Stress-Management for Children with High-Functioning Autism

"I need some stress management techniques to use on my very anxious daughter with autism (high functioning). Thanks in advance."

Children with High-Functioning Autism (HFA) are prone to greater stress in their daily lives than their “typical” peers. Social interaction – especially with more than one peer in which the HFA child has to identify, translate, and respond to social and emotional cues and cope with unexpected noise levels – inevitably increases stress to a point where his or her coping mechanisms may collapse.

A “stress assessment” (based on the knowledge of HFA) will help parents and teachers determine what are the natural and distinctive stressors for the child. Subsequently, an effective stress-management program can be designed.

When there are concerns about an HFA youngster’s stress level, a stress assessment can be conducted in order to better understand why the stress is occurring and to determine the most effective interventions to address it.  

The assessment process involves:
  • observing the child’s behavior while he or she is experiencing stress
  • identifying the context in which the stress-related behavior occurs
  • documenting actions that precede and follow the behavior
  • triggers and payoffs for the behavior
  • parent response
  • child reactions to the parent response
  • frequency of the behavior

The goal here is to gain greater clarity about the child’s distinctive stressors and the function of the stress-related behavior so that effective interventions can be put in place to address his or her individual needs.

==> Parenting Methods for Reducing Stress in Your "Special Needs" Child [audio segment from lecture by Mark Hutten, M.A.] 

Components of a stress-management program may include the following:

1. At school, one option for the HFA youngster who becomes stressed on the playground during recess, for example, is to be able to withdraw to the school library, or for the child who is anxious about socializing during lunch break to be able to complete a crossword puzzle or go for a walk in the gym.

2. Help your HFA child understand his routine each day. He wants to know what is going to happen next. He needs to hear it every day – even if he did the same thing yesterday! You might hear your child ask the same questions over and over again. Try not to get frustrated with him if this happens. This is his way of trying to understand or asking you to give him more information. Also, talk to your child if he gets upset about a change. Ask him why he is upset. He needs help putting his feelings into words. Sometimes he just doesn’t like to stop what he is doing, or sometimes he might be worried about what will happen next.

3. “Cue-controlled relaxation” (i.e., a combination of deep breathing and repetition of the word "relax") is also a useful component of a stress-management plan. One technique is for the HFA child to have an object in his or her pocket that symbolizes – or has been conditioned to elicit feelings of – relaxation. For instance, one AS teen was an avid reader of fiction, his favorite book being The Secret Garden. He kept a key in his pocket to metaphorically open the door to the secret garden (an imaginary place where he felt peaceful and content). A few moments touching or looking at the key helped him to contemplate a scene described in the book and to relax and achieve a more positive state of mind. Parents can have a special picture in their wallet (e.g., a photograph of a beach scene) which reminds their child of the solitude and tranquility of such a place.

4. Let your child know if there is going to be a change in her routine. She feels worried inside when she doesn’t know what is going to happen or if she doesn’t know what she needs to do. It really helps when you tell your child about her day when she wakes up in the morning. Also, keep her updated as the day moves forward. Also, it really helps your child do what she needs to do when you can give her a five minute warning before a change happens. Even if she complains and doesn’t like what is going to happen, she can still get ready and do well with your help, if YOU stay calm.

5. Environmental modification can significantly reduce stress. This can include having a safe area for periods of solitude to relax, minimizing distractions and reducing noise levels.

6. If the parent or teacher recognizes that a particular event is a major cause of stress, then it would be wise to consider whether the source of stress could be avoided altogether (e.g., recommending the temporary suspension of homework).

7. Practice new things with your child before she has to do them with others. If she is going to do something new, it helps her get ready and feel good about trying if she can practice with you first. Even if the practice is not exactly the same as what is going to happen, just pretending about something new or simply reading a book about it can help. When the new thing happens, your child will remember about practicing with you and will know what to do.

8. Help your HFA child know what to do when he misses you. Being away from you is hard for him, even when he is doing something fun or is with someone he likes. Sometimes it helps if you tell your child what the two of you will do together when you come back.

9. Traditional relaxation techniques using activities to encourage muscle relaxation and breathing exercises can be taught to children with HFA as a “counter-conditioning procedure,” but parents and teachers must also consider the circumstances in which the child is particularly prone to stress. Counter-conditioning is the conditioning of an unwanted behavior or response to a stimulus (e.g., nervousness) into a wanted behavior or response (e.g., calmness) by the association of positive actions with the stimulus. For instance, when conditioning a child who has a “startle response” to loud noises, the parent would create a positive response by massaging or hugging the child when he or she reacts anxiously or nervously to a loud noise. Thus, this will associate the positive response with the loud noise.

10. Some stress is “good” stress, and some stress is “bad” stress. Not all stress is bad. Learning to do new things can be stressful for your child, but you can help her take a break if she needs to, or you can help her feel good about trying. 

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