed, the anxiety response becomes chronic and unending. Then, an anxiety disorder may be present.  

The most common symptoms of anxiety include the following:

Sad girl talking with her Mom
  • Worry or Restlessness
  • Nausea
  • Panic attacks
  • Increased heart rate
  • Problems concentrating
  • Changes in appetite (i.e., either constantly or rarely hungry)
  • Irritability
  • Feelings of doom or fear
  • Difficulty concentrating
  • Easily startled or scared

Is Anxiety Common in Children with Autism?

The simple answer is ‘yes’; anxiety is common in autistic children. 

Though recent studies have indicated there’s no precise measure of how prevalent anxiety disorders are for autistic children, those studies that have been conducted have provided results ranging from 11-84% of autistic people experience anxiety.

More research is needed to establish the prevalence of anxiety in children on the spectrum.

Why is Anxiety Common in Children with Autism?

Autistic children can often be anxious for the same reasons as their neurotypical peers. Yet, there are additional factors that an autistic child faces regularly that can cause stress.

Communication Difficulties

Children on the spectrum often experience language and speech difficulties. The variety of speech disorders can include a child being non-verbal or extremely limited in their vocabulary. If these obstacles are not addressed, this can create tremendous frustration and anxiety for the child, especially if they’re in an environment heavily dependent on verbal communication.

Mentally Inflexible

One of the most well-known symptoms of autism is the attention to detail. Many adults and children with autism can process the world around them in minute detail. This is a tremendous strength. However, they’re unable to understand the larger context of these details. Without understanding the larger picture, many autistic kids and adults become anxious if a change quickly occurs or they have to transition from one situation to another.

Social Barriers

The inability to understand unspoken social rules or expectations can lead to tremendous anxiety for autistic kids. Large, unstructured social situations such as school recess or a birthday party are prime examples of where a child on the spectrum may not understand what’s expected of them. Feelings of confusion, frustration, and eventually anxiety can arise, making the child want to avoid social settings altogether.

What Does Anxiety Look Like In An Autistic Child?

Recognizing anxiety in your child with autism is not easy. One of the reasons is that many symptoms of autism and anxiety are similar.

Additionally, if your child is non-verbal, they may be unable to express their feelings (i.e., worry). Instead, they may demonstrate it through disruptive behaviors such as aggression or stimming.

Even if they are verbal, they may not know why they feel this way.

Usually, anxiety will present itself differently depending on the child’s age, abilities, and unique environment. The following are a few examples. 

OCD – Obsessive Compulsive Disorder 

This disorder presents itself with intrusive and unwanted thoughts and resulting compulsive behaviors (i.e., closing a door 20 times). 

Often, a child with autism has OCD; they can exist simultaneously. The difficulty rests in differentiating between a child’s repetitive behavior as a symptom of autism or a sign of OCD.

Social anxiety

Most children with autism will experience social anxiety because of their difficulty gauging a complex social situation. 

From being non-verbal to exhibiting limited social skills or being unable to pick up on social cues, autistic children tend to struggle in an environment where their peers are present.

As such, kids on the spectrum will start avoiding social situations altogether. Their goal is to evade peer reactions, potentially leading to bullying and harassment.  


Intense irrational fear or phobia is often a symptom of anxiety in a child on the spectrum. This fear doesn’t pose any imminent danger. 

Boy being upset

Usually, the phobia is the result of a child’s sensory issues or sensitivities.  For example, if your child finds noise overwhelming, they may develop a fear of noisy places such as stadiums, large restaurants, or even school hallways. 

Unfortunately, the stimuli that launch your child’s fear can be found anywhere.

Other symptoms of anxiety in your autistic child might include:

  • Refusing to go to certain places
  • Covering their ears or eyes
  • Appearing jumpy or jittery
  • Refusing to leave the house
  • Sweating and shaking
  • Experiencing more emotional meltdowns than usual.

How Can I Help My Autistic Child With Their Anxiety?

Many tools are available to parents of autistic kids to help them deal with their anxiety. The most important thing you can do is identify how they show their fear and then isolate the source of it. 

When you can do that, you can take the proactive steps needed to help them feel calm, including the following:

Removing the triggers

Whether it’s bright lights, strong smells, or excess noise, whatever triggers your child’s anxiety must be either removed or reduced. 

Maybe it means not taking your autistic child to professional sports events with bright lights and excessive noise. Or, avoid shopping malls altogether because your child gets extremely anxious in crowds.   

Whatever the solution, by removing the triggers or your child from the environment that makes them feel anxious, you’re helping significantly reduce their anxiety. 

Accommodate or provide support 

From wearing noise-canceling headphones while at a noisy sporting event to having your child wear sunglasses in a bright environment such as the beach, there are many ways to accommodate your child to reduce their anxiety.  

Discovering what works to calm your child requires a lot of trial and error, but once you’ve found it, the result is a relaxed son or daughter!

Learn relaxing techniques

Sometimes, anxiety-generating situations are impossible to avoid. That’s when autism-specific anti-anxiety techniques come in very handy. Whether you help your child count to ten, hand them a stress ball, or sit next to them as you meditate, there are dozens of methods to make them less anxious.

Let Heartlinks Help 

It can be challenging to determine if your child is suffering from anxiety. Because of this, anxiety in an autistic child can go untreated for so long. 

At Heartlinks, we remain vigilant for anxiety symptoms in our young autistic clients. We have a wealth of knowledge, experience, and resources available to you and your family to treat anxiety, including ABA therapy.

Anxiety and autism don’t have to go hand-in-hand, and we’re dedicated to showing you there are ways to treat it.
For more information on how we can help you, contact us.

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