Anxiety in Autistic Kids - Hidden Talents ABA

Supporting Anxious Autistic Kids: Parent’s Guide

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February 8, 2022 Supporting Anxious Autistic Kids: Parent’s Guide

If your child with autism is struggling with anxiety then you are reading the right article. 

Anxiety can be mild or severe and it is very common in children with autism to struggle with it.

In this article, we will explain what anxiety is, list some of its common symptoms, and explore the reasons why children with autism struggle with it.

We will also discuss some treatment options to give you some actionable tips for stopping your child's anxious episode.

What is anxiety?

So, what is anxiety? According to the American Psychological Association, anxiety is an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure.

Anxiety disorders are one of the most common mental health issues in the world affecting over 40 million adults in the United States alone.

Autistic children often struggle with anxiety. In fact, recent studies have suggested that 40-80% of autistic children will experience an anxiety induced episode.

Signs of Anxiety

So what are the signs that your child is struggling with anxiety?

According to the Mayo Clinic, common symptoms of anxiety include:

  • Restlessness: Constant moving, pacing and fidgeting.
  • Feeling on edge: A sense of feeling like something bad is going to happen and that it could happen at any time.
  • Irritability: Your child may get angry easily,
  • Muscle tension: You may notice your child clenching their hands or jaw.
  • Difficulty concentrating: Your child may have a hard time focusing on anything or completing tasks.
  • Insomnia: Difficulty falling asleep or staying asleep.
  • Eating problems: Your child may not eat enough or they may overeat.
  • Panic attacks: Sudden feelings of terror, shortness of breath, chest pain and dizziness.
  • Avoidance of everyday activities: Avoiding school, work and social situations out of worry and fear

If you notice your child struggling with these symptoms, it may be time to contact a therapist or doctor.

Types of anxiety disorders

Sure, here are the different types of anxiety disorders as classified by the American Psychiatric Association:

  1. Generalized Anxiety Disorder (GAD): This disorder is characterized by chronic anxiety, exaggerated worry and tension, even when there is little or nothing to provoke it.
  2. Panic Disorder: People with this condition have feelings of terror that strike suddenly and repeatedly without warning. Other symptoms of a panic attack include sweating, chest pain, palpitations, and a feeling of choking.
  3. Phobia-related Disorders: These involve a persistent and excessive fear of a specific object, situation, or activity that is generally not harmful. Patients know their fear is excessive, but they can’t overcome it.
  4. Social Anxiety Disorder (Social Phobia): This is an intense fear of social situations, leading to avoidance of such. People with social phobia have a persistent, intense, and chronic fear of being watched and judged by others and of doing things that will embarrass them.
  5. Separation Anxiety Disorder: This is a childhood disorder characterized by anxiety that's excessive for the child's developmental level and related to separation from parents or others who have parental roles.
  6. Selective Mutism: This is a complex childhood anxiety disorder characterized by a child's inability to speak and communicate effectively in select social settings, such as school.
  7. Agoraphobia: This is an anxiety disorder characterized by symptoms of anxiety in situations where the person perceives their environment as unsafe with no easy way to escape.
  8. Substance/Medication-Induced Anxiety Disorder: This is characterized by panic or anxiety symptoms that are a direct result of abusing drugs, taking medications, being exposed to a toxic substance, or withdrawal from drugs.
  9. Anxiety Disorder Due to Another Medical Condition: Anxiety or panic is the direct physiological consequence of a physical health problem.
  10. Other Specified Anxiety Disorder and Unspecified Anxiety Disorder: These are terms for anxiety or phobias that don't meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive.

Remember, if you or someone else has symptoms of an anxiety disorder, it's important to seek help from a healthcare provider. They can help determine if the symptoms are due to an anxiety disorder, some other medical condition, or both.

Why do children with autism spectrum disorder struggle with anxiety?

There are many reasons why autistic children struggle with anxiety.

Some of the most common include:

Lack of social skills

 Autistic children may not know how to interact with others which can lead to feelings of isolation and loneliness. This can also cause them to feel anxious about upcoming events where they will have to socialize.

Sensory overload

Autistic children often struggle with sensory overload. This is when they are overwhelmed by too much noise, light, or touch. This can cause them to become anxious and agitated.


Autistic children thrive on routine and order. When things change or are unpredictable it can cause them to feel anxious and afraid.

Bullying: Autistic children are often targeted by bullies because of their differences. This can lead to a lot of emotional distress and anxiety.

common anxiety triggers in children with autism

Children with autism often experience anxiety, which can be triggered by various factors. Here are some common anxiety triggers:

Changes in Routine: Children with autism often thrive on routine and predictability. Any changes, even minor ones, can lead to anxiety.

Social Situations: Social interactions can be overwhelming and confusing for children with autism, causing anxiety.

Sensory Overload: Loud noises, bright lights, or crowded places can overstimulate a child with autism and trigger anxiety.

Communication Difficulties: Struggling to express their thoughts and feelings can cause anxiety in children with autism.

Fear of Failure or Making Mistakes: This fear can lead to anxiety, especially in school or other performance-based situations.

Transitions: Moving from one activity to another can be stressful and trigger anxiety.

Separation Anxiety: Being away from familiar people or places can cause anxiety.

New Environments: Unfamiliar surroundings can be scary and lead to anxiety.

Physical Discomfort: Issues like hunger, tiredness, or illness can trigger anxiety.

Unpredictable Events: Unexpected incidents or surprises can be stressful and induce anxiety.

Remember, every child with autism is unique and may have different triggers. Understanding these triggers can help in managing their anxiety effectively.

Treatment options for anxiety in autistic children

So what are the treatment options for anxiety in autistic children?

There is no one size fits all answer to this question because different things work for different people.

However, there are some common treatment options that can help your child reduce their feelings of anxiety. These include:

  • Behavioral therapy: With behavioral therapy,your therapist will teach you and your child techniques to manage stress and anxiety in everyday life.
  • Cognitive-behavioral therapy: This type of therapy helps your child to change the negative thoughts and beliefs that contribute to their anxiety.
  • Medication: If your child's anxiety is severe, medication may be necessary. There are a variety of medications that can help treat anxiety including antidepressants and anti-anxiety drugs.
  • Talk therapy: In talk therapy, your therapist will help your child explore and understand their thoughts and feelings about anxiety.
  • Support groups: Joining a support group can be helpful for both you and your child. This is a place where they can share their experiences with others who are going through the same thing.
  • ABA therapy: ABA or Applied Behavioral Analysis therapy is a type of therapy that helps your child with communication and learning skills and can help modify anxious behaviors.
  • Relaxation techniques: Teaching your child relaxation techniques such as deep breathing, yoga, tai chi and mindfulness can help them to calm down when they feel anxious.

Tips for helping your autistic child during an anxious episode

So how can you help your child during an anxious episode?

The most important thing is to stay calm. When you notice them becoming upset, try to be reassuring and encouraging. You may want to hold their hand or give them a hug depending on their sensory needs. Try not to force anything on them that they don't want during their anxiety attack. 

It can also be helpful to have a plan in place for when your child has an anxious episode. This may include having a safe place for them to go to, an electronic device to distract them, and other calming activities such as deep breathing exercises or listening to music.

visual tools to help a child with autism and anxiety

Visual tools can be incredibly effective in aiding children with autism to understand, communicate, and manage their anxiety. Here are some visual tools that can be used:

  1. Visual Schedules: These provide a clear outline of the day's activities. This can help reduce anxiety by providing predictability and structure.
  2. Social Stories: Developed by Carol Gray, these are short descriptions of a particular situation, event or activity, which include specific information about what to expect in that situation and why.
  3. Emotion Cards: These cards have pictures of different emotions which can help the child identify and express their feelings.
  4. Visual Timers: These timers provide a visual countdown to transitions, helping the child prepare for the change.
  5. Choice Boards: These boards help children communicate their preferences visually, reducing frustration and anxiety.
  6. Calm Down Kit Visuals: These visuals guide the child through calming techniques like deep breathing or counting.
  7. Break Cards: These cards allow the child to communicate when they need a break, which can prevent meltdowns and reduce anxiety.
  8. Traffic Light System: This system uses the colors red, yellow, and green to help the child express their comfort level in a situation.
  9. First-Then Boards: These boards visually depict that 'first' a certain task needs to be completed, 'then' a preferred activity can be enjoyed.
  10. Visual Rules and Expectations: Clear visuals of rules and expectations can alleviate anxiety by clarifying what behavior is expected.

Remember, it's crucial to introduce and use these tools in a supportive and positive way to ensure their effectiveness. It may be beneficial to seek advice from a therapist or specialist to find the right tools for your child's needs.


Anxiety is a common problem for autistic children, but there are things you can do to help. From therapy to medication to relaxation techniques, there are many options available to help your child manage their anxiety.

Remember to stay calm and be supportive during an anxious episode, and have a plan in place so you know what to do when things get tough.