The following information and resources have been provided courtesy of The Lurie Center for Autism, a program of Massachusetts General Hospital and Mass General for Children.

The Lurie Center for Autism is committed to advancing treatments for and knowledge about Autism Spectrum Disorder (ASD) and other developmental disorders, and translating these discoveries into exceptional clinical care. A program of Massachusetts General Hospital and Mass General for Children, The Lurie Center is a multidisciplinary treatment, research, training, and advocacy organization dedicated to supporting individuals and their families across the lifespan.

This resource is intended to provide information so that you can be better informed. It is not a substitute for medical advice and should not be used to treat any medical conditions.

How to use anxiety strategies to help your child with Autism

Who would benefit from this information?

Children with ASD who have significant anxiety and worries and their families or caregivers. Anxiety is very common in children with ASD and many families find it difficult to manage.

How can creating strategies help to tackle anxiety?

Anxiety is when our bodies and minds tell us we are in danger, when that might not be the case. These strategies will help children and families recognize when anxiety is not helpful and have strategies to promote relaxation and active coping.

What is anxiety?

Anxiety and fear are normal reactions to stress and uncomfortable situations. They are our body’s alarm system and generally push us to escape or avoid dangerous situations. However, sometimes it can be too much and overwhelming because our alarm system is either sending us false alarms or the alarm system is too loud for us to think clearly. This alarm system (anxiety) has signals in our body, thoughts and behaviors:

Body signals

• Racing heart
• Shortness of breath
• Tight muscles
• Hot face
• Upset stomach
• Sweaty palms

Thought signals

• Worries
• "What if?" questions
• Getting "stuck", thinking about the same thing over and over

Behavior signals

• Running away/avoidance
• Hiding
• Reassurance seeking (e.g., repeated questioning)
• Clinginess
• Irritability/fussiness (especially when faced with stressful or anxiety-provoking trigger)
• Nail biting
• Fidgeting or leg tapping
• Overeating
• Lack of sleep
• Mood swings

Exposure – Getting used to the anxiety

• Anxiety is reduced when our body and mind realizes that a situation is not as bad as we thought.
• Start small – baby steps: Start with a small step for your child to get used to first. For example, if they cry when you leave, start by going out of the room for just a few seconds at a time.
• Gradually increase the intensity of the situation or demand (e.g.,staying out of room a little bit longer in the example above).
• Praise and reward your child for being “brave”. Examples of this could be giving high fives or time with a favorite toy after the situations that seem hardest for them.
• When done consistently and gradually, your child’s anxiety in these situations should go down.

Coping skills

• Help your child recognize the signals of anxiety (particularly the body signals).
• Encourage slow breathing, in their nose and out of their mouth – having a child blow bubbles or a pinwheel is a great way to teach this.
• Use distraction – have your child engage in a preferred activity while staying in the anxiety-provoking situation (e.g., listening to calming music).
• Practice these skills when your child is not anxious – have “anxiety drills.”

Parent responses

• Model calm – try to remain as calm as possible when your child is anxious.
• Acknowledge your child’s concerns, emotions and thoughts.
• Avoid excessive reassurance – although it will make your child feel better short term, it may prevent the ability to self-regulate emotion sand maintain anxiety long term.

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