The renowned autism expert Tony Atwood is fond of putting it this way: “Autism is anxiety looking for a target.” Autism and anxiety go hand-in-hand. Autism affects a person’s ability to communicate with others or to understand the world around him, and that’s bound to cause anxiety and panic sometimes.
Anxiety becomes even worse when there is a change in the autistic child’s routine. Even positive and “fun” changes, like a school field trip or a visit to the zoo, can increase anxiety and aggressive behaviors.
For parents, the best course of action is to anticipate upcoming changes and help your child prepare for them. Many parents find it helpful to use stories and pictures to prepare children for impending disruptions. If it’s a field trip to the zoo, for example, use pictures to show your child what he’ll see at the zoo, what the zoo will be like, and what sort of things to expect. Do this each day for three or four days prior to the trip. That way, when the trip actually happens, the child won’t be entirely out of his element, but will already understand and appreciate some of what will be happening.
Other changes in the routine are less enjoyable but still necessary. Getting a new teacher can be traumatic, as can moving to a new house. If at all possible, try to spread out the major changes. If you move to a new house, try to do it during the summer, so that your child won’t have to deal with the added anxiety of getting a new school and new teacher mid-year.
You can also introduce your child to the concept of “change” in a positive way by practicing with non-negative things. For example, just for practice, give him a little extra TV time instead of homework time one night, to show that changes in the routine can often be fun and good. Then practice with a neutral change (homework after dinner instead of before dinner), then with a negative one (changing play time into chore time). This process can help your child grow accustomed to the idea of change and learn to adapt without becoming anxious.
For continual, ongoing anxiety, many parents have begun using anti-anxiety medications for their autistic children. Usually, the medications are selective serotonin reuptake inhibitors (SSRIs), and are also used for obsessive-compulsive disorder and depression. Prozac, Luvox, Zoloft and Anafranil are all common for anxiety in autistic children.
For behavioral problems, antipsychotics such as Haldol, fluphenazine and chlorpromazine can be prescribed. These can reduce aggression in autistic kids, but sometimes also cause sedation and muscle stiffness.
All patients are different. You and your doctor should monitor your child’s progress very closely, using the lowest dose of medication possible, to see if what improvements it makes and whether there are any adverse reactions. Medication should be the last resort for autism, not the first one. There are a number of natural remedies available if you don’t want to go down the drug route. But try behavioral and dietary modifications first, to see what improvements can be made naturally.