2 Asperger’s Syndrome and Anxiety And what to do about it…
33 Remembering the triad of impairments Communication Social interaction Rigid thinking anxiety
44 Double whammy Autistic features lead to more causes of anxiety and because of the autism, individuals have less ability to cope with the anxiety. → A much lower threshold for getting into a panic and fewer strategies for getting out of it. Students with an ASD in a panic tend to become more rigid / obsessive. → A huge anxiety spiral.
5 We know that young children with autism are prone to develop mood disorders and some children seem to be almost constantly anxious...One of the problems faced by children with Asperger’s Syndrome who use their intellect rather than intuition to succeed in some social situations is that they may be in an almost constant state of alertness and anxiety, leading to a risk of mental and physical exhaustion. Dr Tony Attwood
6 Then there is the autistic tendency to awfulise....They are all staring at me!....I can’t do it......He’ll never be my friend now!.....That’s it! I’ve ruined my work!
7 So no surprise then that......a pupil is terribly upset by an unexpected change to routine...a child has phobic reactions to sensory experiences e.g. school bell....a youngster might not want to go to school.....a student is silent (sometimes mute) and does not seek adult attention....a child has a desperate wish to exert control over his surroundings.
8 Jekyll and Hyde Some children will react to stresses at school by “freezing” during school hours and then “exploding” in response to the slightest problem at home. Consequently, when parents’ reports of a child’s behaviour at home differ radically from that child’s behaviour at school, teachers should not...attribute it to their superior “behaviour management” skills and the parents’ presumed inability to “handle” their child. Clare Sainsbury
9 More symptoms of anxiety “I sometimes display mild obsessive-compulsive symptoms such as having to repeatedly return to check that the front door is closed, or that the gas is off, I have my keys, I have all the right things in my bag etc. As a child I would often have to get out of bed at night to make sure the stacks of books in my room were lined up properly at exact right angles.” Clare Sainsbury “Anxiety can also be associated with perseveration and “stuck” thinking: I can end up going on and on and on at people when I’m worried that they may not understand, or do exactly what they say they will.”
10 Results of too much anxiety can go Inwards Self-criticism Depression Even thoughts of suicide Self -blame Outwards Criticism of others Expressions of anger Expressions of frustration Blaming others
11 Vicious circle Thoughts of school Feelings of anxiety Scary thoughts, images, memories Strong physical reactions Sense of impending doom Avoiding school Fewer painful thoughts and feelings Sense of relief
12 Virtuous circle Thoughts of school Decreased anxious thoughts Increased confidence and relaxation Decreased physical reactions Greater sense of coping More engagement with school Fewer painful thoughts and feelings Greater sense of coping
13 Three Types of Help Tackling known causes of anxiety Working round the autism Working with the person
15 Schopler’s iceberg metaphor Aggression Specific Behaviours Pushing Hitting Spitting Swearing Poor social judgement Unawareness of feelings of self and others Sensory hypersensitivity Frustration over communication problems Underlying deficits
16 Refusing to go to Art Uncertain about where to sit /which group to join / how to join in socially.. Poor motor skills: feels he cannot achieve well Difficulties in organising materials in own space More noise and movement around the room making the environment less controlled
20 Working round the autism Provide increased structure →to improve predictability →to reduce anxiety How? Daily schedules Warning re change Routines and rules
21 Working around the autism Remove ambiguity/ uncertainty →to reduce anxiety How? Task lists (mini schedules) Reminder systems: visual prompts Those little things (like where to sit) Watch your language (give simple, clear instructions and talk in do’s, not don’ts) Social stories to explain situations and guide Giving scripts for positive self-talk
23 Working with the person with ASD: putting “money in the bank.” Use signs of anxiety as a signal →Provide support / calming activity →to reduce anxiety How? Additional adult / buddy Task then “cool box” / reward time Time at crucial points of the day to chill (All easier at primary but still possible at secondary) Affirmation / reassurance Teaching positive self-talk
24 Working with the person: emotional education Identifying feelings → learning to comply with strategies given → learning self-help strategies How? Labelling and recognising feelings (use visual prompts) Rehearsing given exit strategies Scaling Anxiety programme (cognitive behaviour therapy) Relaxation techniques Calm cards