Anxiety is a natural response to stressors and in some situations is an adaptive and appropriate reaction. It helps us identify and respond to danger and can help us face difficult challenges. We all experience periods of anxiety throughout our lives. I don’t think many of us can argue with that! However, when feelings of worry, fear or anxiousness are at a level that are impacting our daily life such as performance at work, school, or social relationships it is then considered a diagnosable anxiety disorder. Anxiety disorders are the most common mental disorder in the United States, with research showing that 18% of the general population has an anxiety disorder (ADAA, 2022). However, people diagnosed with Autism Spectrum Disorder may experience it at a greater level and frequency than others. Further, those with ASD are at increased risk for developing an anxiety disorder, with recent prevalence rates estimating 40% of youth with ASD have a separate comorbid anxiety disorder (van Steensel, et al, 2011).
There are several theories as to why anxiety and ASD often co-exist. One thought links some of the common characteristics of ASD, such as attention to detail, sensory sensitivity, and difficulties in social situations to increased anxiety. We know individuals on the spectrum are more detail-focused, which can be a great strength, but can also lead to challenges in transitioning from one activity to the next as well as coping with unexpected changes in routines. Further, research has shown that those on the spectrum have difficulty understanding that others have thoughts, feelings, and perspectives that are different from one's own. Being able to attribute mental states to others makes it possible to explain and predict behavior. Without it the world can be a very unpredictable place, thus leading to increased anxiety in various social situations and a need to have things “just so” in a predictable, structured manner as a way to cope with an uncomfortable feeling.
It has also been found that individuals with ASD tend to be more sensitive to various sensations, such as sounds, lights, textures. Sensory overload can trigger anxiety for some. Those with ASD may have increased difficulty integrating sensory information and may overreact to environmental stimuli. This can be seen when a student sensitive to loud noises holds his hands over his ears and screams in response to a fire alarm going off during a drill.
When supporting someone with ASD it is important to recognize when increased anxiety may occur and identify the triggers. Once this is determined behavioral interventions can be implemented with a focus on teaching the individual a variety of different emotional regulation and coping skills to help manage difficult situations. Interventions should be tailored specifically to the individual and incorporate the use of visual supports, as we know those with ASD process visual information much better than verbal input. It is also important to look at how we can provide structure and routine throughout the individual’s day.
Given that anxiety and ASD go hand-in-hand, Wildwood recognized the need to offer Direct Support Professionals training on this topic, which is offered as part of the “DSP Bootcamp.” This is an exciting opportunity for DSPs to increase their knowledge and learn applied skills in supporting those with ASD who also experience increased anxiety.