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Aspergers and Social Anxiety

It is estimated that up to 80% of Aspergers (high functioning autistic) kids also experience intense anxiety symptoms. Anxiety Disorders (e.g., Obsessive Compulsive Disorder, Social Anxiety, Generalized Anxiety Disorder) commonly co-occur with Aspergers. When anxiety symptoms are untreated, they can further interfere with a youngster’s quality of life. Kids with both Aspergers and Anxiety Disorders experience a more limited social world than kids with only one disorder. They may have difficulty (a) adapting at home and in school, (b) making friends and joining in social activities, and (c) breaking their usual rituals to try something new.

Although little is known about what anxiety symptoms look like in Aspergers kids, the following symptoms, which overlap with Anxiety Disorders, indicate anxiety:

• Withdrawal from social situations

• Somatic complaints

• Irritability

• Avoidance of new situations

Another set of anxiety symptoms may be seen and may be unique to Aspergers kids:

• Becoming "silly"

• Becoming explosive easily (e.g., anger outbursts)

• Increased insistence on routines and sameness

• Increased preference for rules and rigidity

• Increased repetitive behavior

• Increased special interest

Social anxiety is a condition in which the child has an excessive and unreasonable fear of social situations. Anxiety (intense nervousness) and self-consciousness arise from a fear of being closely watched, judged, and criticized by others. The fear may be made worse by a lack of social skills.

Aspergers children with social anxiety may be afraid of a specific situation. However, most kids with social anxiety fear more than one social situation. Other situations that commonly provoke anxiety include:

• Answering questions

• Asking questions

• Attending family get-togethers (e.g., Christmas)

• Attending parties

• Being called on in class

• Being teased or criticized

• Being the center of attention

• Being watched while doing something

• Dating

• Eating or drinking in front of others

• Giving reports in groups

• Going to school

• Interacting with people

• Making phone calls

• Making small talk

• Meeting new people

• Performing on stage

• Public speaking

• Taking exams

• Talking on the telephone

• Talking with “important” people or authority figures

• Using public bathrooms

• Writing or working in front of others

Psychological symptoms of social anxiety include:

Avoidance of social situations to a degree that limits activities or disrupts life
Clinging to the parent
Crying
Excessive self-consciousness and anxiety in everyday social situations
Extreme fear of being watched or judged by others, especially people you don’t know
Fear that others will notice that you’re nervous
Fear that you’ll act in ways that that will be embarrassing or humiliating
Having a meltdowns
Intense worry for days, weeks, or even months before an upcoming social situation
Refusing to go to school
Throwing a tantrum

Physical symptoms of social anxiety include:

• Blushing

• Clammy hands

• Confusion

• Diarrhea

• Dizziness, feeling faint

• Dry mouth

• Muscle tension

• Pounding heart or tight chest

• Rapid breathing

• Shaking

• Trembling voice

• Sweating or hot flashes

• Twitching

• Upset stomach, nausea

Treatment—

Cognitive behavioral therapy, a time-limited approach designed to change thoughts, emotions, and behaviors, has been shown to be successful in treating social anxiety in Aspergers children. Cognitive-behavioral therapy for social anxiety typically involves:

Challenging negative, unhelpful thoughts that trigger and fuel social anxiety, replacing them with more balanced views.
Facing the social situations you fear in a gradual, systematic way, rather than avoiding them.
Learning how to control the physical symptoms of anxiety through relaxation techniques and breathing exercises.

Modifications designed to address the cognitive, social, and emotional difficulties include:

1. "Individualizing" anxiety symptoms—Kids should be helped by the therapist to identify what their own anxiety symptoms look like as anxiety symptoms may present differently.

2. Behavioral management—Addition of a reward and consequence system maintains structure and prevents anger outbursts.

3. Combining visual and verbal materials—Use of worksheets, written schedules of therapy activities, and drawings can be added to increase structure in therapy sessions.

4. Games and fun physical activities are important to include in group therapy to promote social interactions.

5. Greater parent involvement—To build on the attachment between parent and child, it is important to have moms and dads learn the techniques and coach kids to use them at home.

6. More education on emotions—Activities such as feeling dictionaries (i.e., a list of different words for anxiety) and emotional charades (i.e., guessing people's emotions depending on faces) are helpful in developing emotional self-awareness.

Three types of medication are also used in the treatment of social anxiety:

• Antidepressants – Antidepressants can be helpful when social anxiety disorder is severe and debilitating. Three specific antidepressants—Paxil, Effexor, and Zoloft—have been approved by the U.S. Food and Drug Administration for the treatment of social phobia.

• Benzodiazepines – Benzodiazepines are fast-acting anti-anxiety medications. However, they are sedating and addictive, so they are typically prescribed only when other medications for social phobia have not worked.

• Beta blockers – Beta blockers are used for relieving performance anxiety. They work by blocking the flow of adrenaline that occurs when you’re anxious. While beta blockers don’t affect the emotional symptoms of anxiety, they can control physical symptoms such as shaking hands or voice, sweating, and rapid heartbeat.

Practicing breathing exercises can help the Aspergers child decrease the physical symptoms of anxiety and stay calm. Parents and teachers can coach the child on the following techniques:

Sit comfortably with the back straight and the shoulders relaxed. Put one hand on the chest and the other on the stomach.
Inhale slowly and deeply through the nose for 4 seconds. The hand on the stomach should rise, while the hand on the chest should move very little.
Hold the breath for 2 seconds.
Exhale slowly through the mouth for 6 seconds, pushing out as much air as possible. The hand on the stomach should move in when exhaling, but the other hand should move very little.
Continue to breathe in through the nose and out through the mouth. Focus on keeping a slow and steady breathing pattern of 4-in, 2-hold, and 6-out.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book

==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

Highly-Anxious Asperger’s & High-Functioning Autistic Kids

"How can I help my little girl (with autism) to not be so chronically fearful. She's really developing the habit of finding most things quite worrisome?"

All kids experience anxiety. It is expected and normal at specific times in development. However, children with Asperger’s (AS) and High Functioning Autism (HFA) tend to suffer from anxiety more than “typical” children do. Estimates report that as many as 80% of children on the autism spectrum have anxiety disorders. Because these young people may also be quiet, compliant and eager to please, their difficulties may be missed by both parents and teachers.

Other factors that may contribute to heightened anxiety include the following:

Family history is frequently a factor. Both Asperger’s and anxiety disorders run in families. Kids who have a family history of anxiety, often going back several generations, are at increased risk for developing an anxiety disorder.
Kids with introverted temperaments may be more prone to anxiety. Introverted kids are more apt to internalize their distress rather than to act it out.
Kids who are experiencing high levels of family stress or conflict may exhibit signs of anxiety.
Kids with highly anxious moms and dads may exhibit high levels of anxiety themselves. The highly anxious parent who continually worries and frets about her “special needs” child or who is overly-protective can foster high levels of anxiety in her child.

There are several types of anxiety disorders, including:

Generalized anxiety disorder: Involves excessive, unrealistic worry and tension, even if there is little or nothing to provoke the anxiety.
Panic disorder: Children with this disorder have feelings of terror that strike suddenly and repeatedly with no warning. Symptoms include a feeling of "going crazy," a feeling of choking, a feeling of having a heart attack, chest pain, sweating, and unusually strong or irregular heartbeats.
Social anxiety disorder: Involves overwhelming worry and self-consciousness about everyday social situations.
Specific phobias: An intense fear of a specific object or situation (e.g., snakes, heights, flying, etc.). The level of fear is usually out of proportion to the situation and may cause the child to avoid common, everyday situations.

The behavioral and emotional symptoms listed below may signal an anxiety disorder in your AS or HFA child (or the propensity for developing one):

avoidance of activities that require independence
avoidance of social situations
avoidance of stressful situations (e.g., tests and exams, interactions with others, etc.)
avoidance, refusal or reluctance to participate in social activities that might result in social scrutiny
being overly clingy
complains about physical concerns and problems (e.g., headaches, stomachaches, etc.)
constant thoughts and intense fears about the safety of parents
constant worries or concerns about, school
constant worry about everyday activities (e.g., what's going to happen next)
extreme fear about a specific thing (e.g., dogs, insects, needles, etc.)
extreme worries about sleeping away from home
extremely slow to complete tasks in order to ensure they are done correctly
fears of embarrassment or making mistakes
fears of meeting or talking to people
few friends outside the family
highly dependent on a parent
highly sensitive to other people watching them
low self-esteem and lack of self-confidence
many worries about things before they happen
panic or tantrums at times of separation from parents
physical symptoms (e.g., flushing) or an extremely quiet or shaky voice during social situations
refusing to go to school
reluctant to engage in activities without a significant other
repetitive, unwanted thoughts (obsessions) or actions (compulsions)
shows a high need for a great deal of reassurance
signs of perfectionism
trouble sleeping or nightmares

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

Fortunately, much progress has been made in the treatment of children with anxiety disorders. Although the exact treatment approach depends on the type of disorder, one or a combination of the following therapies may be used for most anxiety disorders:

Cognitive-behavioral therapy: A therapeutic approach in which the child learns to recognize and change thought patterns and behaviors that lead to troublesome feelings.
Dietary and lifestyle changes
Medication: Drugs used to reduce the symptoms of anxiety disorders include anxiety-reducing drugs and anti-depressants.
Psychotherapy: Counseling that addresses the emotional response to anxiety. Trained mental health professionals help children by talking through strategies for understanding and dealing with their disorder.
Relaxation therapy

How parents can help the highly-anxious Asperger’s or HFA child:

It’s nearly impossible to “cure” anxiety in AS and HFA kids. Some anxiety is genetic, and others are as a result of situations beyond the parent’s control. But parents can minimize the effect that anxiety has on their youngster’s development. Over time, moms and dads can help their child develop the coping strategies he or she needs to be able to handle day-to-day anxiety and stress. Here are some tips:

1. As a mother or father, it’s natural to want to be supportive of your “special needs” youngster. But you may be unintentionally reinforcing negative behaviors. For instance, if your youngster is anxious when you drop him off at school and he runs back to the car crying, it’s not a good idea to pick him up, hug him, cry too, and tell him ‘it will be okay’. This just reinforces that leaving him is a scary thing to do.

2. AS and HFA children who suffer with anxiety issues are often described as "going from 0-to-60 in a split second," which often results in a meltdown. In reality, however, the child’s emotions probably grew more gradually from calm to uneasy to anxious, but the parent (and the child) didn't notice the build-up. Teaching your child to identify this escalation is essential if he is to learn how to catch himself on the way up. A helpful tool to use is an emotional thermometer. When your youngster is calm, share the graphic with him, explaining how emotions often grow in intensity from calm to uneasy to anxious. Give him a copy of the thermometer and ask him to pay attention to where he is on it at different times of the day over the course of a few weeks, checking in with him as needed to discuss what he is noticing.

3. Breathing exercises that involve your youngster letting her belly expand as she inhales through her nose and deflate as she exhales through her mouth can help alleviate anxiety. The intake of oxygen and exhaling of carbon dioxide when she breathes deeply can lower her blood pressure and slow her heartbeat. When teaching this strategy to your child, tell her to pretend that she is blowing out candles on a cake or blowing up a make-believe balloon.

4. Calming music helps lower a youngster’s level of stress hormones, blood pressure and heart rate. When your youngster feels stressed, have him listen to soothing music (e.g., lullabies) using a pair of headphones. Create a playlist of spa-like music to play on an MP3 player.

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

5. Guided imagery teaches a youngster to calm her body and mind. This works best in a quiet, comfortable environment. Have your child close her eyes as you use a soothing voice to help her imagine that she’s in a relaxing situation (e.g., have her imagine that she’s filling bubbles with her negative emotions, which disappear into the air).

6. Kids pick up on social cues from their moms and dads. If the parent is an anxious person, her youngster is far more likely to be anxious as well. This is why it’s important that parents work on their own anxiety. They should try to minimize their fearful reactions to things when in front of their youngster – and try their best to relax and find composure in daily life.

7. Practice is key. Each day, at a time when your child is calm, ask him to role play what he looks like when he is fearful or anxious. Then ask him to practice self-soothing techniques. To make the practice most effective, have your child do the role-play in the area of the house he is most likely to go when he's actually upset (e.g., bedroom, beanbag chair, reading area, etc.). Then when he goes there in a moment of feeling uneasy, he'll be more able to use the correct technique in that space. Self-soothing training takes only a few minutes a day, but it's important that you focus on it daily with your child until you see him beginning to take hold of the strategies.

8. Social anxiety is easily the most common type of anxiety that affects kids on the autism spectrum. One of the main problems is that the AS or HFA youngster is unlikely to be adept at social skills. Parents should try to make sure that their youngster doesn’t have his fears reinforced. For example, you may be against violent video games or rap music, but the truth is that your youngster will want to converse with peers that will likely be talking about these subjects. The more your child knows about pop culture, the easier it will be for him to get into normal conversations, gain acceptance, and avoid having his social anxiety reinforced.

9. Teach your AS or HFA youngster to identify emotions by conducting a "body check." When you notice signs of anxiety first beginning, label it for your youngster and explain how you know (e.g., “Your voice is getting louder and your facial muscles are clenched, so I can see you're having some anxiety right now"). Over time, your youngster will learn to identify when he's anxious without your cues.

10. Think back to when you were a child. Most certainly, there were things that your parents did or said that helped calm you down. And most likely, there were those things that they did that raised your anxiety level. Vow to pass on the best – and leave the rest. In other words, some of the things that soothed you as a child may very well work with your child – so try them. Also, try to avoid doing the things that caused you be anxious as a child.

11. Try to find your child some very close friends. Studies have shown that having social support from close friends greatly reduces anxiety and improves confidence. As the AS or HFA youngster gets older, she will be able to leverage those friendships in such a way that she becomes less anxious in the process.

12. When your youngster feels anxious, oxygen-rich blood triggered by his fight-or-flight response often causes large muscle groups to feel tense. Practicing progressive muscle relaxation helps release the tension so he feels calmer. Guide your youngster by telling him to bring his shoulders up to his ears for five seconds – and then relax. Repeat the exercise five times.

SHARE WITH YOUR CHILD:

Are you worried that your AS or HFA child may be exhibiting symptoms of anxiety? Observe his or her behavior and ask yourself the following questions:

When did you begin to notice some of the signs of anxiety in your child?
What factors or stressors do you think are contributing to the anxiety?
What effect does anxiety have on your youngster and those around him or her?
On a scale of 1 to 10, how severe do you think the problem is?
Is it hard to manage?
How long have these problems been of concern?
How long do the symptoms of anxiety last?
How frequently does your youngster exhibit symptoms of anxiety?
How does it interfere with your youngster’s life?

By getting answers to these questions – and by utilizing the ideas listed above – parents should be able to greatly reduce the level of anxiety that their “special needs” child experiences.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

Help for Anxious Children on the Autism Spectrum

"How can I help my daughter with autism (high functioning) to deal with her anxiety in ways other than simply hiding in her room all evening and on weekends?"

Anxiety is a common problem in children with Asperger’s (AS) and High-Functioning Autism (HFA). In fact, in some cases fear is their main emotion. One study revealed that 84.1% of kids on the autism spectrum met the full criteria of at least one anxiety disorder (i.e., phobia, panic disorder, separation anxiety disorder, avoidant disorder, overanxious disorder, and obsessive compulsive disorder).

This does not necessarily go away as the youngster grows up. Many teens and young adults with AS and HFA report intense feelings of anxiety that may reach a level where treatment is required. For some children, it is the treatment of their anxiety disorder that leads to a diagnosis of AS or HFA.

Children with AS and HFA are particularly prone to anxiety as a consequence of the social demands made on them. Any social contact can generate anxiety as to how to start, maintain and end a conversation or an activity. Also, changes to daily routine can exacerbate the anxiety, as can sensory sensitivities.

One way these children cope with their anxiety is to retreat into their special interest (e.g., video games, collecting baseball cards, tracking train schedules, etc.). Their level of preoccupation with the special interest can be used as a measure of their degree of anxiety. The more anxious the child, the more intense the interest. Anxiety can also increase their rigidity in thought processes and insistence on routines. In addition, the more anxious these children are, the more they experience other related symptoms. For example, anxiety often leads to depression and obsessive-compulsive behaviors.

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

One of the best ways to treat anxiety in AS and HFA children is through the use of behavioral techniques. This may involve parents (and teachers) looking out for recognized symptoms (e.g., meltdowns, shutdowns, rocking, hand-flapping, etc.) as an indication that the youngster is anxious. These kids can be taught to recognize these symptoms themselves (although some might need prompting).

Specific events may also trigger anxiety (e.g., recess and other unstructured school activities, itchy clothing, routine changes, a stranger entering the room, etc.). When certain events (internal or external) are recognized as a sign of imminent anxiety, action can be taken (e.g., relaxation, distraction, physical activity, etc.).

The choice of relaxation method depends very much on the unique needs of the child. Many of the relaxation products available commercially can be adapted for use for children with AS and HFA. Some kids may respond to watching their favorite video, while others may prefer to listen to calming music. Also, many benefit from having access to a quiet room.

Other techniques include:

aromatherapy
deep breathing
massage
physical activities (e.g., using a swing or trampoline, going for a long walk perhaps with the dog, doing physical chores around the house, etc.)
the use of photographs, postcards or pictures of a pleasant or familiar scene (these need to be small enough to be carried around and should be laminated in order to protect them)
using positive thoughts

It’s best to practice whatever method of relaxation is chosen at frequent and regular intervals in order for it to be of any practical use when anxieties occur.

Drug treatment may be effective for anxiety. Many AS and HFA children have responded well to:

benzodiazepines
buspirone
clonazepam
propranolol
selective serotonin reuptake inhibitors (SSRI) antidepressants
St. Johns Wort

One mother of a child on the autism spectrum states, "My recently diagnosed 13 y.o. daughter with HFA experiences anxiety about some very necessary things, like drinking water (she saw her brother guzzle water and vomit and now associates water intake with vomiting), eating (if she starts to become anxious while eating a particular food, that food becomes a trigger in itself) and sleeping -- haven't quite figured out what frightens her about sleep, but it often results in her staying up until she just can't keep her eyes open any longer. Then of course, she's tired and can't focus and that contributes to her other anxieties in school and such. She's on an SSRI, and has been working with a CBT therapist for several years. I wish it were as simple as avoiding or modifying things that caused her anxiety but eating, drinking and sleeping are everyday necessities."

As with all drug treatments, it will take time to find the correct drug and dosage for any particular child – and must only be conducted through a qualified medical practitioner.

Whatever method is chosen to reduce anxiety, it is vital to identify the cause of the anxiety. This should be done by careful monitoring of the antecedents to an increase in anxiety and the source of the anxiety tackled. For example, many children with AS and HFA have difficulty with noisy, crowded environments. Thus, the newly arrived middle school student who becomes agitated or aggressive in the hallway during passing periods may need an accommodation of leaving class a minute or two early to avoid the congestion and over-stimulation that provokes anxiety and subsequent dysfunctional coping mechanisms.

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

Key issues to address when discussing this strategy are:

Will the antecedent strategy need to be permanent, or is it a temporary "fix" which allows the child to increase skills needed to manage the anxiety in the future?
What can be done to modify the anxiety-producing situation if it can’t be eliminated entirely?
What can be done to eliminate the problem (i.e., the antecedent condition)?

The importance of using antecedent strategies should not be underestimated. Kids with AS and HFA often have to manage a great amount of personal stress. Striking a balance of short and long term accommodations through manipulating antecedents to anxiety and problem behavior is often crucial in setting the stage for later skill development.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

Aspergers and Anxiety: What Parents and Teachers Need To Know

The following is a transcript of the question-and-answer portion of Mark Hutten's seminar on "Aspergers and Anxiety: What Parents and Teachers Need To Know":

Question: Both of my boys have Aspergers, but one exhibits a lot of anxiety, whereas the other does not seem anxious at all. Is there a good explanation for that?

It’s very normal for different children to have different temperaments. Some children are more outgoing and seem to be impervious to feelings of anxiety, whereas other children may always seem to be anxious. But it’s very possible for the more anxious child to learn skills to help manage his anxiety better so he can participate in activities, do well in school, and not be held back due to anxiety-related issues, and so on.

Question: How common is anxiety in children with this syndrome?

Anxiety is extremely common. It’s estimated that up to 80% of people with Aspergers experience intense anxiety symptoms. It can take the form of obsessive-compulsive disorder, specific fears and phobias, and generalized anxieties. Also, 1 in 15 children with Aspergers meet the diagnostic criteria for depression, which can be both a cause and a result of anxiety. We don’t know exactly what causes the depression, but it’s likely a combination of the child’s realization of his difference from peers and the ostracizing that occurs from these peers. Bullying is an extremely common problem among children with Aspergers, and this often leads to an increased rate of both anxiety and depression.

Question: How should I go about choosing a child therapist for my 12-year-old Aspergers son?

In the field of child anxiety as it specifically relates to Aspergers, there are some therapists who have been specifically trained in implementing what we call ‘cognitive-behavioral therapy’ – or CBT. Cognitive-behavioral methods are essentially a set of skills that Aspergers children can learn to help them change their fearful thoughts, anxious behaviors, and to reduce their physical feelings of tension.

Cognitive-behavioral approaches to treating child anxiety have been found to have high levels of success. For example, a child who is experiencing panic attacks might learn how to identify anxious thoughts that trigger panic attacks, learn how to change his anxious feelings, and learn how to change anxiety-triggering behavior. In any event, ideally you will want to seek a Child and Adolescent Psychiatrist who specializes in CBT specific to the Aspergers condition.

Question: How long will it take before I see a change in my Aspergers son once he has started this cognitive-behavioral therapy?

That’ll depend on his unique set of symptoms. At one of our facilities in Indianapolis, children are typically treated within 7-12 sessions for difficulties like specific fears, panic disorder, generalized anxiety disorder, and obsessive compulsive disorder. In some cases, however, additional sessions are needed to help a child make the maximum progress. But even then, 15 sessions will usually be the max.

Question: I'm an anxious person also. Is it possible that I give this anxiety to my Aspergers daughter?

Although research has shown that anxiety may be heritable, there are many other ways that fears can be acquired. Your daughter may have a more anxious, inhibited temperament, which may make her more vulnerable to feeling anxious. Fears are often acquired through the media, through modeling from others, and so on. Fears might also occur after children have experienced some form of trauma. So, although you may feel you are anxious, it is not likely that you simply are ‘giving’ an anxiety disorder to your daughter. There are ways that you can interact with her, though, that may function to increase her anxiety, and it might be important to examine such factors with a therapist.

Question: What do anxiety symptoms look like in a child with Aspergers?

Not much is known about what anxiety symptoms actually look like in a child with Aspergers, but there are symptoms that overlap with Anxiety Disorders, for example: avoidance of new situations, irritability, somatic complaints, and withdrawal from social situations. Another set of anxiety symptoms may be unique to children with Aspergers, for example: becoming ‘silly’, becoming explosive, having anger outbursts or what we call ‘meltdowns’, increased insistence on routines and sameness, preference for rules and rigidity, repetitive behavior, and special interest.

Question: What is the difference between cognitive-behavioral treatment and other kinds of treatment for anxiety?

CBT is focused on teaching children and parents specific skills for changing their fearful thoughts, anxious and tense physical feelings, and avoidant behaviors. Other types of therapy are more focused on using play therapy and/or talk therapy to produce change. There’s a lot of evidence suggesting that cognitive-behavioral techniques are quite successful in reducing anxiety in Aspergers children. Other forms of therapy have less empirical support.

Question: Will my child’s anxiety go away naturally or does he need treatment?

This is an excellent question, and one that is commonly asked by parents. Many childhood fears are part of normal developmental. Fears tend to rise and dissipate at predictable ages in a kid’s life. A child might develop a fear of the dark at age 4, which dissipates by the time he’s 6. Also, it’s normal for children to feel fearful of loud noises when they are very young. However, no matter how old your son is, if he is experiencing a fear that is beginning to interfere with aspects of his functioning, such as academic, social or family functioning …then these fears may warrant treatment.

Very often, successful short-term therapy can help to alleviate an Aspergers child’s fears and help him return to healthy functioning. If you’re unsure whether your son’s fear is normal, or whether it is interfering in his life, it may be a good idea to consult with a psychologist to determine whether he could benefit from treatment.

Question: You say that cognitive-behavioral treatment is the best treatment for anxiety symptoms in children with Aspergers. What does it consist of exactly?

CBT is a time-limited approach designed to change thoughts, emotions, and behaviors and has been shown to be successful in treating Anxiety Disorders in Aspergers children. It should consist of both a child component and a parent component. In using CBT, children should be helped to identify what their own anxiety symptoms look like.

Activities like feeling dictionaries (which is a list of different words for anxiety) and emotional charades (which is guessing people's emotions depending on faces) are helpful in developing this self-awareness. Worksheets, written schedules of activities, and drawings can be added to increase structure during therapy sessions. Games and fun physical activities are important to include in group therapy because they promote social interactions. A reward and consequence system should be used to maintain structure and prevent anger outbursts. Also, to build on the attachment between child and parent, it is important to have parents learn the techniques and coach children to use them at home.

Other useful techniques may include body brushing and massage, chewing gum or sucking on a candy cane to relieve pressure in the jaw, deep pressure activity like lying under a heavy blanket or cushions, physical energy burn like running and jumping on a trampoline, redirection and distraction, and whole-body activities like tug-of-war or rolling on the floor.

As a side note, know that kids with Aspergers tend to have perfectionist attitudes in many areas of their lives. This can be witnessed through their obsessive-compulsive behaviors, repetitive patterns of behavior, and their difficulty coping with change. Now …this self-imposed perfectionism can contribute to their anxiety and pressure to perform. So, since Aspergers kids usually place extreme and unrealistic demands on themselves, it’s important to not push the child too far in therapy. Small steps and taking it ‘one therapy session’ at a time will go a long way in effecting permanent positive change in the child. Go slow, have realistic therapeutic expectations, and monitor progress – these are the big 3 in CBT as far as I’m concerned.

Highly Acclaimed Parenting Programs Offered by Online Parent Support, LLC:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book

==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism

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How to Deal with an Aspergers Child Who Also Suffers with Anxiety

Question

How do you deal with an Aspergers child who also suffers with anxiety?

Answer

For kids with Aspergers (high functioning autism), anxiety can be overwhelming. What causes this anxiety? Just about anything can cause anxiety. The stress of social situations when you have weak social skills, changes in your normal routine or in the order of things, depression due to the loneliness that can come with lacking social abilities, and frustration. Truthfully, frustration is the root of anxiety in kids with Aspergers.

In kids with Aspergers, anxiety builds as frustration builds. Something as simple as being forced to make eye contact and explain your reasons for choosing a certain book to read can cause frustration. Imagine trying to find the words you need and learning that some of those words are missing. Imagine having to look someone in the eye and feeling actual physical discomfort when doing so. Imagine eating in a noisy, crowded cafeteria when the sights, sounds, and smells are painfully overwhelming. Imagine having a deep desire to make and keep friends, but not having the social skills needed to accomplish this desire. Frustration is around every corner, and with that frustration comes anxiety.

Aspergers anxiety must be understood before it can be eliminated or at the very least, managed. Knowing the youngster’s anxiety triggers, or daily frustrations is a good place to start. Once you know the youngster’s frustrations, you can make a plan for these stressful Aspergers anxiety situations.

There are several choices of treatments for parents to choose:

• Moms and dads can choose to teach coping skills at home. Search the Internet for published resources that can make the job easier and more effective.

• In some cases, medication is a necessary treatment. Anti-anxiety medications can make it easier for kids with Aspergers to deal with the depression and anxiety issues. Since medications are not for everyone, a trusted doctor‘s guidance is necessary.

• Counseling is a common treatment option for anxiety. Cognitive-behavioral therapy, as well as psychological counseling can help. Social skills training, sensory integration therapy, and language therapy can also help with the underlying causes of a youngster’s anxiety-inducing frustration.

Aspergers anxiety is a serious condition and should not be taken lightly. Finding the right combination of stress management and treatments will help your family deal with the frustration that leads to anxiety.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

Dealing with Children on the Autism Spectrum Who Refuse to Go to School

Has your ASD (high functioning autistic) child given you some indication that he is nervous about starting back to school? He may have even said, “I’m not going!!!”

What youngster hasn't dreaded September, the end of summer and the return to school – but for many ASD students, the prospect of school produces a level of fear so intense that it is immobilizing, resulting in what's known as school-refusal behavior. Some children with autism spectrum disorder have been known to be absent for weeks or months.

Some may cry or scream for hours every morning in an effort to resist leaving home. Others may hide out in the nurse's office. Some children who miss school are simply truant (i.e., they'd just rather be doing something else), but sometimes there are genuine reasons to fear school (e.g., bullying, teasing).

Anywhere from 5% to 28% of kids will exhibit some degree of school-refusal behavior at some point, including truancy. For children with anxiety-fueled school refusal, the fear is real and can take time to overcome. Families may struggle for months to help an autistic youngster get back into the classroom. Ignoring the problem or failing to deal with it completely can lead to more-serious problems later on. Individuals who experience school-refusal behavior and anxiety disorders in childhood may face serious ramifications in adulthood.

Psychologists say and studies show the following:

Alcohol, drug use: A study of kids ages 9 to 13 with an anxiety disorder showed that those who still had the disorder seven years after treatment drank alcohol more often and were more likely to use marijuana than those whose disorders had resolved.
Depression: Teens and young adults ages 14 to 24 that had social anxiety were almost three times as likely to develop depression later on than those without the anxiety disorder.
Different life choices: Psychologists say they've seen young people with persistent anxiety make fear-fueled choices that can have long term effects, such as selecting a less-rigorous college or a less challenging career.
Psychiatric treatment: A study of school-refusing kids showed that about 20 to 29 years later they received more psychiatric treatment than the general population.

School refusal affects the entire family. If a child doesn't go to school, it may be hard for a parent to keep her job. Children are at heightened risk when starting a new school, and especially when entering middle school. It is the perfect storm with the onset of puberty, a huge transition and a chaotic academic environment.

Well-meaning moms and dads can make things worse by allowing an anxious youngster to miss school. Such an accommodation sends the message that school is too scary for the youngster to handle and the fear is justified. Overprotective moms and dads rush in way too quickly to shield their Aspie from any experience that creates distress.

Untreated, a youngster on the spectrum with school-refusal behavior is likely to fall behind academically, which can then lead to more anxiety. And there may be longer-term consequences. A 1997 study followed 35 students (ages 7-12) treated for school refusal. Twenty years later they were found to have had more psychiatric treatment and to have lived with their parents more often than a comparison group.

Some ASD teens with unresolved anxiety may go on to self-medicate with alcohol and drugs. A 2004 study followed 9- to 13-year-olds who were treated for an anxiety disorder. Seven years after treatment, those who still had the disorder drank alcohol more days per month and were more likely to use marijuana than those whose disorder had resolved.

Children with school-refusal behavior may have (a) separation anxiety (i.e., a fear of being away from their moms and dads), (b) a social phobia (i.e., an inordinate fear of being judged), or (c) a fear of being called-on in class or being teased. A specific phobia (e.g., riding the bus, walking past a dog, being out in a storm, etc.) may be present as well. Other kids are depressed, in some cases unable to get out of bed.

Because many children complain of headaches, stomachaches or other physical symptoms, it can be difficult to tell whether anxiety, or a physical illness, is to blame. (Note: Anxiety-fueled ailments tend to disappear magically on weekends.)

Autistic kids with school refusal may complain of physical symptoms shortly before it is time to leave for school or repeatedly ask to visit the school nurse. If the youngster is allowed to stay home, the symptoms quickly disappear, only to reappear the next morning. In some cases, the child may refuse to leave the house. Common physical symptoms include headaches, stomachaches, nausea, or diarrhea. Tantrums, inflexibility, separation anxiety, avoidance, and defiance may show up, too.

Starting school, moving, and other stressful life events may trigger the onset of school refusal. Other reasons include the youngster’s fear that something will happen to a parent after he is in school, fear that she won’t do well in school, or fear of another student. Often a symptom of a deeper problem, anxiety-based school refusal affects 2 to 5 percent of school-age kids. It commonly takes place between the ages of five and six and between ten and eleven, and at times of transition, such as entering middle and high school. Kids who suffer from school refusal tend to have average or above-average intelligence. But they may develop serious educational or social problems if their fears and anxiety keep them away from school and friends for any length of time.

What Can Parents Do?

The most important thing a mother or father can do is obtain a comprehensive evaluation from a mental health professional. That evaluation will reveal the reasons behind the school refusal and can help determine what kind of treatment will be best. Your youngster’s pediatrician should be able to recommend a mental health professional in your area who works with kids on the spectrum.

The following tips will help you and your Aspie develop coping strategies for school anxieties and other stressful situations:

Arrange an informal meeting with your youngster’s teacher away from the classroom.
Emphasize the positive aspects of going to school: being with friends, learning a favorite subject, and playing at recess.
Encourage hobbies and interests. Fun is relaxation, and hobbies are good distractions that help build self-confidence.
Expose kids to school in small degrees, increasing exposure slowly over time. Eventually this will help them realize there is nothing to fear and that nothing bad will happen.
Help your Aspie establish a support system. A variety of people should be in your youngster’s life—other kids as well as family members or educators who are willing to talk with your youngster should the occasion arise.
Learn about your Aspie’s anxiety disorder and treatment options. For more information about school refusal and kid’s anxiety disorders, type "anxiety" and/or "school problems" in the search box at the top of this page.
Meet with the school guidance counselor for extra support and direction.
Talk with your Aspie about feelings and fears, which helps reduce them.
Try self-help methods with your Aspie. In addition to a therapist’s recommendations, a good self-help book will provide relaxation techniques. Be open to new ideas so that your youngster is, too.

Treatment—

Cognitive behavioral therapy (CBT), in which clients learn to change negative thoughts and behavior, is the main treatment for school-refusal behavior and the anxiety disorders that often underlie it. The primary technique is exposure therapy, where children gradually face and master their fears.

CBT is very effective. Recent studies have shown that about half to 70% of children with anxiety disorders treated with CBT will have a significant improvement in function and decrease in their symptoms. Some specialized school-refusal clinics have success rates that are even higher.

Antidepressants such as Zoloft (sertraline) or Prozac (fluoxetine) are often prescribed for kids with anxiety disorders, although their use in kids is controversial.

Psychologists stress the importance of seeking treatment quickly—after as little as two weeks of missed school. The longer they've been out of school, the poorer the prognosis.

Resources for parents of children and teens on the autism spectrum:

==> How to Prevent Meltdowns and Tantrums in Children with Autism Spectrum Disorder

==> Parenting System that Reduces Defiant Behavior in Teens with Autism Spectrum Disorder

==> Launching Adult Children with Autism Spectrum Disorder: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social-Skills and Emotion-Management to Children with Autism Spectrum Disorder

==> Parenting Children and Teens with High-Functioning Autism: Parents' Comprehensive Handbook

==> Unraveling the Mystery Behind High-Functioning Autism: Audio Book

==> Crucial Research-Based Parenting Strategies for Children and Teens with High-Functioning Autism

Aspergers and Separation Anxiety

Question

Our son Jack, who is turning 6 next week, and has Aspergers is not coming to terms that mum and dad will be going away for 4 days for a holiday in January (20th to be exact). It is my and my husband 1st year anniversary (strange as it seems after being together for almost 12 years). It is important for us as a couple to have this time away, and a friend in our compound has agreed to look after Jack. She also has a boy who is 6 1/2 years old. I have two other sons who will be going to other houses in the compound whilst we are away. The kids will still be close to each other but not in each other’s pockets.

I tried to explain to Jack via using a calendar of the days we will be away, but he had a complete meltdown. Not sure if this is just a manipulation game but I will admit I haven't left him with anyone for a very long time. Their father leaves a lot for travel for work but mum is always home.

Are you able to provide me with a strategy to discuss with him of our leave away? Should I not go? My only concern with this is that then I will never be able to have time away with my husband and sometimes things get strained as it is.

Is the change too much? We do have a nanny, but not to sound rude, the nannies here in Ghana are not a western nanny and she simply can't cope with Jack - let alone with 3 boys by herself. I can have the option of the nanny staying in the house here with the three kids, but last time we were out and Jack vomited, she left him in his vomit (so not exactly reliable).

Has any other parents asked you this question before? I will admit to you our relationship is not going the greatest so I am hoping that having time away from the kids may help.

Answer

Separation anxiety is a problem for many kids, but with an Aspergers (high functioning autistic) youngster, the situation is even more serious due to sensory issues, poor social skills, and the need for structure and routine.

Separation anxiety is defined as excessive anxiety about becoming separated from mother, father, and any siblings that might be in the home. Aspergers kids experiencing separation anxiety often exhibit generalized fear, anxiety over the possibility of death, and recurrent nightmares. Unlike the occasional worries that kids may feel at times of separation, separation anxiety causes fears that may limit a youngster’s ability to engage in ordinary life.

Normal separation anxiety and “Separation Anxiety Disorder” share many of the same symptoms, so it can be confusing to try to figure out if your youngster just needs time and understanding—or has a more serious problem. The main differences between healthy separation anxiety and a disorder are the intensity of your youngster’s fears, and whether these fears keep him from normal activities. Kids with separation anxiety disorder may become agitated at just the thought of being away from his parents, and may complain of sickness to avoid playing with friends or attending school. When symptoms are extreme enough, these anxieties can add up to a disorder.

Kids with Separation Anxiety Disorder feel constantly worried or fearful about separation. Many kids are overwhelmed with one or more of the following:

• Kids with anxiety disorder may fear that once separated from mom or dad, something will happen to keep the separation (e.g., they may worry about being kidnapped or getting lost).

• Kids with separation problems often have scary dreams about their fears.

• The most common fear a youngster with separation anxiety disorder experiences is the worry that harm will come to his mother or father in the youngster's absence (e.g., the youngster may constantly worry about a parent becoming sick or getting hurt).

Separation Anxiety Disorder can get in the way of a youngster’s normal activities. Kids with this disorder often:

• Shadow you around the house or cling to your arm or leg if you attempt to step out.

• Complain they feel ill.

• Anxiety may make these kids insomniacs, either because of the fear of being alone or due to nightmares about separation.

• A youngster with separation anxiety disorder may have an unreasonable fear of school, and will do almost anything to stay home.

Here are some tips to help your Aspergers youngster deal with his separation anxiety:

• Allow your youngster to call once each evening to reassure him that you will be home soon.

• Anticipate separation difficulty. Be ready for transition points that can cause anxiety for your youngster. If your youngster separates from one parent more easily than the other, have that parent handle the separation.

• Develop a “goodbye” ritual. Rituals are reassuring and can be as simple as a special wave through the window or a goodbye kiss.

• Educate yourself about separation anxiety. If you learn about how your youngster experiences this condition, you can more easily sympathize with his struggles.

• Give your child a calendar with the days that you will be gone circled. Call daily and have him put a big ‘X’ inside the circle that corresponds to the current date, bringing him that much closer to your return home.

• Have a consistent primary caregiver. If you hire a caregiver, try to stick with this one person for as long as possible.

• Help him practice relaxation. Your youngster can control stress levels with relaxation techniques like yoga, deep breathing, or meditation.

• If possible, try to arrange it so that the anxious youngster and his brother or sister stays with the same caretaker while you’re gone. In this way, the anxious youngster will still be in the presence of a family member throughout your absence.

• Keep a sense of humor. The act of laughing helps the body fight stress in a number of ways.

• Keep calm during separation. If your youngster sees that you can stay cool, he is more likely to be calm, too.

• Keep familiar surroundings when possible. Have the caretaker come to your house.

• Leave him with a picture of you and a personal item of yours before you leave.

• Leave without fanfare. Tell your youngster you are leaving and that you will return, then go—don’t stall.

• Listen to and respect your youngster’s feelings. For a youngster who might already feel isolated by his anxiety, the experience of being listened to can have a powerful helping effect.

• Make new surroundings familiar. When your youngster is away from home, let him take a familiar object with him.

• Make sure he gets enough sleep. Feeling tired will only increase stress, causing him to think irrationally or foggily.

• Make sure your youngster eats right. A well-nourished body is better prepared to cope with stress, so be mindful of what he eats.

• Make sure your youngster exercises regularly. Physical activity plays a key role in reducing and preventing the effects of stress.

• Minimize scary television/movies. Your youngster is less likely to be fearful if the shows you watch are not frightening.

• Offer choices. If your youngster is given a choice or some element of control in an activity or interaction with an adult, he may feel more safe and comfortable.

• Practice separation. Leave your youngster with a caregiver for brief periods and short distances at first.

• Praise your youngster’s efforts. Use the smallest of accomplishments—going to bed without a fuss, a good report from school—as reason to give your youngster positive reinforcement.

• Provide a consistent pattern for the day. Don’t underestimate the importance of predictability for kids with separation problems. If your family’s schedule is going to change, discuss it ahead of time with your youngster.

• Reassure your youngster that you will return and at what day/time.

• Schedule the separation in the morning right after breakfast. Kids are more able to deal with separation anxiety if they are rested and fed.

• Set limits. Let your youngster know that although you understand his feelings, there are rules in your household that need to be followed. And one of the rules is “mommy and daddy go on trips together sometimes.”

• Spend a considerable period of time with your youngster before you leave and upon your return.

• Support the youngster's participation in activities. Encourage your youngster to participate in healthy social and physical activities while you’re gone.

• Talk about the issue. It’s healthier for kids to talk about their feelings—they don’t benefit from “not thinking about it.” Be empathetic, but also remind the youngster—gently—that he survived the last separation.

• Try not to give in. Reassure your youngster that he will be just fine—setting limits will help the adjustment to separation.

If you see any of the following “red flags” and your interventions don’t seem to be enough, it may be necessary to get a professional to diagnose and help your youngster:

Age-inappropriate clinginess or tantrums
Constant complaints of physical sickness
Excessive fear of leaving the house
Preoccupation with intense fear or guilt
Refusing to go to school for weeks
Withdrawal from friends, family, or peers

Therapists can address physical symptoms, identify anxious thoughts, help your youngster develop coping strategies, and foster problem solving. Professional treatment for separation anxiety disorder may include:

• Counseling for the family. Family counseling can help your youngster counteract the thoughts that fuel his or her anxiety, while you as the parent can help your youngster learn coping skills.

• Medication. Medications may be used to treat severe cases of separation anxiety disorder. It should be used only in conjunction with other therapy.

• Play therapy. The therapeutic use of play is a common and effective way to get kids talking about their feelings.

• Talk therapy. Talk therapy provides a safe place for your youngster to express his or her feelings. Having someone to listen empathetically and guide your youngster toward understanding his or her anxiety can be powerful treatment.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

Anxiety Management in High-Functioning Autism: 25 Tips for Parents

Anxiety can't be measured or observed except through its behavioral manifestation, either verbal or nonverbal (e.g., crying, complaining of a stomachache or headache, crawling under the table, becoming argumentative, etc.).

To manage the anxiety in Aspergers and High-Functioning Autistic (HFA) kids, moms and dads are encouraged to do any – or all – of the following:

1. Avoid over-scheduling. Soccer, karate, baseball, music lessons, play-dates the list of extracurricular activities children can take on is endless. But too many activities can easily lead to stress and anxiety in kids. Just as grownups need some downtime after work and on weekends, kids also need some quiet time alone to decompress.

2. Be flexible and try to maintain a normal routine.

3. Consult a counselor or your pediatrician. If you suspect that a change in the family such as a new sibling, a move, divorce, or a death of a family member is behind your youngster's stress and anxiety, seek advice from an expert such as your youngster's school counselor, your pediatrician, or a child therapist.

4. Create an anxiety hierarchy, and put the events in order from easy to hard.

5. Develop, practice, and rehearse new behaviors prior to exposure to the real anxiety-producing situation.

==> Preventing Meltdowns and Tantrums in HFA Children

6. Don’t dismiss his feelings. Telling your youngster “not to worry about his fears” may only make him feel like he’s doing something wrong by feeling anxious. Let him know that it’s okay to feel bad about something, and encourage him to share his emotions and thoughts.

7. Don’t punish mistakes or lack of progress.

8. Get him/her outside. Exercise can boost mood, so get him moving. Even if it’s just for a walk around the block, fresh air and physical activity may be just what he needs to lift his spirits and give him a new perspective on things.

9. Gradually shift “anxiety control” to your youngster by preparing him for anxiety-producing situations by discussing antecedents, settings, triggers, and actions to take.

10. Help your youngster identify the source of the anxiety if he is old enough to understand this concept.

11. If he is old enough, teach your youngster increasing independence in anticipating and coping with anxiety in a variety of situations.

12. Implement new behaviors in the actual situations where anxiety occurs.

13. Keep your youngster healthy. Make sure he’s eating right and getting enough sleep. Not getting enough rest or eating nutritious meals at regular intervals can contribute to your youngster’s stress. If he feels good, he’ll be better equipped to work through whatever is bothering him.

14. Limit your youngster's exposure to upsetting news or stories. If she sees or hears upsetting images or accounts of natural disasters such as earthquakes or tsunamis or sees disturbing accounts of violence or terrorism on the news, talk to her about what's going on. Reassure her that she and the people she loves are not in danger. Talk about the aide that people who are victims of disasters or violence receive from humanitarian groups, and discuss ways that she may help, such as by working with her school to raise money for the victims.

15. Listen carefully to your youngster. You know how enormously comforting it can be just to have someone listen when something’s bothering you. Do the same thing for your youngster. If he doesn’t feel like talking, let him know you are there for him. Just be by his side and remind him that you love him and support him.

16. Make a list of numerous anxiety-producing situations, from easy ones to those that are more difficult (this is called “anxiety mapping”).

17. Modify expectations during stressful periods.

18. Offer comfort and distraction. Try to do something she enjoys, like playing a favorite game or cuddling in your lap and having you read to her, just as you did when she was younger. When the chips are down, even a 10-year-old will appreciate a good dose of parent TLC.

19. Plan for transitions (e.g., allow extra time in the morning if getting to school is difficult).

20. Prevent anxiety by “external control” (i.e., structuring the environment to make it predictable, consistent, and safe).

==> Discipline for Defiant Asperger's and HFA Teens

21. Use psychological, environmental and psychopharmacological treatments as needed (see below).

22. Recognize and praise small accomplishments.

23. Set a calm example. You can set the tone for how stress and anxiety in kids is handled in your house. It's virtually impossible to block out stress from our lives in today's high-tech, 24-hour-news-cycle world, but you can do something about how you handle your own stress. And the more you are able to keep things calm and peaceful at home, the less likely it is that anxiety in kids will be a problem in your household.

24. Stay calm when your youngster becomes anxious about a situation or event.

25. Stick to routines. Balance any changes by trying to maintain as much of her regular routine as possible. Try to stick to her regular bedtime and mealtimes, if possible.

Behavioral Manifestations of Anxiety in Kids on the Autism Spectrum:

==> Parenting Children and Teens with High-Functioning Autism

Summary of Anxiety Treatments for Children on the Autism Spectrum—

1. Psychological Treatments:

Behavioral Therapies: Focus on using techniques such as guided imagery, relaxation training, progressive desensitization, flooding as means to reduce anxiety responses or eliminate specific phobias.
Cognitive-Behavioral Therapy: Addresses underlying “automatic” thoughts and feelings that result from thoughts, as well as specific techniques to reduce or replace maladaptive behavior patterns.
Psychotherapy: Centers on resolution of conflicts and stresses, as well as the developmental aspects of an anxiety disorders solely through talk therapy.

2. Environmental Treatments:

Reduction of stressors. Identify and remove or reduce stressful tasks or situations at home, school and work.
Good sleep habits. Getting adequate, restful sleep improves response to interventions to treat anxiety disorders.
Avoidance or minimization of stimulants. No caffeine, minimize use of asthma medications if possible (bronchodilators, theophylline), avoid use of nasal decongestants, some cough medications, and diet pills.

3. Psychopharmacological Treatments (used as a last resort only):

Antihistamines: Older medications used for mild to moderate anxiety for many years. These, like the benzodiazepines, work fairly quickly (Atarax, Vistaril).
Benzodiazepines: Long-acting are best (Klonopin, Ativan, Valium, Librium, Serax) to quickly reduce the symptoms of an anxiety disorder. However, if used long term the result may be that tolerance develops.
Buspirone (BuSpar): A new serotonergic combination agonist/antagonist. Is nonaddicting, but may take 2 to 4 weeks for full effect.
Combination Serotonin/Norepinephrine Agents: New medications such as Effexor, Serzone, and Remeron, also with excellent tolerability and effectiveness. Takes 4 to 6 weeks for full response.
Major Tranquilizers (also called neuroleptics): Medications that act on a variety of neurotransmitter systems (acetylcholine, dopamine, histamine, adrenergic). Most are somewhat sedating, and have been used in situations where anxiety is severe enough to cause disorganization of thoughts and abnormal physical and mental sensations, such as the sense that things around you aren't real (derealization) or that you are disconnected with your body (derealization). Commonly used neuroleptics include: Zyprexa, Risperdal, Seroquel, Mellaril, Thorazine, Stelazine, Moban, Navane, Prolixin, and Haldol.
Serotonergic Agents: Newer antidepressants act as antianxiety agents as well, with excellent tolerability and effectiveness. Takes 4 to 6 weeks for full response (Luvox, Prozac, Zoloft, Paxil).
Tricyclic Antidepressants (TCAs): Older antidepressants with more side effects typically than the serotonergic agents, but also effective. Takes 4 to 6 weeks for full response (Tofranil, Elavil, Pamelor, Sinequan)

Resources for parents of children and teens on the autism spectrum:

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…

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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...

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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…

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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…

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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.

Click here to read the full article...

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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...

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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.

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Anxiety Management in High-Functioning Autism: 25 Tips for Parents

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Older Teens and Young Adult Children with ASD Still Living At Home

Parenting Children and Teens with High-Functioning Autism

Highly Effective Research-Based Parenting Strategies for Children with Asperger's and HFA