What Triggers Anxiety for an Individual with ASD?

Each day all of us are faced with situations or circumstances that can cause anxiety for us, sitting in a traffic jam, arriving late to a job interview, even something as silly as not understanding a joke that others find extremely funny.While those examples are not life threatening, for the individual experiencing each situation, their abilities to reason and see the whole picture can assist them to calm themselves, breathe and realize things do happen and life will go on. But, for someone with ASD, some commonplace situations can cause great anxiety.

Most people can experience frustration, stress, or anxiety in everyday life situations. There are people who learn how to cope so well that stress or anxiety has little impact on them. But for others, including individuals with ASD, stress and anxiety can cripple them to varying degrees. Remember, situations that create anxiety in one individual may not for another. What are some common stressors that individuals with ASD might experience? The following examples of common stressors at home and at school are suggested by Dr. Chuck Edington (2010) in his presentation, Emotional Regulation and Anxiety Management in Autism, and from the brochure, "Anxiety Disorders in Children" from the Anxiety Disorder Association of America (ADAA, partial listings):

Unstructured Time: Unstructured time that has no specific rules or activity which creates boundaries or limits can be very challenging. Examples of unstructured time are:

  • Waiting for and/or riding the school bus
  • Before and after school time
  • Transitions throughout the day (place to place, person to person, topic to topic)
  • Lunch/cafeteria
  • Recess
  • Physical education


Academic Situations:

  • Understanding what to do and how to do it
  • Breaking down tasks
  • Writing
  • Reading
  • Organization
  • Grades
  • Presentations in class
  • Answering aloud in class
  • Tests 

Sensory issues can be triggered almost any time or anywhere on a daily basis. Whether the individual is experiencing an anxious moment or not, sensory integration challenges can overpower a person’s ability to control him or herself. Sensory situations that may provoke anxiety can include:

  • Crowds - school assemblies, concerts, field trips, grocery store, etc.
  • Space - too large, too crowded, too bright, too loud, too smelly, etc.
  • Sounds/noise
  • Natural disasters
  • Smells - cafeteria, restrooms, cleaning materials, markers, paints, colognes,
  • Food - sight, texture, taste, smell, sound when eating
  • Haircuts
  • Dental or medical issues
  • Showers, bathing (some individuals have shared that showers ‘hurt’ their bodies)
  • Clothing - too tight, scratchy
  • Brushing teeth 

Social situations are already challenging for individuals with ASD and can increase anxiety in the moment or even in anticipation of an upcoming event. Some examples include:

  • Novel events - unplanned and unannounced
  • Changes in plans - daily school routine interrupted or family plans changed
  • Adjusting personal interests with class or family plans
  • Outdoor activities - concerts, picnics, recess
  • Large gatherings - school assemblies, family gatherings
  • Young children (who are unpredictable in many ways)
  • Initiating a conversation with a peer 

Routines: After a day at school where the child was able to maintain body control, listen, complete activities, and appear composed, going home and having even more expectations including typical routines, can increase anxiety and agitation. Routines such as:

  • Doing homework
  • Chores
  • Meal, bath, bed time routines
  • Getting ready for school 

For all of us, there are many other seemingly harmless and safe situations that occur in daily living, but to an individual with ASD, that same situation could be totally frightening and create great anxiety or panic.

Educator Dave Nelson (Nelson, 2008) director of The Community School in Decatur, Georgia, a junior high and high school for adolescents with autism, said,

"Every single one of my students has anxiety almost every day. What is so interesting, however, is how different the manifestations of that condition can be. Some students begin asking constant questions; some interrupt constantly; some retreat or run away; and some get rude or provoking. Everyone (adults included) has their own special way of showing when they're anxious, from biting fingernails to getting headaches to talking a lot."

Louise Page (2009), an autism therapist and mother of an individual with an autism spectrum disorder adds:

"You may observe them, for example, looking down at their feet, or wringing their hands or their hands may be set flat against their thighs, looking fearful or frozen to the spot, or outwardly distressed (e.g. behaviour outburst) and so on. Also, their fight or flight response may be exaggerated and efforts to return their state to a relative calm may be very difficult."

Other indicators of a person experiencing anxiety an include, when the individual feels incredibly self-conscious and overloaded and "speaks" through "characters" or phrases from TV shows; jingles; objects; as another person, or retreats to a corner, drawing up the knees to their chest; mumbling; etc. Each person's response to anxiety can be as individual as they are. "What makes the experience of helping students with their anxiety so interesting and challenging is that many times, they don't even know how they're feeling, so they have no foundation for trying to manage the feeling (Page, 2009)".

Thank you to the Indiana Resource Center For Autism for their kind permission to use this article.

What Triggers Anxiety for an Individual with ASD: Articles: Indiana Resource Center for Autism: Indiana University Bloomington

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