- Supporting Students with Asperger's Syndrome Who Present Behavioral Challenges
- A Brief Explanation of Discrete Trial Training
- Applied Behavior Analysis: A Focus on Outcomes
- A Challenge to Reframe our Thinking About Behavior
- Concerning Consequences: What Do I Do When...?
- Consequences, Behavior, and My Birds
- Don't Forget About Self Management
- Ever Had a Crisis Kind of Day?
- Movement Difference: A Closer Look at the Possibilities
- Movement Differences Among Some People with Autism: an Impetus to Re-Examine Behavioral Issues
- Observing Behavior Using A-B-C Data
- Positive Behavior Supports Creating Meaningful Life Options for People with ASD
- Ten Steps Towards Supporting Appropriate Behavior
- The Challenge of Combining Competing Input in the Classroom
- "Your Attitude Just Might Be My Biggest Barrier"
- Applied Behavior Analysis: The Role of Task Analysis and Chaining
- Tips for Choosing a Provider for Applied Behavior Analysis (ABA)
- What to Consider When Looking for a Qualified ABA Provider
- “If They Could Only Tell Me What They Are Thinking.” The Need for Augmentative Communication for Individuals with Autism Spectrum Disorders
- Assessment Day: Questions About the Communication Development of Your Young Child with an Autism Spectrum Disorder
- Aiding Comprehension of Individuals with Autism Spectrum Disorders During One-on-One Interactions
- Can Social Pragmatic Skills Be Tested?
- Comprehension of the Message: Important Considerations for Following Directions
- First Steps and the Journey to a Diagnosis of ASD for a Child under Three
- Functional Categories of Delayed Echolalia
- Functional Categories of Immediate Echolalia
- Initial Guidelines for Developing a Communication Intervention Plan for Individuals with Autism Spectrum Disorders and Significant Limitations in Communication Ability
- Long and Short Term Strategies for Reducing Specific Repetitive Questions
- Successfully Using PECS with Children with ASD
- Meeting the Challenge of Social Pragmatics with Students on the Autism Spectrum
- Opportunity to Communicate: A Crucial Aspect of Fostering Communication Development
- Reading with Your School-Age Child: Building Vocabulary One Word at a Time
- Social Communication and Language Characteristics Associated with High Functioning, Verbal Children and Adults with ASD
- The 21st Century Speech Language Pathologist and Integrated Services in Classrooms
- The High Functioning Person with an Autism Spectrum Disorder: A "Tourist" in His Native Country
- The Role of the School Speech Language Pathologist and the Student with Autism
- Using a Visual Support to Enhance WH Question
- Visual Resources for Enhancing Communication for Persons with Autism Spectrum Disorders and Other Disabilities
- Visual Schedules and Choice Boards: Avoid Misinterpretation of their Primary Functions
- Visual Supports: Sources for Symbols for Receptive and Expressive Communication
- What is the Picture Exchange Communication System or PECS?
- Articles - Communication
- Articles - Communication
- Articles - Communication
- Articles - Communication
- Articles - Communication
- Articles - Communication
- Articles - Communication
- PICO - A Decision Making Tool For Selecting Apps
- Helping Your Child to Develop Communication Skills
- Evidence-Based Practices for Effective Communication and Social Intervention
- Important Predictors
- The Use of Technology in Treatment of Autism Spectrum Disorders
- Collaborative Teaming
- Educational Programming
- Academic Supports for College Students with an Autism Spectrum Disorder
- Advice from Adults with Autism Spectrum Disorder to Teachers Regarding Literacy Instruction
- Advice for Peer Tutors
- Applying the Ziggurat and CAPS Model in Your School District
- Aspects of Support for Learning
- A Young Adult's Guide to Deep Breathing as a Relaxation Technique: A Personalized Fact Sheet
- Can Schedule Usage Training Include Elements of Literacy Instruction?
- Clean Up Your Act! Creating an Organized Classroom Environment for Students on the Spectrum.
- Change is Good! Supporting Students on the Autism Spectrum when Introducing Novelty
- Classroom Choreography: The Art of Scheduling Staff and Students
- Creating a Circle of Support
- Complexities of Instructional Support
- Critical Features of Early Intervention: Merging Best Practices
- Developing Long Term Relationships Between School and Parents
- Early Intervention for Young Children on the Autism spectrum: Parent’s Perspective
- Educating Students with Autism: Are There Differences in Placement?
- Establishing Long Term Goals: What Are We Hoping to Achieve
- For General Education Teachers: Helpful Questions to Ask About Students with ASD
- Get Engaged: Designing Instructional Activities to Help Students Stay On-Task
- "Ham It Up and Get It Cookin!!" Thoughts From Dr. Greenspan
- Home-School Communication
- "I Can Do It Myself!" Using Work Systems to Build Independence in Students with Autism Spectrum Disorders
- “I Wake Up for MY Dream!” Personal Futures Planning Circles of Support, MAPS and PATH
- Life After High School...So Now What
- Literacy Resources
- Lovaas Revisited: Should We Have Ever Left?
- Making the Most of Morning Meeting
- Motivating Students Who Have Autism Spectrum Disorders
- Moving from Preschool to Kindergarten: Planning for a Successful Transition and New Relationships
- Peer Support Programs
- Promoting the Educational Success of Students with Autism: The Role of the Parent-Staff Relationship
- Planning for Successful Transitions Across Grade Levels
- Practical Steps to Writing Individualized Education Program (IEP) Goals: And Writing Them Well
- Practical Recommendations for Utilizing a Range of Instructional Approaches in General Education Settings
- Recognizing Different Types of Readers with ASD
- Reframing Our Thinking and Getting to Know the Child
- Restricted Repertoires in Autism and What We Can Do About It
- School Cultures that Support Students Across the Autism Spectrum
- Service Learning: Something to Think About
- Supporting Staff Using Coaching Model
- Supporting Students with Asperger's Syndrome
- Teaching Students Who Are Low-Functioning: Who Are They and What Should We Teach?
- Theory of Mind in Autism: Development, Implications, and Intervention
- There is No Place Called Inclusion
- The Road to Post-Secondary Education: Questions to Consider
- Tips for Teaching High-Functioning People with Autism
- Tips to Consider When Including a Student with ASD in Art, Music, or Physical Education
- Transition: Preparing for a Lifetime
- Transition to Middle School
- Transition Time: Helping Individuals on the Autism Spectrum Move Successfully from One Activity to Another
- Understanding the Design and Power of a Personal Schedule
- Using Visual Schedules: A Guide for Parents
- Who Are We Working for Anyway? Avoiding Personal Agendas at Meetings to Better Support Individuals Across the Autism Spectrum
- Structured Teaching Strategies: A Series
- Growing Up Together
- How to Open A Combination Lock/Locker
- Supporting Youth with Autism Spectrum Disorders Through Postsecondary Transition
- Curriculum Materials and Programs for Individuals on the Autism Spectrum
- Implementation and Effectiveness of Using Video Self-Modeling with Students with ASD
- Video Self-Modeling How To and Examples
- Advocates: Qualities to Look for and Choosing the Correct One for YOU
- Considering an Overnight Camp Program for your Child on the Autism Spectrum?
- Finding or Starting a Support Group
- Making the Most of the Holidays for Your Family and Your Son/Daughter on the Autism Spectrum
- Selected Bibliography for Families of People within the Autism Spectrum
- Selected National Resources for Information on Autism Spectrum Disorders
- Selected Resources for Understanding and Supporting Siblings
- Setting the Stage for Parent-Professional Collaboration
- Siblings Perspectives: Some Guidelines for Parents
- What About the Dads?
- When Your Child is Diagnosed with an Autism Spectrum Disorder
- What to Do If You Suspect Your Son/Daughter Might Have an Autism Spectrum Disorder
- For Parents: Preparing for the School Year
- Self Help/Medical
- Teaching a Young Man to Shave
- An Introduction to Possible Biomedical Causes and Treatments for Autism Spectrum Disorders
- The "M" Word
- Mealtime and Children on the Autism Spectrum: Beyond Picky, Fussy, and Fads
- Good Night, Sleep Tight, and Don’t Let the Bed Bugs Bite:
- Taking Your Son/Daughter with an Autism Spectrum Disorder to the Dentist
- Teaching a Young Woman to Shave
- Anxiety and Panic Struggles
- Anxiety and Autism Spectrum Disorders
- Having THE Talk with Your Child with ASD
- General Information
- Assessment Processes for Autism Spectrum Disorders: Purpose and Procedures
- Autism Awareness Month: Facts and Tips for Working with Individuals on the Autism Spectrum
- Diagnostic Criteria for Autism Spectrum Disorder
- Diagnostic Criteria for Social (Pragmatic) Communication Disorder
- Disability Information for Someone who has an Autism Spectrum Disorder: A Customized Example
- Getting Started: Introducing Your Child to His or Her Diagnosis of Autism or Asperger Syndrome
- Increasing Incidence of Autism Spectrum Disorders Continues in Indiana
- Standardized Tests and Students with an Autism Spectrum Disorder
- Article 7, Title 511
- What’s in a Name: Our Only Label Should Be Our Name: Avoiding the Stereotypes
- For Physicians: Diagnosing Autism Spectrum Disorders and Working with Schools
- Behavioral Issues and the Use of Social Stories
- How to “Lose the Training Wheels:” A New Way to Teach Bicycle Riding
- Living in Fear: Anxiety in Adolescents with Autism Spectrum Disorders
- Local Community Resources to Enhance Activities
- Making (and Keeping) Friends: A Model for Social Skills Instruction
- Making Camps Accessible for All
- Play in the Lives of Young Children with Autism
- Play Time: An Examination Of Play Intervention Strategies for Children with Autism Spectrum Disorders
- Social Activity Groups: Another Approach for Helping to Bridge the Friendship Gap
- Teaching Social Skills through Theatre
- The Collective Outcomes of School-Based Social Skill Interventions for Children on the Autism Spectrum
- The Value of Movement Activities for Young Children
- We All Need Exercise
- Finding a Friend in School
- Bullying and Students on the Autism Spectrum
- Incorporating Typical Peers Into the Social Learning of Children with Autism Spectrum Disorders
- Articles by Temple Grandin
- An Inside View of Autism
- Choosing the Right Job for People with Autism or Asperger's Syndrome
- Evaluating the Effects of Medication
- Genius May Be an Abnormality: Educating Students with Asperger's Syndrome, or High Functioning Autism
- Making the Transition from the World of School into the World of Work
- Social Problems: Understanding Emotions and Developing Talents
- Teaching Tips for Children and Adults with Autism
Anxiety and Panic Struggles
Contributed by Kim Davis
Anxiety is a word that is often associated with individuals on the autism spectrum. If one looks up the word anxiety in the dictionary, you will find many definitions, all relating to an intense feeling of uneasiness or fear in response to a real or imagined threat. For anyone who has witnessed or experienced an anxiety or panic attack, that definition lacks the potency and impact that an actual anxiety or panic attack creates. After recently supporting a loved one through episodes of panic and intense anxiety attacks, I began to pay more attention to the word anxiety or anxious when they were used in conjunction with a student with an autism spectrum disorder (ASD). For years I’ve witnessed these words used to describe the people I was supporting. I know now I had not given the descriptors anxiety/anxious enough attention. I now view scenarios through new lens. As I witnessed my loved one go from being an intelligent, verbal, physically capable person, to one who could barely utter a word, control her crying, body movements, and her real or imagined fear, I realized that anxiety is all encompassing and can paralyze anyone in an instant. It was also apparent that simply saying, “You are okay and you don’t need to worry” was never enough. The anxiety and panic was a more powerful emotion than simple words could eliminate. It was frightening, frustrating, horrifying, and sad to witness and experience. Both my loved one and I felt completely out of control and helpless to stop the eruption of emotions and behaviors.
It took time, but once the panic and anxiety were under control and life was beginning to get back to some state of normalcy, I began to think about how many times anxiety appeared in the IEPs of students with ASD and wondered how often is it truly addressed? As I had witnessed and experienced firsthand, anxiety and panic are debilitating, to even the most capable person.
According to the Anxiety Disorder Association of America (ADAA), anxiety disorders affect 40 million US adults age 18 and older and affects one in eight children. Anxiety disorders have the potential to impact many people on the autism spectrum. “Once a general anxiety disorder develops, it tends to become chronic (Autism Help)” and will interfere with how the individual functions at home, school, or in other activities of daily living. Reassurance and comfort are not enough to calm the fears.
Dr. Tony Attwood has states that “Autism is anxiety looking for a target. Autism and anxiety go hand-in-hand. Autism affects a person’s ability to communicate with others or to understand the world around him, and that’s bound to cause anxiety (Evans, 2006)”. The numbers of individuals with ASD who experience anxiety may be as high as 80% according to Eric Storch, PhD, associate professor of pediatrics and psychiatry at University of South Florida Health (Nauert, 2009). Anxiety attacks trigger distress and impairment over and above that caused by an autism diagnosis alone he continued. Anxiety can affect adults with ASD as well as children and adolescents (Autism Help). These statements would indicate teachers and parents who support someone with ASD are very likely to also provide support to someone who experiences anxiety. As anxiety becomes more prevalent among people with ASD, those who provide support must have a general knowledge about anxiety, what symptoms to look for, and what might help when anxiety overwhelms someone.
- Anxiety: What an Individual May Be Experiencing or Feeling
- What Triggers Anxiety for an Individual with ASD
- Providing Support
- Classroom Ideas to Reduce Anxiety
- Treatment Options
It is critical to realize that when someone is anxious, talking at them can increase their anxiety and behaviors. More visual, less verbal is a good rule of thumb. Both home and school could have small white boards available that can be used to write simple and concrete messages to the individual, such as, you are safe no one will hurt you or take slow deep breaths instead of merely talking to the person. The written message is there for them to see as they need it. Often, teachers and parents can exacerbate an anxious moment by pushing too hard for immediate relaxing of the body or verbal responses from the student. Be quiet, reassuring, nonconfrontational, and calm each time you are needed to support an anxious student. Remember that the individual is not thinking clearly and you will have to become their rational, calm support. “That means that you might sit near them, not demand any eye contact, be genuine in your caring and reflect that caring in your vocal tone and pace. Be sure to allow for processing time and when appropriate use a bit of humor to ease the pain (Page, 2009)."
Anxiety and panic are real and a person cannot simply relax or snap out of it on command. The fears encompass the person completely. They need compassion, patience, reassurance, and true care from family, friends, teachers, therapists, or staff people who are in their lives. Because someone has ASD does not make the anxiety or panic any less real to them. For them, due to the impact of their ASD (difficulty understanding abstract ideas or feelings), the anxiety and panic might become greater. Support people must begin to pay closer attention to the words anxiety, anxious, panic, etc. when they appear in reports or IEPs. They are not just words. They indicate real emotions that impact a person completely and can inhibit them from performing even simple tasks. In fact, the anxiety or panic may be more debilitating than their ASD. It is up to those who support individuals with ASD to be aware of anxiety and panic struggles and more important learn the best ways to provide the type of support that is truly helpful and allows the person to move through the fears and trust that they are safe and in good hands.
References and Resources
1. Anxiety Disorders Association of America (http://www.adaa.org)
2. Bellini, S. (2004) “Living in fear: Anxiety in adolescents with autism spectrum disorder”. The Reporter, 9 (3), 1-2.
3. Edington, Chuck, PhD. “Emotional Regulation and Anxiety Management in Autism” . http://www.okautism.org. Presentation at Oklahoma Autism Network, Autism Toolkit Series: Life 1st! September 7, 2010. Accessed July, 2011. http://www.okautism.org/documents/EmotionalRegulationAnxietyManagementPresentation.pdf.
4. Evans, Rachel. “Autism Anxiety Overload”. http://ezinearticles.com/ November 27, 2006. Accessed July 2011, http://ezinearticles.com/?Autism-Anxiety-Overload&id=369821.
5. Nauert, Rick. Behaviorial Therapy for Anxiety with Autism. http://psychcentral.com/, October, 2009. July, 2011 http://psychcentral.com/news/2009/10/30/behavioral-therapy-for-anxiety-with-autism/9239.html
6. Nelson, Dave. “Autism and Anxiety”. http://www.divinecaroline.com/. April 15, 2008. Accessed June, 2011. http://www.divinecaroline.com/24169/48021-anxiety-autism.
7. “Anxiety and Autism” (July 22, 2009). Page, Louise. Accessed June, 2011. http://www.articlesbase.com/disabilities-articles/autism-and-anxiety-1059884.html#axzz1QgX5LpTH.
8. “General Anxiety Disorder”. June, 2011. http://www.autism-help.org/comorbid-general-anxiety-disorder.htm (reproduced with permission from a range of fact sheets available at http://www.autism-help.org).
9. “Anger & Autism Spectrum Disorders. http://www.autism-help.org/index.htm. 2008. Accessed July, 2011. http://www.autism-help.org/adults-aspergers-anger.htm. (Reproduced with permission from a range of fact sheets available at http://www.autism-help.org).
10, “Anxiety in Adults with an Autism Spectrum Disorder”. http://www.autism.org.uk/. 2010. Accessed July, 2011. http://www.autism.org.uk/living-with-autism/understanding-behaviour/anxiety-in-adults-with-an-autism-spectrum-disorder.aspx.
11. National Institute for Mental Health website for Anxiety disorders: http://www.nimh.nih.gov/topics/topic-page-anxiety-disorders.shtml.
12. “Interview with June Groden”. (November 1996). Autism Research Institute. http://www.autism.com/fam_page.asp?PID=367.
13. Panic Attacks and Autism Spectrum Disorder”. (2008). Autism Help. Accessed June, 2011 http://www.autism-help.org/adults-panic-attacks.htm. ("Reproduced with permission from a range of fact sheets available at http://www.autism-help.org").
14. “Sample Accommodations for Anxious Kids” (2009). The Children’s Center for OCD and Anxiety. Accessed February 29, 2012. http://www.worrywisekids.org/schools/sample_accomodations.html.
15. Stress and Coping in Autism (2006). Edited by M Grace Baron, June Groden, Gerald Groden, & Lewis P. Lipsitt. Oxford University Press, NY. NY.
Autism Society of America: (http://www.autism-society.org/).
Kim, Joseph A., Szatmari, P., Bryson, S.E., Streiner, D.L., Wilson, F.J. (June 2000) “The Prevalence of Anxiety and Mood Problems among Children with Autism and Asperger Syndrome”. Autism, vol. 4, 2: pp. 117-132.
Rudy, Lisa Jo. “Mood Disorders and Asperger Syndrome”. http://www.about.com/. Updated July 06, 2008. Accessed June, 2011.
Rudy, Lisa Jo. Autism. “Anxiety and Nightmares”. http://www.about.com/. Updated December 17, 2010. Accessed June 2011, http://autism.about.com/od/copingwithautism/f/nightmares.htm.
“Stress and Autism Spectrum Disorders”. http://www.autism-help.org/index.htm. 2008. Accessed June, 2011. http://www.autism-help.org/adults-aspergers-stress.htm ("reproduced with permission from a range of fact sheets available at http://www.autism-help.org")