How to Monitor & Manage Anxiety in Autistic Children & Teens
Recently, I attended a session on Emotion Management for Children & Teens with ASD, presented by Tony Attwood and Michelle Garnett. Tony is an internationally renowned expert on ASD and Aspergers’ and he, and Michelle, consult at Minds & Hearts in Brisbane, Australia.
The session was packed with information and I came away with lots of ideas for helping my autistic kids better cope with their emotions, in particular, with their anxiety. I want to share some of the information provided in the session as I feel this is advice we can all use to better help our kids.
Why are autistic kids more anxious than their neurotypical peers?
Tony and Michelle ran through the physiology of the brain and how this ties in with the neurology of autism. Scientific investigation has revealed that autistic brains are very different to neurotypical ones. The main differences are seen in the amygdala and in the frontal lobe.
The instinctive fight/flight/freeze response comes from the amygdala. When facing a threat, the amygdala sends signals to the rest of the body to increase the chance of survival. This results in increased heart rate, greater oxygen intake, sweat production, gastro-intestinal changes and other physical signs, to get us ready to fight, flight or freeze.
We’d all be familiar with how our own bodies deal with pressure when under threat.
The amygdala sends these signals through the white matter of the frontal lobe. The frontal lobe assesses the chance of danger and comes up with an appropriate response. More often than not, it tells the body to stand down as the threat to survival is not significant. In a way, the white matter of the frontal lobe acts as a brake on our instinctive reactions to stress.
In many autistic individuals, the amygdala is enlarged and appears to engage the fight/flight/freeze response at lower levels of stress than in neurotypical individuals. In addition, there is reduced white matter in the frontal lobe, meaning that communication between the amygdala and the frontal lobe is reduced. Which means autistic individuals potentially feel more stress, more frequently, with less lead up and with reduced control over their reactions.
The result? Repetitive behaviour (to cope with anxiety), intense special interests (to escape from anxiety), heightened sensory sensitivity (because of the ongoing anxiety), communication difficulties (can’t explain the anxiety) and, ultimately, meltdowns (to resolve the anxiety).
Although there is more to autism than this, I found this explanation spot on for my kids. Anxiety is definitely ruling Gilbert’s life at the moment as he struggles with his new school, new teachers, new classmates, social pressures, hormones, adolescence and new expectations. I can definitely see why some of his behaviours have heightened since the beginning of the year, due mainly, to his increased levels of anxiety.
What can we do to monitor levels of anxiety?
This is really important to me right now as I try to help Gilbert identify when he’s anxious and understand when he needs to use strategies to self-regulate. Thankfully, Tony and Michelle had some practical ways to monitor our kids and teach them to recognise the signs of anxiety in themselves.
Identify how anxiety looks in your child: you may already know when your child is anxious and you can read the signs. But if you don’t, take the time to observe them in daily life and record how they look when under stress.
Anxiety looks very different in my kids. When Gilbert is stressed, he asks me questions for reassurance. He already knows the answer but he needs to hear the same answer from me to feel calm. He also wants more physical contact, like bear hugs or having his hand squeezed. These only happen when he is anxious.
For Matilda, I can tell she is anxious if she starts chewing her clothes, bed sheets or scarves. She also needs more reassurance than normal and will react angrily at any perceived sign of criticism, quickly dissolving into tears once the anger has escaped.
If you have a good grasp on how anxiety looks in your child, you can then share this with them so they can become more aware themselves. This is the first step in teaching them self-regulation.
Understand how anxiety feels for your child: this is slightly trickier as we need to get our kids to tell us how they are feeling and what that means for their body. A good way to start this is to explain how your body feels when you are anxious.
For me, my heart beats faster, I get butterflies in my stomach, I breathe faster, I can’t keep still and I can’t concentrate on anything. Sharing this with my kids, they could relate to my feelings and could add a few of their own.
Once you both understand how being anxious feels for your kids, you can monitor this yourself, through observation, and encourage your kids to look out for the signs of anxiety themselves. Another step towards improved self-regulation.
Use tools to monitor heart rate: Heart rate is one of the best measures of anxiety and stress in the body. Tony and Michelle suggested using a Fitbit or a wrist band heart rate monitor to collect data on your child’s heart rate over the course of a day. They have used this data to identify spikes in heart rate and connect these spikes to stresses during the day. It’s a clever way to understand when and why your child becomes stressed.
I think this is a genius idea and I’ll be using this for my kids (as long as I can get them to wear something on their wrist!) I wear a Fitbit myself and the data it collects on heart rate, exercise and sleep patterns is amazing. I hope I can appeal to Gilbert’s love of statistics and Matilda’s interest in health to get them on board with using this technology to monitor their anxiety too.
Identify daily activities that drain and replenish emotional energy: Tony referred to an idea created by Maja Toudel to identify how emotional energy is used during a day. The idea is to imagine a bank account, where you make deposits and withdrawals, except the currency is energy, not money. Maja originally put this together as a means to manage her own depression, but I think it’s just as valid an idea for monitoring anxiety too.
Divide a piece of paper in half and title each column, energy withdrawals and energy deposits. In the withdrawal column, help your child list all the things that drain their energy each day (e.g. socialising, concentrating at school, trying to keep their feelings under control, change in routine, making a mistake, etc.). In the deposit column, help your child list all the things that replenish their energy levels (e.g. being alone, enjoying their special interest, eating their favourite food, reading, computer time, jumping on the trampoline, etc.).
Each day you and your child can review the list and give each withdrawal and deposit a value from 0-100. Ideally, energy deposits should exceed withdrawal values (or, at least, balance out) but, if they don’t, this can be a marker for increased anxiety and stress. I’m keen to use this process with my kids, who are facing increasing energy challenges at high school. I think it will be a practical exercise for all of us.
What can we do to manage anxiety in our autistic kids?
This is the holy grail for all of us. How can we help our kids better manage their levels of anxiety?
Well, some of the suggestions above for monitoring anxiety represent a great start. However, there are other strategies we can use as part of an emotional toolbox, according to Tony and Michelle.
Physical Activity Tools: it’s no surprise physical exercise helps manage feelings of anxiety and stress. It provides a quick release of emotional energy and helps with physical health and well being as well. Walking, running, trampolining, swimming & dancing are all great ways for our kids to manage their anxiety through physical activity.
Relaxation Tools: providing a slower release of emotional energy, relaxation tools are another strategy to manage anxiety. Meditation, solitude, massage, sleep, quiet time in nature and being with animals can all provide another outlet for releasing feelings of stress and anxiety. Plus these activities help replenish energy too.
Awareness Tools: these can help our kids stop for a moment and become more aware of the signs of anxiety in their own body. Breathing activities, yoga, martial arts, meditation & taking deliberate pauses between activities can interrupt the anxious thoughts and help them become more aware of how they are feeling in that moment.
Social Tools: sometimes being with a trusted friend or loved one can help address anxiety by providing the opportunity to talk over their feelings and have them validated. Sharing their concerns through poetry, writing, art, music and other creative means can also help (it’s often easier to do this than talk directly about their feelings).
Special Interest as a Tool: special interests provide relaxation and pleasure and are our kids’ go-to strategy for dealing with anxiety. They provide a thought-blocker and can give our kids relief from their worries for a period of time. They can also help kids makes sense of the world and be a way for them to describe their feelings.
Sensory Tools: these are key in managing anxiety, giving our kids one less stressor each day by addressing their sensory sensitivities. There are different tools for each different sensitivity – ear defenders, sunglasses, fidget toys, chewy jewellery and portable fragrance are just a few of the many sensory tools available.
Medication Tools: in instances where anxiety cannot be regulated or improved with the above tools, medication may be required to help reduce anxiety to a more manageable level. It’s important to note that medication won’t change the anxious thoughts & feelings but it can help reduce the signs of anxiety & assist in daily life.
As you can see, I learned a lot from Tony and Michelle’s session. I now have more strategies to try with my kids and I feel I have a better understanding of WHY they are experiencing greater levels of anxiety at the moment.
For the first time in a while, I feel a little more optimistic about the future. All I want is for my kids to be as happy and healthy as possible. These insights give me hope that I can help them navigate this current rough patch so they can find a happier state of being in the future.
Do you have any further advice to share? How do you monitor and manage anxiety in your autistic kids?
This post is part of a Parenting a Child with Special Needs blog hop where myself and other special needs bloggers share our thoughts on a set theme each month. This month’s theme is “best tips and advice.” I’d love for you to check out all the other posts linked up for this month!
The Best Montessori Tips for Families with Special Needs | Every Star is Different
5 Ways Churches Can help with Special Needs Kids | Family, Food and Faith
Advice for Parents of Children with Special Needs | The Chaos and The Clutter
What Autistics Wish You Knew About Your Child | This Outnumbered Mama
2 Things Every Hyperlexia Parent Should Know | And Next Comes L
How to Reconnect with Your Child When Things Aren’t Okay | Parenting Chaos
The Best Self Care for Single Moms of Special Needs Children| Finding the Golden Gleam
Tips on How Having a Sibling with Autism Has Changed my Life for the Better | Learning for a Purpose
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