To someone with autism spectrum disorder (ASD), an anxiety burst feels like an internal hurricane: overwhelming, devastating and intense. The only response is to batten down the hatches and shut down, or to let the hurricane out to express itself in a variety of challenging behaviors, including injury to self and others.
As we support individuals with ASD, we need to become aware the moment the wind starts shifting. When we do so, we can offer support at the earliest stages, and prompt recovery and self-regulation strategies that will often head off the storm entirely. Here are the 5 most important things to think about to ensure anxiety doesn’t overwhelm:
1. Personal Non-Reactivity
Anxiety bursts can be scary or involve behavior that makes you uncomfortable. If you are in a support role, it is imperative that you remain a calm, non-anxious presence. Become aware of what triggers you and practice your own self-regulation techniques to recover from fight/flight responses. Managing your own response and ensuring that you aren’t acting out of embarrassment, disgust or fear will keep a situation neutral and focused on the individual with ASD.
2. The Function of Anxiety
It is easy to focus on the behavior that results from anxiety rather than the function of it, but we need to keep our eyes on what the individual is trying to get or communicate. Look behind the behavior to find the trigger of the anxiety. Tend to the person’s physical and sensory needs if they are not feeling safe, offer emotional support and reassurance if they need to feel accepted, and help the person gain confidence in problem-solving, organizing or learning if they feel incompetent.
3. Building Capacity
We often work so hard to protect the people we support from being overwhelmed that we err on the side of asking too little of them. However, true support will focus on building capacity. This will help build cognitive self-regulation and increase their ability to handle anxiety without being overwhelmed by it.
Focus on teaching recovery strategies and self-awareness so the individual can learn to identify when things are getting to be too much and make choices about how to respond before they go into fight or flight. When you are teaching this, take micro steps – tiny little challenges – instead of big leaps, and offer concrete support.
4. Acting as a GPS
During an anxiety burst, there is simply too much information to process. The individual needs you to act as a sort of GPS system – calm, prompting the next action, re-calculating without judgment if you get off course.
Your role is to make the choice of what information is important in that moment, whether it is a verbal command – “Sit down” or “Take a deep breath”, a physical redirection to a place of safety or a visual schedule that shows the next step. Stay focused on what is relevant in that moment and what is most effective to help that person get what they need. Visuals and simple words are often more effective than “why” questions or any information that requires processing.
5. Planning for the Future
During an anxiety burst, you have to respond to the immediate need and help the person navigate their way through. However, during times of calm, it is important to teach physical, cognitive and emotional self-regulation skills so the individual has more tools to bring with them the next time they feel anxious.
Start by teaching a variety of breathing techniques. Deep pressure and body awareness help the individual explore their own body as a resource that can help them feel calm. Introduce the idea of emotions and what people need to help them process. Many of us have been taught that if we are feeling something slightly uncomfortable, we need a break. However there are many other ways of processing that might actually be more effective. Teach cognitive self-regulation strategies like task completion and planning.
These five ideas will help de-escalate an anxiety burst and help the individual experience fewer episodes in the long term. Instead of looking for the next hurricane, we can focus on learning, enjoyment and engagement.
For more information about supporting people with ASD to get through their anxiety, please register for the CTRI course Autism: Strategies for Self Regulation, Learning and Challenging Behaviours.