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Autism and Anxiety
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High levels of anxiety – as norm
Increased anxiety states for specific
reasons
Global levels of high anxiety due to
environmental factors
Possible as high as 90% of individuals
have a recognisable anxiety disorder
Secondary Psychiatric
Disorders
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Not a primary mental illness
Result of environmental factors
High level in people with Autism
compared to peer groups
Better support should lead to a better
prognosis and reduction in secondary
conditions
Specific Reasons for Anxiety
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As a result of specific neurological
differences in Autism:
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learning processes
communication
social interaction
Theory of Mind
Executive Functioning
emotional recognition
Sensory processing
Central Coherence
obsessions
Learning Processes
Direct learning vs Indirect learning
Examples of indirect learning /
development:
Theory of Mind
Social skills
Social cues
Non verbal communication
Verbal Communication
◈Accurate interpretation
◈Metaphor / sarcasm / irony
◈Need for accuracy / lack of tautology
◈Echolalia / palilalia / delayed echolalia
◈Delayed processing
◈Meaning transferability
◈Expressive vs receptive skills
Non Verbal Communication
◈Prosody
◈Facial expression
◈Body posture
◈Inference
◈Contextual information
Social Skills
◈Recognising the ‘unwritten rules’
◈Assessing situations
◈Reacting appropriately to the PNT
social circumstance
◈Adapting social skills to the PNT
situation
Social Cues
◈Conversational turn taking
◈Following the leads of others
◈Understanding ‘friendships’
◈Group settings
◈Sharing
◈Participating in game scenarios
Theory of Mind
◈Alexithymia
◈Mentalising abilities
◈Empathy
◈Trust
◈Appearance of rudeness
Executive Functioning
◈Planning
◈Impulse control
◈Sequencing
◈Scripting
Central Coherence
◈
Identifying the pattern or
underlying rules
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Attention to detail
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Knowing what is relevant and
redundant
◈
Recognising the 'big picture'
OBSESSIONS
 Can be socially inappropriate
 Need boundaries around obsessive
behaviour
 Must recognise that obsessive
behaviours can
be used as coping mechanisms
 Obsessions may be misinterpreted
Sensory Differences
◈
Neuro-physiological differences in
filtering processes
◈
Can have major impact on behaviour
◈
Environmental aspects can influence
Global Reasons
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Resistance to Change
Environmental factors
Trust
Sense of self/diagnosis
Physical
Hypothesis - resistance to change
Individuals with Autism have
significantly lower ‘stability rates’ in
their day to day lives than the
neurotypical
This may lead, in part, to an explanation of
‘resistance to change’
Stability
Dependent on:
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Communication
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Understanding other people
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Social awareness
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Predictability
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Fulfilled expectations

Shared sensory environment
Autism and Resistance to Change
Neurotypical
24 Hour Period
2
Unstable
Stable
1
Bullying
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Individuals with Autism are highly
vulnerable:
– don't 'fit in'
– will not necessarily follow traditional social
convention (fashion, etc.)
– problems with adhering to social rules within
society (classroom, playtime, employment,
social arenas, etc.)
– communication problems
– poor PNT ToM
EDUCATION
PROBLEMS INCLUDE
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Cognition can hide core defects
Peer group
Lack of understanding from staff
Transference of problems (home to school/work/service and
vice-versa)
Academia takes preference over social and emotional
development. Can lead to...
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Isolation
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Poor self-esteem
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Poor motivation
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Depression
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Unrealised potential
Ethics, Morality, and
Normalisation
It is essential that individuals
with Autism are treated with
respect for their way of thinking
and behaving, and that ‘normal’
value bases are not enforced
upon them