My youngest daughter, who is autistic, has struggled with social anxiety from a young age. Because autism affects social skills, I thought the characteristics she was exhibiting were a part of her diagnosis, not realizing that they were signs of something deeper.
As she grew, we explored various therapies, including occupational, physical, and music therapy, to help her navigate her autism-related challenges. Despite these efforts, I noticed troubling changes during her teenage years. She started reverting to old behaviors and struggled with new challenges.
She became anxious in crowds, avoided eye contact, and refused to eat in public places. She displayed signs of heightened anxiety, such as flickering her fingers, rocking back and forth, and showing physical signs of nervousness. It became clear to me that these were symptoms of social anxiety rather than just aspects of her autism.
Social anxiety in autistic children
Social anxiety in children with autism intensifies because they see life and the world we live in differently from many neurotypical people. We all perceive the world as being large, however, for children on the spectrum, the world is humongous!
Many autistic children struggle with identifying the difference between fiction and reality. Like most children, children on the spectrum are either visual or hands-on. They are either literal or figurative.
It is important to determine at an early stage in their lives how to explain the difference between the two. This will benefit parents and assist with the growth and development of children on the spectrum.
Signs of social anxiety in autism
Identifying social anxiety involves observing several key behaviors and emotional responses. An individual with social anxiety may exhibit clinginess, frequently seeking comfort from one or both parents.
They might prefer eating at home rather than in social settings due to discomfort around others and could seem withdrawn or isolated. Common physical signs include fidgeting, flickering their fingers, or rocking back and forth.
They often avoid social activities and require constant reassurance to feel secure. Persistent worrying about various situations is also a hallmark of social anxiety, reflecting their ongoing struggle with anxious thoughts.
How social anxiety affects children with autism
Social anxiety can significantly impact children with ASD in various ways. They may experience frequent headaches and stomach aches as physical manifestations of their anxiety. Panic attacks might occur, leading to sudden and intense feelings of fear or discomfort.
Their ability to concentrate can be compromised, making it difficult for them to focus on tasks or activities. Social anxiety can also disrupt their sleep patterns, leading to trouble falling or staying asleep.
In addition, they might become impatient and moody, displaying irritability in their interactions. Avoidance behavior is another common effect, where they actively steer clear of social situations or new experiences to escape the anxiety they feel.
How to manage social anxiety
Managing social anxiety involves several proactive strategies to create a supportive environment and ease anxiety. Establishing a consistent routine helps provide stability and predictability, which can reduce anxiety.
Preparing in advance for changes in the environment or daily routines can also alleviate stress by minimizing surprises. Practicing social skills regularly can build confidence in social interactions.
Identifying a “safe buddy” at school (someone the individual feels comfortable with and can confide in) offers additional support. Providing calming tools, such as a stress ball, fidget spinner, or a small comforting object like a bag of rice, can help manage immediate anxiety.
Creating a code word for moments when your child feels overwhelmed allows them to signal their need for help discreetly.
Potential causes of stress and anxiety in autistic children
Stressors that contribute to anxiety can vary widely, but common triggers include loud noises, which can be overwhelming and disruptive. A lack of structure and routine often leads to increased stress, as predictability is crucial for maintaining a sense of security.
Insufficient preparation for events or activities can heighten anxiety, as it leaves individuals feeling unready and unsure. Sensory issues, such as discomfort with certain touches or textures, can also be significant stressors.
Additionally, a lack of understanding from others and facing unknown situations can intensify feelings of anxiety, as they disrupt the sense of control and predictability.
Supporting our autistic children
As parents, we must make our children feel safe, and equip them with the tools and techniques for them to successfully reduce and overcome anxiety and stress. Children with autism need structure and understanding to be successful and thrive in a world that’s often unaware of their needs, and the unique differences that make them so valuable to us all.
This article was featured in Issue 120 – Epilepsy: High Risk for ASD Kids
FAQs
Q: What does autistic anxiety feel like?
A: Autistic anxiety often manifests as overwhelming stress, discomfort, and nervousness, which can be triggered by changes in routine or sensory overload. It may also include physical symptoms such as fidgeting, increased heart rate, or difficulty concentrating.
Q: Can anxiety cause stimming?
A: Yes, anxiety can lead to stimming behaviors as a way to self-soothe or cope with overwhelming emotions. Stimming can provide comfort and help manage the heightened stress levels associated with anxiety.
Q: Can anxiety be mistaken for autism?
A: Anxiety and autism can share similar symptoms, such as social withdrawal and repetitive behaviors, which may lead to confusion between the two. However, while autism is a neurodevelopmental condition present from early childhood, anxiety is typically an emotional response to specific stressors or situations.
Q: Does anxiety make you rock back and forth?
A: Yes, anxiety can cause behaviors like rocking back and forth as a coping mechanism to manage overwhelming stress and provide a sense of relief. This repetitive motion can help soothe heightened emotional states associated with anxiety.
References
Briot, K., Jean, F., Jouni, A., Geoffray, M. M., Ly-Le Moal, M., Umbricht, D., … & Amestoy, A. (2020). Social anxiety in children and adolescents with autism spectrum disorders contribute to impairments in social communication and social motivation. Frontiers in psychiatry, 11, 710. https://www.frontiersin.org/articles/10.3389/fpsyt.2020.00710/full
Pickard, H., Hirsch, C., Simonoff, E., & Happé, F. (2020). Exploring the cognitive, emotional and sensory correlates of social anxiety in autistic and neurotypical adolescents. Journal of Child Psychology and Psychiatry, 61(12), 1317-1327. https://acamh.onlinelibrary.wiley.com/doi/abs/10.1111/jcpp.13214
Dickter, C. L., & Burk, J. A. (2021). The role of social anxiety in autism and the broader autism phenotype: Evidence from childhood through adulthood. Factors affecting neurodevelopment, 551-560. https://www.sciencedirect.com/science/article/pii/B978012817986400047X
Spain, D., Sin, J., Linder, K. B., McMahon, J., & Happé, F. (2018). Social anxiety in autism spectrum disorder: A systematic review. Research in autism spectrum disorders, 52, 51-68. https://www.sciencedirect.com/science/article/pii/S1750946718300643
