It is well documented that anxiety and poor stress management are common in children with autism and that anxiety may worsen during adolescence, as young people face increasingly complex social interactions and often become more aware of their differences and interpersonal difficulties. As yet there is little research into the prevalence of those with ASC and EBSA but evidence and experience suggests that due to the anxieties that the children with ASC experience they are at increased risk of EBSA.
The factors which influence levels of anxiety in those with ASC, as with any child, are multiple and often complex; associated with context blindness, executive functioning, limited theory of mind, difficulties processing language, focus on detail, sensory processing differences. Recent research also considers intolerance of uncertainty as a key contributing factor to anxiety in children with ASC.
Schools will be aware that they are complex social environments that children with autism can find exhausting; they are spending cognitive energy managing this social experience and can become overloaded. Indeed, their anxiety may become ‘overflowing’ as depicted below and place them at risk of EBSA.
Given the increased risk of a child with ASC experiencing high levels of anxiety that may lead to EBSA, it is essential that there is early attention and intervention given to developing the child’s social skills, emotional literacy, resilience and their ability to self-regulate. Steps to address these are set out below.
Working with the child
Evidence and experience demonstrates that anxiety levels in children with ASC can be reduced by adopting good practice approaches that are individualised to the child’s specific needs including visual supports, structure, managing change and generally increasing the certainty of the school day. Further details of good practice strategies can be found in our downloadable section, and should include all adults working with a child being made aware of the affect their communication style can have.
Steps to support reducing anxiety
Step 1
Ensure that all adults working with the child have an understanding of ASC and communicate appropriately and that adults have implemented general autism ‘good practice’ strategies e.g. the child uses and is engaged with a visual timetable, relevant visual supports, calm, space.
Step 2
Key to the effectiveness of any intervention is having a sound understanding of the child’s needs and how ASC specifically affects the child. Consider using tools:
Social stories
Visuals
Information provided by neurodevelopmental service
Step 3
Plan and implement individualised strategies to develop the emotional and social skills identified in step 2. Strategies may include those described in the school's guide to EBSA.
Step 4
Review the impact of the interventions. It may be that, despite the good practice and interventions, the child’s anxiety continues to increase placing them at risk of EBSA and additional interventions will require implementation.
Please note that the advice in previous pages regarding Action Planning are also relevant here and should be followed.
If there are indications that the child is at risk of EBSA it will be important to build up a clear picture of exactly what elements of attending school are increasing their anxiety in order that best endeavours can be made to alleviate the anxiety using suggested resources in the EBSA Resources.
It may also be appropriate to seek specialist, outside agency support such as the ASC Outreach Team, Educational Psychology, Family Centres and/or the Educational Social Workers.
Working with parents
Many parents of children with autism report that they notice their own emotions have an impact on their child’s emotions and vice versa. Therefore, it is important to emphasise the need for school to build a collaborative partnership with parents in the best interest of the child, as described previously.
Parents may have received minimal guidance regarding strategies to support their child and schools could consider training courses that may be available to parents e.g. Early Birds Plus. Third sector organisations may provide training, such as STANDNW (standnw.org). They offer access to a range of training locally. Autismwales.org have many resources available for schools and parents.
This is very important – take care of yourself, not just your child. Autism is a marathon, not a sprint. You owe it to yourself and your child to be whole, healthy, and happy. Do whatever it takes to get there. Parents and carers need to pay attention to their own emotional needs. Parents support programmes can be accessed through the Family Centres, teach parents to take care of themselves in order to be in the best physical and mental health to help their child, whilst also teaching them strategies to develop their child’s emotional resilience.
