Thanks for reading our newsletter! This month, we look at anxiety among people with autism, and share some resources to help reduce anxiety.
Announcements:
New Token Economy! Check out Positively Autism's motivating token economy system with a dinosaur theme: http://www.teacherspayteachers.com/Product/Dinosaur-Token-Economy-1185770
Articles and Information:
Positively Autism March Topic: Autism and Anxiety - http://positively-autism.blogspot.com/2014/03/positively-autism-march-topic-autism.html
Prevalence and Types of Anxiety in People with Autism - http://positively-autism.blogspot.com/2014/03/prevalence-and-types-of-anxiety-in.html
The Sensory System and Anxiety - http://positively-autism.blogspot.com/2014/03/the-sensory-system-and-anxiety.html
"Challenging Behaviors in Children with ASD" Video - http://positively-autism.blogspot.com/2014/03/challenging-behaviors-in-children-with.html
The Relationship Between Social Experiences and Anxiety - http://positively-autism.blogspot.com/2014/03/the-relationship-between-social.html
Anxiety Q and A's from Autism Speaks - http://positively-autism.blogspot.com/2014/03/anxiety-q-and-as-from-autism-speaks.html
Cognitive Behavior Therapy for Anxiety - http://positively-autism.blogspot.com/2014/03/cognitive-behavior-therapy-for-anxiety.html
New Free Downloads:
Morning and Evening Routine Picture Cards - http://positively-autism.blogspot.com/2014/03/morning-and-evening-routine-picture.html
“Ouch” Cards: Teach a Child To Tell You Where They Feel Pain - http://positively-autism.blogspot.com/2014/03/ouch-cards-teach-child-to-tell-you.html
News:
March 2014 Positive Autism News Stories - http://positively-autism.blogspot.com/2014/03/march-2014-positive-autism-news-stories.html
Monday, March 31, 2014
Thursday, March 27, 2014
March 2014 Positive Autism News Stories
Artist with autism leads a colorful life: Joel Anderson paints, creates video, writes music, poetry and books and does public speaking
March 26, 2014
http://www.utsandiego.com/news/2014/mar/26/joel-anderson-artist-with-autism/
I only found one that met my criteria this month! I look for articles that portray the accomplishments, talents, and positive characteristics of people with autism. If you have an article link to contribute, please e-mail Nicole@positivelyautism.com . Thanks!
March 26, 2014
http://www.utsandiego.com/news/2014/mar/26/joel-anderson-artist-with-autism/
I only found one that met my criteria this month! I look for articles that portray the accomplishments, talents, and positive characteristics of people with autism. If you have an article link to contribute, please e-mail Nicole@positivelyautism.com . Thanks!
Wednesday, March 26, 2014
Tuesday, March 25, 2014
Morning and Evening Routine Picture Cards
New freebies from Positively Autism this month include sets of morning and bedtime routine picture cards. These cards can be used to make picture schedules of these routines to make the transitions easier.
Monday, March 24, 2014
Cognitive Behavior Therapy for Anxiety
Note: if you prefer to listen to this article, a audio/video link is at the bottom of this page.
One possible treatment option for anxiety among people with autism is Cognitive Behavior Therapy, or CBT. CBT was initially developed to treat depression in the general population, but is now being used to address additional needs. CBT focuses on changing negative and anxiety-producing thoughts and beliefs. CBT clients are taught to examine their emotions and thoughts, and recognize when negative emotions and thoughts are becoming more intense. They are also taught strategies to change their thinking, the premise being that this change in thought patterns can change the person's their behavior. CBT can be accompanied by other interventions including positive reinforcement and social stories.
While there are various components of CBT, many programs include the following. Initially, the client may be assured that they are not to blame for their anxiety. Once this is established, the therapist and client come to a consensus about how the anxiety is causing problems for the client (such as social anxiety preventing a person from attending events of interest). This can provide a rationale and motivation for the CBT program.
The client and therapist work together to create a list of situations that produce anxiety for the client. This list is ordered from most to least anxiety-producing. The client is taught coping methods (such as relaxation techniques and logical, more positive thinking patterns about the anxiety-producing situations). At the same time, the client is gradually exposed to the anxiety producing situations, staring with the least anxiety-producing.
CBT may be somewhat more challenging for a person with autism due to difficulty identifying feelings and thought patterns. This may be challenging for the general population as well, but it may be more so for a person with autism. Some methods for making CBT more autism-friendly might include using visual aides, explaining complex social issues using social stories, allowing the person with autism to type their responses to therapist questions (or using online chat to ask questions), and incorporating the client's special interests into therapy sessions. More explanation and application of CBT for individuals with autism can be found in these resources from Tony Attwood:
According to the Autism Evidence-Based Practice Review Group at the Frank Porter Graham Child Development Institute at University of North Carolina at Chapel Hill, CBT meets the criteria as an evidence-based intervention. According to the research they evaluated, CBT has been effective for both elementary school and high school-age children with autism. They also report that CBT can be used to address communication, behavior, social, cognitive, adaptive, and mental health outcomes.
If you are interested in finding a cognitive behavior therapist, here are some tips: http://abct.org/docs/Members/FactSheets/Guidelines_for_Choosing_Cognitive.pdf
References:
"Treatment of Anxiety in Autism Spectrum Disorders Using Cognitive Behaviour Therapy: A Systematic Review" by Russell Lang, April Regester, Stacy Lauderdale, Kristen Ashbaugh, and Anna Haring. Developmental Neurorehabilitation, February 2010, Volume 13, Issue 1.
"Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder" by Connie Wong, Samuel L. Odom, Kara Hume, Ann W. Cox, Angel Fettig, Suzanne Kucharczyk, Matthew E. Brock, Joshua B. Plavnick, Veronica P. Fleury, and Tia R. Schultz http://autismpdc.fpg.unc.edu/sites/autismpdc.fpg.unc.edu/files/2014_EBP_Report.pdf
One possible treatment option for anxiety among people with autism is Cognitive Behavior Therapy, or CBT. CBT was initially developed to treat depression in the general population, but is now being used to address additional needs. CBT focuses on changing negative and anxiety-producing thoughts and beliefs. CBT clients are taught to examine their emotions and thoughts, and recognize when negative emotions and thoughts are becoming more intense. They are also taught strategies to change their thinking, the premise being that this change in thought patterns can change the person's their behavior. CBT can be accompanied by other interventions including positive reinforcement and social stories.
While there are various components of CBT, many programs include the following. Initially, the client may be assured that they are not to blame for their anxiety. Once this is established, the therapist and client come to a consensus about how the anxiety is causing problems for the client (such as social anxiety preventing a person from attending events of interest). This can provide a rationale and motivation for the CBT program.
The client and therapist work together to create a list of situations that produce anxiety for the client. This list is ordered from most to least anxiety-producing. The client is taught coping methods (such as relaxation techniques and logical, more positive thinking patterns about the anxiety-producing situations). At the same time, the client is gradually exposed to the anxiety producing situations, staring with the least anxiety-producing.
CBT may be somewhat more challenging for a person with autism due to difficulty identifying feelings and thought patterns. This may be challenging for the general population as well, but it may be more so for a person with autism. Some methods for making CBT more autism-friendly might include using visual aides, explaining complex social issues using social stories, allowing the person with autism to type their responses to therapist questions (or using online chat to ask questions), and incorporating the client's special interests into therapy sessions. More explanation and application of CBT for individuals with autism can be found in these resources from Tony Attwood:
If you are interested in finding a cognitive behavior therapist, here are some tips: http://abct.org/docs/Members/FactSheets/Guidelines_for_Choosing_Cognitive.pdf
References:
"Treatment of Anxiety in Autism Spectrum Disorders Using Cognitive Behaviour Therapy: A Systematic Review" by Russell Lang, April Regester, Stacy Lauderdale, Kristen Ashbaugh, and Anna Haring. Developmental Neurorehabilitation, February 2010, Volume 13, Issue 1.
"Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder" by Connie Wong, Samuel L. Odom, Kara Hume, Ann W. Cox, Angel Fettig, Suzanne Kucharczyk, Matthew E. Brock, Joshua B. Plavnick, Veronica P. Fleury, and Tia R. Schultz http://autismpdc.fpg.unc.edu/sites/autismpdc.fpg.unc.edu/files/2014_EBP_Report.pdf
Audio recording of this article:
Monday, March 17, 2014
Anxiety Q and A's from Autism Speaks
Question: What behavioral therapies can help someone with autism and severe anxiety? Answered by Jeffrey Wood, PhD, a psychologist at the University of California, Los Angeles.
http://blog.autismspeaks.org/2012/02/24/what-behavioral-therapies-can-help-someone-with-autism-and-severe-anxiety/
Question: My eight-year-old with autism rips his clothes when he gets nervous at school. How can I manage my son’s anxiety? Answered by Jeffrey Wood, PhD, a psychologist at the University of California, Los Angeles.
http://www.autismspeaks.org/blog/2012/11/16/managing-anxiety-children-autism
Question: How common are anxiety disorders in people with autism, and are there effective treatments? Answered by Rob Ring, PhD, Autism Speaks vice president of translational research.
http://blog.autismspeaks.org/2012/01/06/how-common-are-anxiety-disorders-in-people-with-autism-and-are-there-effective-treatments/
http://blog.autismspeaks.org/2012/02/24/what-behavioral-therapies-can-help-someone-with-autism-and-severe-anxiety/
Question: My eight-year-old with autism rips his clothes when he gets nervous at school. How can I manage my son’s anxiety? Answered by Jeffrey Wood, PhD, a psychologist at the University of California, Los Angeles.
http://www.autismspeaks.org/blog/2012/11/16/managing-anxiety-children-autism
Question: How common are anxiety disorders in people with autism, and are there effective treatments? Answered by Rob Ring, PhD, Autism Speaks vice president of translational research.
http://blog.autismspeaks.org/2012/01/06/how-common-are-anxiety-disorders-in-people-with-autism-and-are-there-effective-treatments/
Friday, March 14, 2014
The Relationship Between Social Experiences and Anxiety
By PositivelyAutism.com
As we've discussed in a previous post, the causes of anxiety in individuals with autism are currently unclear. Sensory hypersensitivity may be a contributing factor to anxiety development. Additionally, some theories suggest that difficulty with social situations may also play a role. This anxiety may interfere with the ability to form meaningful personal relationships, and also may contribute to isolation, depression, and substance abuse.
Social anxiety is characterized by a strong fear of social situations and/or performance situations (such as public speaking) where embarrassment may take place. Of course, plenty of people without autism may experience anxiety in such situations. People with anxiety severe enough to disrupt daily living may experience anxiety about only performance situations, but it is more problematic when an individual experiences both types of social anxiety. This is associated with a higher level of impairment, a longer duration of symptoms, and higher co-occurrence of other conditions, such as depression. Additionally, anxiety and worry can also hinder social performance because of the anxiety, creating a self-fulfilling prophecy. Among people with autism specifically, social avoidance and increased levels of repetitive behavior may also stem from social anxiety.
Social anxiety can result from negative experiences in social situations, such as confusion and unpredictability. Difficulties in social skills are one of the contributing factors, but peers may also play a role. When an individual experiences peer rejection and victimization, it may increase social anxiety. When individuals with autism are aware of their social differences, it may also lead to higher levels of anxiety.
Interventions for Social Anxiety
When working with children and adolescents with autism and social anxiety, one option is social skills instruction. Helping children understand the emotions and thoughts of others, as well as what is expected in various social situation can help make social experiences more predictable and less confusing. Social stories are a great tool for helping to explain social situations to people with autism.
However, social skills instruction should not be limited to the child or adolescent with autism. Autism awareness programs to educate peers without disabilities should also be considered. It is important for peers have a better understanding of their classmate with autism, as well as positive ways to interact with him/her. This may decrease peer rejection and victimization, reducing negative social experiences for the person with autism. Anti-bullying initiatives may fall into this category as well.
Another strategy is to help the person with autism learn strategies for relaxation and self-regulation. Check Positively Autism's upcoming blog posts for more information on these types of strategies. As a side note to this idea, many individuals with autism say that their "stimming" behavior, such as rocking and hand-flapping, help serve a self-regulatory and calming function. It may be beneficial to allow children and adolescents to use stimming as a "tool" to calm down when anxious. However, we must also realize that this is a coping response that does not address the root cause of the anxiety or stress. Digging a bit deeper to teach the child to deal directly with the cause of the stressful situation may also be warranted.
All of the above issues should be discussed with your or your child's doctor, but particularly our next option. It is also possible that some medications, specifically SSRIs, may decrease anxiety in children with autism. Talk with your doctor before making any decision about whether medication is right for your child or yourself. Autism Speaks offers a free medication decision guide that you can use in conjunction with speaking with your doctor. http://www.autismspeaks.org/science/resources-programs/autism-treatment-network/tools-you-can-use/medication-guide
References:
"The Development of Social Anxiety in Adolescents with Autism Spectrum Disorders" by Scott Bellini. Focus on Autism and Other Developmental Disabilities. Volume 21, Number 3, Fall 2006.
"Anxiety Disorders and Sensory Over-Responsivity in Children with Autism Spectrum Disorders: Is There a Causal Relationship?" by Shulamite A. Green and Ayelet Ben-Sasson. Journal of Autism and Developmental Disorders. Volume 40, 2010.
"Exploring the Nature and Function of Anxiety in Youth with Autism Spectrum Disorders" by Jeffrey J. Wood and Kenneth D. Gadow. Clinical Psychology: Science and Practice. Volume 17, Issue 4, December 2010.
As we've discussed in a previous post, the causes of anxiety in individuals with autism are currently unclear. Sensory hypersensitivity may be a contributing factor to anxiety development. Additionally, some theories suggest that difficulty with social situations may also play a role. This anxiety may interfere with the ability to form meaningful personal relationships, and also may contribute to isolation, depression, and substance abuse.
Social anxiety is characterized by a strong fear of social situations and/or performance situations (such as public speaking) where embarrassment may take place. Of course, plenty of people without autism may experience anxiety in such situations. People with anxiety severe enough to disrupt daily living may experience anxiety about only performance situations, but it is more problematic when an individual experiences both types of social anxiety. This is associated with a higher level of impairment, a longer duration of symptoms, and higher co-occurrence of other conditions, such as depression. Additionally, anxiety and worry can also hinder social performance because of the anxiety, creating a self-fulfilling prophecy. Among people with autism specifically, social avoidance and increased levels of repetitive behavior may also stem from social anxiety.
Social anxiety can result from negative experiences in social situations, such as confusion and unpredictability. Difficulties in social skills are one of the contributing factors, but peers may also play a role. When an individual experiences peer rejection and victimization, it may increase social anxiety. When individuals with autism are aware of their social differences, it may also lead to higher levels of anxiety.
Interventions for Social Anxiety
When working with children and adolescents with autism and social anxiety, one option is social skills instruction. Helping children understand the emotions and thoughts of others, as well as what is expected in various social situation can help make social experiences more predictable and less confusing. Social stories are a great tool for helping to explain social situations to people with autism.
However, social skills instruction should not be limited to the child or adolescent with autism. Autism awareness programs to educate peers without disabilities should also be considered. It is important for peers have a better understanding of their classmate with autism, as well as positive ways to interact with him/her. This may decrease peer rejection and victimization, reducing negative social experiences for the person with autism. Anti-bullying initiatives may fall into this category as well.
Another strategy is to help the person with autism learn strategies for relaxation and self-regulation. Check Positively Autism's upcoming blog posts for more information on these types of strategies. As a side note to this idea, many individuals with autism say that their "stimming" behavior, such as rocking and hand-flapping, help serve a self-regulatory and calming function. It may be beneficial to allow children and adolescents to use stimming as a "tool" to calm down when anxious. However, we must also realize that this is a coping response that does not address the root cause of the anxiety or stress. Digging a bit deeper to teach the child to deal directly with the cause of the stressful situation may also be warranted.
All of the above issues should be discussed with your or your child's doctor, but particularly our next option. It is also possible that some medications, specifically SSRIs, may decrease anxiety in children with autism. Talk with your doctor before making any decision about whether medication is right for your child or yourself. Autism Speaks offers a free medication decision guide that you can use in conjunction with speaking with your doctor. http://www.autismspeaks.org/science/resources-programs/autism-treatment-network/tools-you-can-use/medication-guide
References:
"The Development of Social Anxiety in Adolescents with Autism Spectrum Disorders" by Scott Bellini. Focus on Autism and Other Developmental Disabilities. Volume 21, Number 3, Fall 2006.
"Anxiety Disorders and Sensory Over-Responsivity in Children with Autism Spectrum Disorders: Is There a Causal Relationship?" by Shulamite A. Green and Ayelet Ben-Sasson. Journal of Autism and Developmental Disorders. Volume 40, 2010.
"Exploring the Nature and Function of Anxiety in Youth with Autism Spectrum Disorders" by Jeffrey J. Wood and Kenneth D. Gadow. Clinical Psychology: Science and Practice. Volume 17, Issue 4, December 2010.
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