Autism and Anxiety Parents Talking Asperger s An Asperger s Poem an interpretation by a parent Words, too many words bombard my fragile senses Hands over ears before they shatter my defenses Expressions on a mobile face impossible to fathom Distorted image in my mind, a hole, a gaping chasm Who is that I see when I catch my own reflection? A stranger stands before me, not worthy of inspection Plagued with insecurities and lacking self-esteem Tantrums aimed at those that care, interpreted as mean The only way, that I can hear, a word of what you say Is to take my eyes away from you and look the other way If you should think, I drift away, I m focusing my mind On something far more interesting, to you it seems unkind I am immune to subtle nuances in social conversation You see, I lack the skills required which causes agitation I crave predictability and change is hard to gauge To alter one of my routines will cause a bout of rage I cannot be the way you want, I wasn t born that way The world, for me, an alien place, I struggle every day The noise, the light, the frantic pace, I try to understand Confusion all around me I need to hold your hand I ll let off steam and shout at you when I have had enough Be my guide and teach me how to cope when life gets tough Don t try to change the way I think, or what I choose to do I live in this world upon my terms but still depend on you.. By SusanWithey (Mother of a 13 year old boy with Asperger s Syndrome) 1
What is Anxiety? It is fear in the absence of real danger that we call anxiety (Manassis, 1995) Please be respectful and try to work with the fear/ anxiety Anxiety? Subjective state based on personal reports of anxiety producing experiences Involves arousal of the central nervous system May lead to avoidance of anxiety producing agents Eg- smell of the swimming pool Negative stimuli beware spiders 2
Fears & Anxieties WHAT DO YOU FEAR? Spiders? Flying? Heights? Snakes? Traveling? HAVEYOU EVER FEARED.? The Colour Orange? Fire Extinguishers? British People? Cameras? Conversation? We need to be respectful and understand the best we can I can t fully understand the fear of travelling, for example. changes in routine poor concept of time does not know / understand rules unsure what is going to happen STRESS anxious about failure difficulties with communication literal interpretation of situation sensory difficulties 3
Anxiety a big deal for people with autism? It goes with the territory! John Clements 2010 THE ISSUE People on the AS face multiple threats to their sense of well being sustaining a sense of wellbeing is a big challenge for many Lack/ loss of wellbeing plays a key role in many of the most serious behavioural challenges that we face John Clements 2010 4
AUTISM AND WELLBEING John Clements Intrinsic vulnerabilities Social isolation Depression link Health problems Sensory difficulties Difficulty with future oriented thinking Limited access to laughter Emotional dysregulation Vulnerability to expressed emotion and emotional atmosphere It is important to understand that anxiety is virtually part and parcel of having autism. Tony Atwood, Ph.D., an internationally renowned expert, is fond of saying Autism is anxiety looking for a target. 5
Anxiety and Stress ANXIETY BEHAVIOUR PUNISHMENT (or inappropriate response) Anxiety is the enemy of Wellbeing and the catalyst for poor behaviour. (Gareth Lewis 2008) 6
HOW LACK OF WELLBEING IS EXPRESSED/ IMPACTS BEHAVIOUR Lack of enjoyment Changes in eating/ drinking/sleeping habits Feeling got at Irritability and emotionality free floating anxiety/ anger Reduced tolerance of demands/ intrusions Enhanced reaction to sensory discomforts Increased compulsive rituals and resistance to interruption Tyrannical control Classic depression Time perspectives include difficult moments, cyclical state changes and serious breakdown THE GOALS OF A WELLBEING PRACTICE To give people enhanced access to states of comfort To enable people to feel strong, secure and valued 7
Anxiety Issues: Anxiety Level Assessment Clearly define levels of anxiety For each time period, environment, activity rate the level of anxiety Look for patterns in time, activity, environment How do I feel? 5 LOST IT! I need you to help me now. 4 I am angry. I want to shout or scream, to make a noise. 4 Leave what you are doing: listen to some music. Tell an adult what is wrong 3 I am starting to feel cross I don t like what is happening. 2 I feel a bit upset and sad. I am unsure what to do - puzzled 3 Walk away. Find an adult to talk to. Do something you know helps you feel better. Tell someone how you feel. 2 Take time to calm a little read a book, ask for help, think about something you like 1 I feel calm. Everything is ok. 1 Keep doing what you are doing 8
The Anxiety Ladder Get out of the situation, I need to leave now I am about to lose it! LOST IT! It s too late you now need to make sure I m safe! I m About to Lose It! If you don t help now I ve lost it! Ask for help. Leave the situation. Remember your breathing ideas. Remember what kept me calm. I can ask for help, I m puzzled can you help? What is keeping me calm? I like it here. This is where I want to stay Getting a Little Mad I m getting quite stressed! Help Me Now! A Little Puzzled I m climbing the ladder! I need a little help! Calm Bottom of the Ladder Kari Dunn Buron & Mitzi Beth Curtis 2003 5 point scale 9
What Does it Look or Feel Like? The Incredible 5-Point Scale Baron, Curtis (2003) Example. The Incredible 5- Point Scale Baron, Curtis (2003) 10
Can they draw out how they feel at the different times? Sometimes just being able to use a median to get their feeling across can help for example; ranking lessons or times 5 to 1 of stress levels The Incredible 5-Point Scale Baron, Curtis (2003) Feel-o-Meter (Tony Attwood, 2001) 11
Visual Imagery What image relaxes you? Relaxation Resources 1978 Joseph R. Cautela & June Groden www.grodencenter.org 1998 Brian Doan Or any favoured piece of relaxing music 12
With thanks To: Kevin Baskerville (KB Autism) and John Clements. 13