Anxiety in children with an Autism Spectrum Disorder (ASD) or Sensory Processing Disorder (SPD)

Anxiety is a very real thing for children on the autistic spectrum.

Imagine popping out to the shops for ten minutes and then coming home.

When you walk in the door everything is different, the sofa has moved, the TV is gone. The carpet has changed colour and it doesn’t look like your house. You turn around and you are somewhere you don’t recognise.

How does this make you feel? Its confusing right? It doesn’t make sense? Maybe you are worried someone has been in your house? Maybe you feel anxious that everything has changed?

An autistic child’s world just doesn’t make sense unless everything is in the right place. My house example was a bit extreme but that is how even small changes can feel to children with autism.

Imagine you have a presentation to do at work and you’re nervous about it.

On the way you get stuck in a traffic jam and you might be late. You’ve needed to use the toilet all morning  and you wanted to read through your notes before the interview but now you aren’t going to have time. You’ll just have to wait to use the toilet and try to remember the notes you were relying on knowing.

You walk into the room and your boss’ boss is there to watch. You realise you forgot your laptop.

Your anxiety has been building all morning but this is the point where you really start to panic. Your heart is racing, your muscles tense, you start to sweat  and your stomach starts to hurt!

These are the sorts of feelings that children with autism can get on a daily basis.

Anxieties build up throughout the day until one small thing might be the last straw. Looking at the child we might think everything is fine meaning we don’t always understand why they have overreacted to someone walking past them, dropping their pen or realising there is no drink where they thought it was. The anxiety however, might have been building since they woke up that morning.

An autistic child probably won’t be able to tell you they are feeling anxious either. They may not recognise the build up of anxiety in themselves and communicating feelings you don’t understand yourself is impossible.

Intense anxiety can manifest in different ways. A child may meltdown or shutdown. They may feel ill. Their behaviour might change. Anxiety can also result in repetitive behaviors.

There are common themes that make most children with autism anxious such as changes to their environment or routine, unexpected situations or situations where they are experiencing sensory overload.

However, every child with autism is different and presents differently so the causes of one child’s anxieties may be different to another child’s. We have to get to know each child and what makes them anxious in order to help them.

Some of the more common reasons that children with autism become anxious are explained here:


Most autistic children need routine in order for them to make sense of the world. If everything happens when it should and where is should anxiety can be dramatically reduced. They need to know what is happening and when, so anything unexpected can cause a lot of anxiety.

Sensory processing

If your child struggles with sensory processing disorder then situations where they have too much or too little sensory input may cause them to be overwhelmed and anxious. Children will also attach anxieties to past experiences so if, for instance, the school dining room was too noisy and hurt their ears last week then they might be anxious about going into the dining room in the future.

Social anxiety

Children with autism can struggle with interacting with others and communicating. They don’t always understand social situations and this can cause lots of anxiety. Children can become anxious about being in these situations as well as suffering from anxiety caused by misinterpreting situations. Children worry that they will get social situations wrong and they may feel very self conscious.

There are many other causes of anxiety in children with autism and each child is different.

Tips to help minimise anxiety for children with autism:

Get to know the child. Knowing their sensory triggers and the things that make them anxious is a great starting point. From here you can start to address the issues to minimise the anxiety.

Try having a timetable or daily routine with pictures to help your child know what is happening each day and when.

Give children plenty of warning if anything is going to change or if you need to do anything out of the ordinary so they can get used to the idea before it happens.

If your child responds well to social stories, you can use them to explain new situations before they happen. Some children like to see pictures of where they will be going.

Try working out what their sensory triggers are and putting things in place to limit problems. This article  on Sensory Processing Disorder explains this in more detail.

You may need to support your child by supervising social situations even from a distance so as to explain things if necessary.

Storyboards or comic book strips about social interactions and what to say and do in certain circumstances can also be useful.  

Try to provide an escape – a safe and quiet space they can escape to if social pressure gets too much can help ease the anxiety as they know they can get away if they need to.

Structured social times rather than unstructured times might help too so taking your child to more structured clubs with a small group of children rather than playgrounds full of children could be a good idea.

If school has a social skills group this can also be a useful group for your child to attend. The school SENDCO will have information about this.

This list is in no way exhaustive and just offers some practical tips. If your child’s anxieties are severe it is a good idea to talk to a health professional who may refer your child for more help in dealing with their anxiety.

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