Anxiety and Autism
One of the greatest barriers to communicating and learning—for all of us—is anxiety. Anxiety is a state of apprehension, uncertainty, and fear resulting from the anticipation of a realistic or fantasized threatening event or situation, often impairing physical and psychological functioning. Individuals with too much anxiety simply cannot afford to stay engaged and interactive, which means they cannot move up the developmental ladder in any consistent way—in short, they cannot learn. This definition captures the experience of my son Graham, who was diagnosed with autism at three. It also fits many of my students at The Community School in Decatur, Georgia.
The Community School works with a small group of teenagers, all on the autistic spectrum. On a daily basis, I see my students struggle with anxiety. As an example, I remember an encounter with a student at 10:03 a.m. one day, when I told him it was time to go to class. He said, “Where is everyone?” I said I thought they had already gone down to the classroom. “This school is so disorganized!” he says. “What do you mean?” I ask. “Nobody told me that class had started.”
To me, this student has had a moment of anxiety, but it’s more than just a momentary feeling because this kind of reaction is always close to the surface for him. In other words, any of a number of events could trigger this kind of reaction. I don’t mean to single this student out. Every single one of my students has anxiety almost every day. What is so interesting, however, is how different the manifestations of that condition can be. Some students begin asking constant questions; some interrupt constantly; some retreat or run away; and some get rude or provoking. Everyone (adults included) has their own special way of showing when they’re anxious, from biting fingernails to getting headaches to talking a lot. What makes the experience of helping students with their anxiety so interesting and challenging is that many times, they don’t even know how they’re feeling, so they have no foundation for trying to manage the feeling.
Think about it this way. If you’re driving down the road and you see the car begin to veer off the edge of the road, you’ll take steps to correct the direction of the car. But what if your eyes “told” you that the car was still in the middle of the lane? You would be likely to resist anyone telling you to change what you’re doing, and in fact you might get pretty upset if that person kept insisting that you were headed in the wrong direction. Many of the students have poor “emotional vision” in the best circumstances, and it’s even worse when they’re under stress.
We try to address this issue in two basic ways. The first goal is to strengthen each student’s ability to anticipate and perceive stress as it begins to occur. We want a student to be able to say, for example, “I get uncomfortable when I have unstructured time and lunch time is coming up soon so I better get ready.” For students who often live in the moment, this is a big challenge. If I could magically give every student one ability instantly, I think it might be the ability to anticipate future events and their associated feelings. This is hard for lots of kids because of difficulties they may have in sequencing ideas, in rapidly processing information, and in holding ideas in their heads (working memory). To strengthen these skills, we do lots of activities that require sequencing (as several students are doing with photos in Photography class) and rapid back-and-forth information processing (as the whole group did on the trail playing “Human Scavenger Hunt,” trying to identify specific people with verbal clues).
Dealing with Stress
The second goal is to strengthen each student’s ability to take steps to calm and regulate himself when he is anxious. In addition to knowing when he is actually anxious, a student must have some ways of dealing with the stress. For a student who has language processing difficulties, it might be hard to say to someone else, “I’m feeling anxious now because I don’t know how to do this work.” But, it might be easier for them to get up and walk around, or take a short break, or even give some kind of nonverbal signal to an adult. With this student, we will coax reflective language while we also support his use of the nonverbal, motoric strategies. For a student who has visuospatial difficulties and/or motor planning issues, it might be hard to separate from others when he is getting upset, as he may become rooted to one spot and over-rely on aggressive, demanding language-based strategies to try to calm himself. But, it might be possible to engage in soothing interactions with this student that don’t add to the language overload; these interactions might involve an overall reduction in sensory stimulation, a calming voice, and gentle support in coaxing the student to walk around or take a break.
In the service of the first goal, we will almost always revisit these difficult events to try to help each student process what happened and anticipate its recurrence. Sometimes students don’t want to go there. It’s over, they say, and I don’t want to talk about it. We push them on this point, but never force them.
Is it possible to strengthen these abilities without having lots of “bad” experiences? Yes and no. Realistically, there’s no way to prevent every student from getting frustrated, anxious, or surprised by unpredictability. We make reasonable efforts to limit these experiences, but we recognize that they’re going to happen anyway. I had a college professor once who used to say that if you put all your energy into keeping the vacuum cleaner salesman outside your front door, then when he finally did get in, you were sunk. Instead, he suggested, invite the salesman in, give him some coffee, ask him to show you his product. That welcoming, anticipating attitude gives you power (in that case, the power to say no).
We’ve seen improvement in everyone’s ability to manage stress and anxiety in the time they’ve been with us, even our newest students. Everyone has their own starting point and their own rate of growth, but everyone’s movement is positive, and we’re excited about this. This is important because as a student’s ability to manage stress and anxiety goes up, so does their availability for learning.
My son Graham is now nineteen years old and he spent several years in the school program that I created. I believe that the work we did with him in the area of understanding and managing anxiety was crucial, and ultimately provided a foundation for him that enabled him to function better in personal relationships, manage his feelings better, and to complete his high school degree. Graham now attends a young adult transition program in another state, shares an apartment with a roommate, and attends college classes at a nearby university. Ask him what his biggest hurdle is, and he will tell you it is anxiety. He remains hyper-alert, reactive to unexpected challenges or too much rapid processing of information; he gets overloaded in social situations. In essence, he sometimes insists that the car is moving in a straight line when in fact it is veering off the road. At the same time, he is reflective and even analytical about his situation, and he is much better at problem-solving when he gets into difficulty. He is better able to advocate for himself, and to protect interpersonal relationships (by explaining himself to others) when he gets overloaded or reactive. He has a lot of work ahead of him, but he is more understanding and accepting of himself and his struggles with anxiety (among other things), and this helps him to navigate the world more successfully and even a little bit happily.