*Here my focus will be on high functioning autism (which encompasses what many still refer to as Aspergers). But I will not continue to repeat the term.
FREQUENT TRAVEL PALS
Do you have an anxious child on the autistic spectrum?
If so, get in line…because autism and its pal anxiety love to travel as a pair.
Yet anxiety often slips past security, so to speak, creating greater problems for its travel pal, autism.
HOW ANXIETY CAN SLIP UNDER THE RADAR
When a parent learns that their child is on the autistic spectrum, it can be alarming.
As human beings, we often fear what we don’t know or understand.
We are all familiar with anxiety, to one degree or another, because it’s something that we all experience…as it is a needed safety mechanism for survival.
So, whether we contend with anxiety of the problematic sort or not, we all are familiar with anxiety.
The same does not hold true for autism.
Most parents know very little about autism…that is until it enters their life on a personal level.
When parents suspect or receive the news that their child is on the spectrum, they feel thrust into a front row seat with their own anxiety.
They often then place their focus on figuring out what it means and how they can best help their child.
They dive in, studying the diagnostic symptoms of ASD (Autistic spectrum disorder) and think, “Okay, we’ll need to work on this, and this, and this…”
And anxiety is not a diagnostic symptom of ASD.
The two are distinct and separate.
All children on the spectrum do not have anxiety in the clinical sense of the word.
But anxiety does show up in far too many of these children…
As a by-product.
ANXIETY AND AUTISM: THE RESEARCH
Studies have shown that children on the spectrum have a far greater risk of developing an anxiety disorder than other children.
Research has indicated that in a given twelve-month period between 8.6% and 20.9% of children in the general population have an anxiety disorder.
In contrast, between 42% and 79% of children on the autistic spectrum qualify for an anxiety disorder.
The differences in the prevalence rate between the two groups are striking.
So, why are so many more children on the spectrum having to contend with problematic anxiety?
CONTEXT, CONTEXT, CONTEXT
Many children on the spectrum feel confident and good about themselves…until they enter school.
So, the problem could be seen as contextual…
A mismatch between these children and the inhospitable environments in which they too often find themselves in.
Many of the problematic behaviors exhibited by children on the spectrum are not due to their autism…
But due to the intense frustration, sense of aloneness, and heightened anxiety they so often experience in response to this environmental mismatch.
Autism doesn’t cause anxiety.
Being cast into the role of the maligned misfit, however, does.
DIFFERENT ISN’T LESS THAN
Children on the spectrum relate to themselves and others differently than children not on the spectrum.
But their way of relating is not less than.
It’s just different.
Western culture, such as that found in the United States, is said to promote and celebrate individualistic expression.
But does it really?
There seems to be an unspoken rule that individualistic expression can’t go too far out of the box if it is to be deemed “acceptable”.
And it is easy to see this unspoken rule in full effect with children on the spectrum.
These children live in an environment where they are often misread, misunderstood, and judged in negative ways based on their uniquely individualist expression.
Being misread and misunderstood happens to all of us at times.
But imagine this happening over and over day in and day out…the rule rather than the exception.
It would be exhausting, nerve-wracking, toxic…and highly anxiety producing!
LONGING FOR BELONGING
One of our greatest longings as human beings is to have a sense of belonging, to be understood, to be appreciated for who we are.
Regardless if we are on the spectrum or not, if those longings are not met, we don’t fare well.
Many children on the spectrum, once they reach a certain age, become keenly aware that they do not possess the same social “programming” as that of their peers.
They notice that their social communication is not “landing” in the way they intend.
They perceive the judgments, the slights, the misunderstandings.
And this, of course, is anxiety producing.
LIVING BEHIND A MASK
Some of these children react by doubling up their efforts, determined to fit in, whatever the personal cost.
They may meticulously study the behavior of their well-liked peers…wanting to emulate them…
With the hope that they can reshape themselves in a way that will be deemed acceptable by others…wanting nothing more than to fit in and be appreciated.
This natural longing for acceptance can lead some of these children to create a false self…a mask.
We all wear masks at times…but here the frequency and level can become exhausting, demoralizing…fueling ever more anxiety.
PERPETUAL STATE OF TRIAL AND ERROR
To complicate matters, children on the spectrum have great difficulty generalizing the social skills they do acquire.
It is as though they must reinvent the wheel with every different setting and situation.
Thus, they are constantly having to second-guess themselves, caught in a perpetual state of trial and error.
What can then develop is a kind of social hyper-vigilance.
With all this unpredictability in the social realm, it’s little wonder that many of these children rigidly cling to their predictable routines and set ways of doing things.
Furthermore, even when these children learn “proper” social skills, the execution of these skills can often come across as unnatural…because they are to these children!
THE ANXIETY CRASH AND BURN
When children on the spectrum have social successes, they often feel very satisfied.
But, when they don’t, anxiety can hit them like an electric surge, igniting a shame bomb.
The child may then need to retreat in order to shore up their mental resources to face it all again.
Sometimes, especially at school, this is either not possible or their need goes unrecognized…and then a meltdown can ensue.
This can increase the negative perceptions of their peers toward them, not to mention test the patience of teachers and parents…increasing their anxiety and shame.
Many of these children are extremely intelligent.
But their constant social faux pas make it so their peers often perceive them as less than bright…and label them as such.
So again, how frustrating it must feel to be highly intelligent but to not be given their due respect by peers for this strength.
And so, the pressure to prove that they are indeed intelligent adds yet more fuel to feed the anxiety.
WHAT NEEDS TO GIVE?
So, the question becomes, do these children need to change or do we as a society need to change?
Well, clearly, we as a society need to change.
But this will not happen overnight.
Neurodiversity is sometimes celebrated theoretically in certain societal corners.
And the autistic spectrum community has been highly instrumental in bringing this about.
But there’s still a wide gap between a theoretical celebration and the day-to-day life of a child on the spectrum
These children will continue to need a lot of support on the individual and societal level.
GROWING PSYCHOLOGICAL FLEXIBILITY
When treating any type of anxiety, the principal target is to create greater emotional flexibility and an increased and more effective behavioral repertoire.
And aren’t these the very things we want for our children on the spectrum?
Children on the spectrum have great difficulty with these things.
But, again, it’s one of those unanswerable questions, what came first the chicken or the egg?
We can’t separate context, that environmental mismatch, from these children’s reactions and behaviors.
And due to this mismatch, children on the spectrum need to develop even more psychological flexibility than their peers.
Context, context, context…
And so, everything becomes foremost a question of workability.
What works in the context one is given.
In terms of workability, these children will need to learn and practice the social skills of the larger culture to which they are embedded.
It is worth pointing out that most of these children do understand these social skills on an intellectual basis.
The difficulty comes with implementing the skills in an “acceptable” way since they don’t come naturally to these children.
Social skills, as practiced in our culture, often don’t fit into these children’s logical framework.
Let me explain what I mean by that.
LIKE TRAVELERS IN A FOREIGN LAND
We might hear about a certain cultural practice far removed from our own and think, “How strange…I would never want to do things that way…glad I live here and not there.”
But is that other culture’s way of doing things wrong and our way right?
Most of us, would say, “No, it’s just different.”
And if we dug deeper, that culture’s practice would most likely make sense when put into that culture’s context.
Let’s say a child on the spectrum is corrected for not responding to a greeting from a peer or teacher in the hall at school.
The child may think, “Well, why would I say hello to that person just because I passed them in the hallway? I’m was in the middle of thinking about something much more interesting.”
The child’s intention was not to be rude. They might even really like the person that greeted them.
But the language of “social lubrication” can seem absurd to such a child…especially in a moment when all their brain cylinders were firing full thrust with something that truly excited and fascinated them.
When we dig a little deeper, we can understand…and our perspective can shift.
FOCUSING ON STRENGTHS
We, as parents, can often become overly focused on teaching our children what we think they’ll need to know to get by in the world.
And we do it with the very best of intentions.
And there’s certainly an important role for this.
But at times we can lose sight of the most important thing…our child’s strengths.
And I think this concern about our child’s future is especially prominent with a child on the spectrum.
Flipping the script
Every child, regardless of whether they are on the spectrum or not, has a unique set of strengths and talents…as well as things that hold them back.
But some of the very characteristics that identify a child as being on the spectrum can also be their greatest strengths when channeled in the right way.
These can include:
The ability to think outside of the box…to be an original, creative thinker.
The ability to examine social and societal norms from an outsider’s perspective, which can lend to more objective evaluations.
The ability to direct razor-sharp focus toward areas that excite their interest, which is often a prerequisite for deep insight and innovation.
ANXIETY TREATMENT ON THE SPECTRUM
Helping children on the spectrum understand and develop a healthy relationship with anxiety is at least as important as teaching them contextual social skills.
Because the intense anxiety experienced by far too many of these children can detrimentally impact them…
It can greatly contribute to them turning excessively inward or to lashing out in unproductive ways.
Is anxiety treatment some sort of panacea for children on the spectrum?
Of course not.
We need a societal paradigm shift…
A wider acceptance of out of the box ways of being…
This process is slowly beginning to unfold…
And as it continues to unfold, anxiety and autism will be less frequent travel partners.
IS ANXIETY TREATMENT DIFFERENT FOR CHILDREN ON THE SPECTRUM?
The general treatment principles are the same because anxiety works the same way for everyone.
But just as with any child being treated for anxiety…factors such as personality, age, developmental level, interests, strengths, weaknesses, thinking styles, and family dynamics need to be considered.
As the saying goes, when you know one child with Aspergers, you know one child with Aspergers.
Likewise, when you know one child with anxiety, you know one child with anxiety.
The better question is, how is anxiety getting in the way of this particular child living a fulfilling, meaningful life?
What current ways of thinking and acting are serving as roadblocks for this child?
And from which of this child’s strengths can we draw from and build upon?
And, of course, these questions are useful for all of us.
Diagnostic labels often attempt to box people in…but children on the spectrum cannot be placed in a box, as they are the true avatars of seeing things outside of the box.
My hope is that we will move away from boxes and shift to considerately considering the needs of each individual on what might better be known as the spectrum of humanity.
Helping Anxious Kids is here to support your family. If you are seeking anxiety treatment for your child and my approach resonates with you, schedule an appointment today.