Anxiety: An Intrinsic Feature of High-Functioning Autism

“Why do children on the high functioning side of autism seem to experience more than their fair share of anxiety? And, are there any drugs that can be used to help with this problem?”

Young people with High Functioning Autism (HFA) are particularly vulnerable to anxiety. This vulnerability may be an intrinsic feature of HFA due to a breakdown in circuitry related to extinguishing fear responses, specific neurotransmitter system defects, and/or their inability to make social judgments throughout development.

Other reasons for anxiety in HFA children/teens include the following:

  • Limitations in generalizing from one situation to another often contributes to repeating the same social gaffes.
  • Limitations in their ability to grasp social cues - and their highly rigid style - act in concert to create repeated social errors. 
  • Many experience the discomfort that comes from somatic responses that are disconnected from events and experience.
  • The lack of empathy severely limits skills for autonomous social problem-solving. 
  • The social challenges of AS and HFA make it difficult for kids with the disorder to develop coping strategies for soothing themselves and containing difficult emotions. 
  • There is sufficient grasp of situations to recognize that others “get it” when they do not. 
  • They are frequently victimized and teased by their peers and can’t mount effective socially adaptive responses.

Several medications have been tried for treatment of anxiety in this population. There is no reason to suspect that kids with HFA are less likely to respond to the medications used for anxiety in “typical” kids. Thus, SSRIs, buspirone, and alpha-adrenergic agonist medications (e.g., clonidine or guanfacine) have been tried. 
The best evidence to date supports use of SSRIs. However, it is also true that young people on the autism spectrum may be more vulnerable to the associated side-effects. Disinhibition is particularly prominent, and can be seen with any of the SSRIs.
As one mother states: "Working with a psychiatrist, one trained especially with children, is vital in helping our Aspergers/HFA kids with their anxiety, to managed use of medications. Fine tuning is critical to the process. We also had enroll our child into a day program as weekly counseling wasn't keeping up with his anxiety and depression. Daily and intensive individual and group therapy are the focus of this program. 5 months in and we've seen dramatic improvement. We're about to start the transition back to his normal school (they tutor at the day program). Most important is to pay attention to the child's anxiety levels. We almost waited too long to take a big step toward doing something different." 
More articles for parents of children and teens on the autism spectrum:
Social rejection has devastating effects in many areas of functioning. Because the ASD child tends to internalize how others treat him, rejection damages self-esteem and often causes anxiety and depression. As the child feels worse about himself and becomes more anxious and depressed – he performs worse, socially and intellectually.

Click here to read the full article…


Meltdowns are not a pretty sight. They are somewhat like overblown temper tantrums, but unlike tantrums, meltdowns can last anywhere from ten minutes to over an hour. When it starts, the Asperger's or HFA child is totally out-of-control. When it ends, both you and your child are totally exhausted. But... don’t breathe a sigh of relief yet. At the least provocation, for the remainder of that day -- and sometimes into the next - the meltdown can return in full force.

Click here for the full article...


Although Aspergers [high-functioning autism] is at the milder end of the autism spectrum, the challenges parents face when disciplining a teenager on the spectrum are more difficult than they would be with an average teen. Complicated by defiant behavior, the teen is at risk for even greater difficulties on multiple levels – unless the parents’ disciplinary techniques are tailored to their child's special needs.

Click here to read the full article…


Your older teenager or young “adult child” isn’t sure what to do, and he is asking you for money every few days. How do you cut the purse strings and teach him to be independent? Parents of teens with ASD face many problems that other parents do not. Time is running out for teaching their adolescent how to become an independent adult. As one mother put it, "There's so little time, yet so much left to do."

Click here to read the full article…


Two traits often found in kids with High-Functioning Autism are “mind-blindness” (i.e., the inability to predict the beliefs and intentions of others) and “alexithymia” (i.e., the inability to identify and interpret emotional signals in others). These two traits reduce the youngster’s ability to empathize with peers. As a result, he or she may be perceived by adults and other children as selfish, insensitive and uncaring.

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to read the full article...


Become an expert in helping your child cope with his or her “out-of-control” emotions, inability to make and keep friends, stress, anger, thinking errors, and resistance to change.

Click here for the full article...
A child with High-Functioning Autism (HFA) can have difficulty in school because, since he fits in so well, many adults may miss the fact that he has a diagnosis. When these children display symptoms of their disorder, they may be seen as defiant or disruptive.

Click here for the full article...

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