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Anxiety
Anxiety.   In my experience, its the leading cause of 'problem behaviour' in children with autism.   If there's no obvious reason for a behaviour, I usually assume anxiety until proven otherwise.   The trick then is to find the cause of the anxiety, not always easy when you're looking at someone who has difficulty with communicating and trouble understanding emotions!

There are many sources of anxiety associated with autism, we've looked at several already.   Not knowing where you are in time, fearing social situations, being scared of the unknown, worrying about painful sensory stimuli, when you think about it, all these things cause us anxiety too!

When I'm doing my autism talk, I do a little exercise to help people understand how it feels to experience anxiety.   We've talked about people with autism having difficulties with generalising and understanding social 'rules'.   I've tried to come up with a scenario where you would experience the same difficulties, so you can think about how you would feel and what would help you in that situation.   I call it the marketplace scenario.
 
Marketplace Scenario
Imagine you have decided, for some crazy reason, to go on a coach tour of Afghanistan.   It's you, a tour guide, a bus driver and a bunch of other tourists on a coach, driving round and seeing the sights.   You're in Kabul, and you're visiting a busy local market.   You're wandering around, and suddenly you find you're separated from your tour group.

You don't know the way back to your hotel or coach, no one speaks English, the signs are all in a script you cannot read, the sights, sounds and smells are all alien to you, how would you feel?
Market Collage
I know that is this situation I would be feeling very unsafe and anxious.   My heart would be racing, I would have sweaty hands and armpits, I'd probably look pale, I wouldn't be able to think clearly, but I would not feel safe enough to display any of my anxiety.   That would draw unwelcome attention to me.

PickpocketI'm aware that the locals have specific customs and social rules, I've read and been told about these, but don't fully understand them and haven't had a chance to practice them.   I'd be worried about people's reactions should I get anything wrong.

I've also seen on the news about kidnappings, pickpockets, con artists, but how can I tell who is a nice person and who isn't?   It's not like they're wearing helpful badges to help me identify who is who or anything.

The busy, noisy, colourful environment would confuse my senses, its all stuff I'm not used to so my poor brain is working overtime trying to process it all, assessing what is a threat and what can safely be ignored.   There are traders shouting in a language I don't understand, people are haggling (or are they arguing?   What's the difference?   The voices and gestures are so similar!), trucks and vans are tooting their horns and weaving in and out of the crowds, the smell from their exhausts mix with the smells of the spices and other wares on sale.   Sensory overload!

Have a think about how you would feel in this situation.   It's probably how you child feels when they're in a supermarket or leisure centre they haven't been in before.   It's how they feel when they move class or school, or start at a new club.   And its not that surprising.

Going back to the scenario, you somehow find your way back to your tour group, and guess what?   They didn't even notice you were missing!   How would you feel towards your tour guide?   Angry?   Would you 'have a go'?   He was supposed to look after you, to keep you safe.   Not only did he fail, he didn't even notice he'd failed!

So, what could he have done to help?   He could have given you a map, swapped mobile numbers with you, pointed out a landmark or two, put you into groups, made sure you knew a few local customs.   All of these things would have helped.

Tour GuideYou are your child's tour guide.   You are there to look out for them in the crazy, confusing, overloading journey we call a day.   You make sure they don't get lost, bail them out of sticky situations, interact with people on their behalf, and make sure they don't get things wrong.

When we were thinking about being in the marketplace, I said I wouldn't feel safe enough to display my anxiety while still lost, but would have a go at the tour guide when I got back to the safety of the tour group.   Has your child ever 'had a good day' at school, 'had a good stay' at respite or 'been fine' at an after school or holiday club, then had a meltdown as soon as they get home or into your car?

Lets think a little about the things that would have helped you in the marketplace.   First the map.   A social story is a map through a social situation, it has routes, customs and landmarks (places or times), and should always bring you back to a safe point, like home or a situation resolved.

What about the mobile number swapping?   Sometimes we need to give children with autism the tools to communicate their anxiety, this may be a simple as identifying a person to tell, or maybe a card or symbol to give to someone.   We may need to train people to recognise the early warning signs and intervene accordingly.

And the groups, ever heard of buddying schemes or keyworkers?

Another important point I can make here is trust.   You need to trust your tour guide in order to feel safe.   If he says one thing and does another, or changes his mind as to what the customs and rules are, you don't trust him and don't have confidence in his ability to keep you safe.   Even if you don't like what he's telling you, if the information is consistent you can trust it to be true.   It only takes one little inconsistency to undo trust built up over a period of time.

And how about if you have two tour guides who say different things, how do you know which one is right?   Would that worry you?

Hopefully I've given you a little flavour of anxiety, sorry it wasn't very pleasant!   You may have come up with things that would have helped you that I haven't mentioned here, can you turn it into something that could help your child?   If your child struggles in certain situations, try and find a similar situation in which you would struggle, and think about what would help you.