HELP FOR PARENTS OF CHILDREN WITH ASPERGER'S & HIGH-FUNCTIONING AUTISM

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Why Your Child on the Autism Spectrum Experiences a Significant Degree of Anxiety

“Why does it seem to be the case that many (if not most) children with ASD also suffer from a significant degree of anxiety?”

Kids with High-Functioning Autism (HFA) and Asperger’s (AS) are indeed particularly vulnerable to anxiety. This vulnerability may be an intrinsic feature of the disorder through a breakdown in circuitry related to extinguishing fear responses, a secondary consequence of their inability to make social judgments throughout development, and specific neurotransmitter system defects.

Specific reasons for experiencing high degrees of anxiety include the following:

1. Limitations in generalizing from one situation to another contribute to repeating the same social errors.

2. Limitations in their ability to grasp social cues and their highly rigid style act in concert to create repeated social gaffs as well.

3. The lack of empathy severely limits skills for autonomous social-problem solving.

4. The social-skills deficits of HFA and AS make it difficult for kids with the disorder to develop coping strategies for soothing themselves and controlling difficult emotions.

5. There is the discomfort that comes from “somatic responses” (i.e., relating to the body, especially as distinct from the mind) that are disconnected from events and experience.

6. They are frequently victimized and teased by their peers and can’t mount effective socially adaptive responses.

7. With these “special needs” children, there is sufficient grasp of situations to recognize that others “get it” when they do not.

Several medications have been tried for treatment of anxiety in young people on the autism spectrum. There is no reason to suspect that kids with the disorder are less likely to respond to the medications used for anxiety in “typical” (i.e., non-autistic) children. 

Therefore, selective serotonin reuptake inhibitors (SSRIs), buspirone, and alpha-adrenergic agonist medications (e.g., clonidine or guanfacine) all have been tried. The best evidence to date supports use of SSRIs.

Note: Kids with HFA and AS may be more vulnerable to side effects of medications - and many exhibit unusual side effects. “Disinhibition” (i.e., a lack of restraint manifested in disregard for social conventions) is particularly prominent and can be seen with any of the SSRIs. 

Similarly, excessive doses may produce  “amotivational syndrome” (i.e., a lack of desire to complete tasks, a sense of apathy about the future, poor concentration, and decreased interest in social and other activities).


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