Autism, anxiety and rigid thinking patterns – what can be done to help?

A number of features of autism are well known to the general population, and difficulties with social skills are probably the most commonly mentioned or noticed.

But at the bottom of some of the anxiety that non-neurotypical children experience are rigid ways of thinking. (I've talked more generally about rigid thinking here.)

Rigid thinking

If you have trouble changing how you think, you’ll more likely suffer anxiety. This is because, to deal with future possible difficulties, you need to be able to look at them in different ways.

This might involve: 

• throwing certain worries out as “nothing I can do about them”, 
• asking for help because it’s someone else’s responsibility, or 
• doing something about it yourself – which often involves rethinking what’s causing the unwanted emotion!

That's where the problem lies. Some children on the autism spectrum find it really hard to think differently. That's rigid thinking in a nutshell.

Actually, many neurotypical children also get stuck in patterns of worrying because they, too, can’t think of different options and perspectives.

On the other hand, children on the autistic spectrum can also have difficulty recognising thoughts and feelings, in themselves and in their friends etc. So this will hinder their ability to change their thinking.

Uncertainty

Linked to this rigid and inflexible thinking is an inability to deal with uncertainty. Habits and routine become important aspects of autism for a good reason.

Heck, in every adult’s life there's uncertainty. Our fondness for habits, plans and routines is precisely to make the uncertainty more certain! But we can live with it:

• We have plan Bs lined up if necessary. 
• We think on the spot. 
• We juggle possibilities in our heads ready for the crunch.

Children on the autism spectrum find this really hard. Sometimes impossible. So they get highly anxious.

Social skills

There’s yet another aspect to why children with autism get anxious, and that’s the social skills bit.

This too links in to rigid thinking and not being able to think up alternative possibilities.

Imagine knowing you simply won’t understand what voice tone, facial expression and body language mean when you meet a friend.

The biggest stuff, yes, that's probably manageable. Your child meets someone with hands up, fists clenched and a red face, and they’ll probably recognise that this is a fight brewing.

But nuances… that’s different. And if you can’t read the nuances you're going to get into difficulties. That’s a cause of anxiety.

Besides, children with autism are more likely to interpret something they're uncertain about as "threatening". And less likely to think of an alternative meaning.

Feeling threatened is linked back to our amygdala (part of the brain) – which, in ancient times, helped the body react to danger and threats. 

So, the amygdala diverts oxygen to the heart and muscles to help us have the stamina to run away. Hands feel sweaty, cheeks redden, breath gets quicker – and suddenly we can see where a meltdown comes from.

Apart from rigid thinking patterns that affect uncertainty and social skills, the most usual triggers of anxiety in a child with autism are sensory issues and things specific to a particular child, such as (but not exclusively) phobic-like reactions to (eg) buttons, or beards, or even seeing a person with a disability. 

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This web page is not a total run-down on autism and features of it. 

I’m dealing here with how it causes anxiety. I know you’ll have other sources of help for all the other aspects if your child’s been diagnosed with autism.

NB I use "children with autism", "autistic child" and "child on the autistic spectrum" interchangeably here for ease of reading – no offence is meant to the many parents who prefer one or the other. I’m writing for everyone, and hope to help, not hinder.

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What can you do to help your child with their anxiety?

Many of the tactics that best help your child through the day are based in CBT – cognitive behavioural therapy.

This is not totally straightforward to use, because CBT depends on a child learning that their thoughts affect their feelings of anxiety, and their anxious feelings affect their behaviour.

They're encouraged to challenge their initial thoughts and fears in gradual steps of difficulty. This requires something of an abstract-thinking approach if they're going to test out alternative thoughts to see what happens as a result, and how their feelings can change.

As we’ve just said, a child on the autism spectrum is going to find it hard to make changes because their thinking tends to be rigid and more concrete.

Most CBT approaches will therefore use: 

• more visuals, 
• more stories and 
• more tangible comparisons, and
• perhaps emphasise coping skills rather than change.

Parents can do this too.

Use pictures to help explain.

Draw cartoon strips to explain what you're saying in the context of what you're talking about – what will happen, for instance.

Compare any new idea to something your autistic child is keen on.

Help them learn relaxation skills, such as diaphragmatic breathing, blowing candles and the butterfly tap.

In addition, you have to play detective to realise it’s actually anxiety your autistic child is showing.

As we can see from the symptoms page, anxiety shows up in many ways apart from what we might expect from the word!

Belligerence, anger and lack of concentration result from anxiety. As do meltdowns. This can apply to neurotypical children too.

A slight difference is in what’s called stimming – making repetitive movements, actions or noises. This too will show that a child with autism is anxious.

And there's a wide spectrum of autism – which is why it’s called a spectrum, of course! – so each child will differ in how far it affects them. They will also be at different ages and stages of understanding and development, too.

So you'll be adapting all the resources to suit your child with autism anxiety – but you'd do that anyway!

So what’s the answer to how you can help your anxious child with autism?

I have three suggestions.

1 Look through all the help resources given on individual pages here, under symptoms. Adapt any you feel you can use with your child – in the way you know they can and will respond to. 

There are more items you can try on the strategies tab, divided into “reducing anxiety” and “engaging with your child”. This resource is being added to regularly. 

2 If your child is non-verbal, that doesn’t mean they can’t be helped, just that you will need to employ more visual tactics and explanations of what’s happening, and employ physical means to calm them, such as butterfly tapping, rocking and singing.

Whatever you know from experience will help them.

And keep talking to them. It’s a bit like how a mother or primary carer will regulate a baby until they learn to self-regulate. Talking soothingly in a calm way during and after any “episode” will reinforce for them that you can contain their anxiety, even though they’re no longer babies.

3 Recognise when your child is trying to regulate themselves and let it happen. If your child with autism seems to want to repeat patterns and interests from earlier years, this is good, because it shows they know what they need – and they’ll move on again when they’re feeling less anxious.

We would allow a neurotypical child this flexibility too. It’s quite a grown-up thing to do.

If they have a meltdown in reaction to their anxiety, on the other hand, that's rather different, and you undertake the regulation yourself, knowing that they cannot.

Staying calm in a crisis is key – for all children, but especially non neurotypical children whose anxiety levels can be quickly triggered due to their autism.

Sometimes you’ll find your child reverts to trying to control others, after a period when they’d learnt not to do this socially if they want to make friends.

This is just another attempt by them to control their rising anxiety. You may need to remind them of what they know and help them reset their thinking.

But it can be frustrating for you as a parent because it seems a backward move.

Just remember that this is a normal ploy used by any neurotypical child, not something particularly “on top of the autism thing” that brings feelings of dread to your heart! Don’t we all try to control things – as I said at the start?!

So there are a variety of signs to look for that show your autistic child is anxious. And also a variety of things you can do in response.

The important thing to remember is that managing your child’s anxiety when they’re on the autism spectrum is basically the same as with a neurotypical child – although the triggers may be different. 

You'll have to try to do the same things you would for any anxious child, and adjust any of those tactics and strategies to the particular needs and personality of your autistic child. 

No other form of help works anyway! Just personalised stuff for your own child, who you know intimately better than anyone else.

Special note

If you're also struggling to contain your autistic child's anxiety post Covid, do have a look at my page on Covid Trauma and see if there's anything there that will also help you at this time.

We've all had a trying time of moving from our usual flexible days, to inflexible rules, and back to varying rules. If we ourselves are stressed, it's no wonder our child on the autistic spectrum will have been too!

Making a connection with your child with autism

When calming an anxious child, we often want to cuddle them, share eye contact, or celebrate togetherness in some way – because this calms their over-alert system and brings homeostasis back to their nervous system.

But if these methods are not how your child likes you to approach them, how can you calm them?

One way to show solidarity – so they feel less anxiously alone – is to simply join them in their play. If that means stacking bricks or lining up toy cars "just so", then so be it! Do it their way. This confirms your connection.

Plus, model their body posture and speak or not according to what you know they prefer.

Another way to show solidarity is to take an interest in what they're doing – this might be something they're reading or watching that is one of their strong interests.

Or it might be taking the anxious moment to consult about this topic or show a real interest in it – you can't fake, but you can use your moment well. This is akin to distraction, but the point is that it again promotes the connection they need at the anxious moment.

There are two bonuses that go with either the "playing it their way" idea or the "talking about their special topic" idea.

One is that the joint experience is stashed away as an anchor for future anxious moments.

The second is that you can use their play habits or special interests to illustrate another point you need to make at some future time – for instance, helping them think about a social issue they struggle with. Or some point they need to learn.

When they have a link to something they know or understand, learning is so much quicker and easier to take on board. 

And guess what...?

One day soon, when they're a little older, you'll find their non-neurotypical way of thinking has certain benefits! 

Harriet Cannon of the University of Leeds made a list of many positives – while acknowledging that every child with autism is unique and of course not every child will show all the positives.

But it might help you bear the difficulties en route! And here is my own take of some of those possible benefits! Lighthearted but with an element of truth.

A book or two to help

The Parents’ Guide to Managing Anxiety in Children with Autism by Raelene Dundon (Jessica Kingsley Publishers) is a good book with lots of good advice, although fewer practical activities. That’s not a criticism but a fact. I like the book.

If you haven’t found it already, try Can I Tell You About Autism? by Jude Welton (again, Jessica Kingsley Publishers). For reading with the 7+ age range, this is useful for parents, carers, teachers and others, because “Tom” explains all about his autism and what can help and why.

A course for those in schools and other settings

Positive About Autism runs the Autism Workshop. You can find more details and watch one of the free videos here. This one is about separating activities into how much they drain your autistic child – red, orange or green circle activities – and making adjustments.

At the time of writing there is also a note on this page to contact them for access to 3 free modules (scroll down).

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ALWAYS:

Trust your instincts,
use your judgement, protect the spirit
of your child