My ASD Child: Fretfulness in Kids on the Autism Spectrum

“My youngest child has high functioning autism and has been officially diagnosed with anxiety disorder. She is clearly a child who reacts to stress with anxiety, constantly fretting about something which then often converts to meltdowns. Anyone else having this issue, and what do you think might help in situations like this?”

The benefit of being a kid is not having a care in the world, yet for many children with ASD or High-Functioning Autism, worry is a reality and something that takes a toll on the joy of childhood. What’s even more alarming is that many moms and dads are completely unaware that their “special needs” child is even feeling this way.

Most children will experience worry at some point. For example, your youngster may have repetitive, exaggerated thoughts such as, “What if I fail English?” …or “What if no one likes me?” He may fear that someone will hurt him or his family, or he may become excessively worried at bedtime, at school, or in social situations. This is O.K. to an extent, because a small amount of apprehension can actually help prepare children to handle tough situations later on in life.

The difference between normal worry and an Anxiety Disorder is the severity of the worrying. Although feeling fretful is a natural reaction to a stressful or dangerous situation, an AS or HFA youngster may need help if her fretfulness is out of proportion, if it persists, or if it interferes with her life and healthy development.

It's always painful to watch a youngster suffer from stress and worry, but it's especially difficult if you're not sure whether he is worrying “too much” and in need of assistance. So, how do you know if your youngster’s worries are cause for concern? Here are some signs that your child is a chronic worrier:

An ASD youngster who is overwhelmed by worries may not realize that those worries are unrealistic or exaggerated, and she may not express them – except by her behavior. For example, if she's fretful that something could happen to her mother or father, she may have trouble separating or falling asleep.
The youngster may say negative things, such as “I’m no good” …or “I hate myself” … or “I can’t do this.”
The youngster may have excessive concerns or irrational fears, complain of stomachaches, be nervous at school or refuse to go all together, be afraid to go to sleepovers or birthday parties, or have frequent headaches.
Kids who have severe angst will try to avoid the things that trigger it. For example, anxiety may be the culprit if the youngster spends a great deal of time in the school nurse's office, refuses to participate in activities other kids enjoy, throws a tantrum before every appointment with the dentist or doctor, or gets sick on Sunday nights due to worrying about going back to school on Monday morning.
If the youngster can't stop fretting about germs or getting sick, she may seek constant reassurance or wash her hands obsessively.

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

All kids want to be reassured, and they want to know they will be safe. Some need extra reassurance. If this is the case, routines and traditions can help calm these children. However, many autistic kids will not be calmed by the parent’s answers. It doesn’t matter how many times the parent reassures them or how many times they check on them, they still fret. Kids who have these kinds of worries often struggle in other situations, too. For example, they may not want to meet new peers or go to other’s homes because of their worries (e.g., “What if I need something?” …or “What if I don’t know what to do?”).

Obsessive-Compulsive Behaviors and Anxiety in Kids on the Autism Spectrum

How to help the fretful ASD child:

1. Set aside a designated time for your child to fret. This is called “fret time.” If he frets about many things throughout the day, pick a special time for it. Set aside 10 minutes where your youngster can talk about his worries, or he can write his worries on paper and share them with you. Also, try to eliminate all distractions during “fret time.” If your youngster starts to fret at some time other than “fret time,” he can say to himself, “Stop. That is for my fret time.” Then he should do something else to distract himself. As a mother or father, you may need to help your youngster remember to wait for “fret time” by saying something like, “Save that for fret time. We’ll talk about it then. For now, how about playing a video game?”

2. Create a “fret jar.” Have your youngster picture a ‘jar with a lid’ in her mind. This is a “fret jar.” If she starts to fret, she can imagine opening the jar, putting the worrisome thought in the jar, screwing the lid on tightly, and sealing the worry there. Alternatively, you can create a real “fret jar” rather than an imaginary one, and encourage your youngster to write the anxiety-inducing thought on a piece of paper and put it in the jar. Then, she can talk about the worry during “fret time.” You can help with some techniques and ways to deal with the concern at that time.

3. Don’t allow your youngster to avoid everything that worries her. Fretfulness tends to peak at the beginning of a new or scary situation, then eases off. If parents can help their youngster get through the initial stage of high stress, she’s likely to have a positive experience, which will make it easier the next time.

4. Don’t model “excessive caution.” Overly-cautious moms and dads are likely to say things, such as “Be careful on the swing because you might fall and hurt yourself” without realizing that they are increasing the youngster’s fretfulness. It’s better to say confidently, “I’m sure you’ll have fun on the swing. I’m right over here if you need me.”

5. Increased exposure to the stressful situation is an effective strategy for overcoming anxiety. For example, if your youngster is afraid of cats, start out by showing him pictures of cats, then visit an animal shelter, then go to someone’s house where they have cats, and finally, have your child pet a cat. The important idea here is to take small steps and gradually expose your youngster to the fear.

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

6. Help your youngster put the worry outside of himself. It can help him to think of himself as being separate from the worry. For example, have him picture the worry as a funny looking monster. Help him create the image (e.g., furry with claws, a blob with a big mouth, etc.), and then have him draw a picture of the monster. Next, remind him to visualize the “worry monster” as something that is outside of himself. When your youngster starts to fret, he can picture the monster and can do something about it (e.g., talking back, standing up to it, etc.). Also, have him write down things to say to the “worry monster” (e.g., Get away! I don’t like you! Stop that!). The first few times your youngster does this, the monster will return. When this happens, he should repeat his message in a firm voice (either in is mind or aloud), or he can imagine catching the monster in a net and kicking it out of the house.

7. Help your child to find a distraction when he is in a state of anxiety. Being involved with some activity is key in keeping away worries. The way our minds are, we can’t be relaxed and stressed at the same time. This can be a powerful tool for helping children on the autism spectrum to keep worries away. If your youngster is drawing, reading, or playing a video game, there is little room for the “worry monster” to pester him. Your youngster may not feel like reading a book, for example, but help him understand that being active will help. He may have to force himself to get busy with some activity. As kids realize that staying busy helps keep worries away, it will be easier to want to engage in fun activities. Also, make a list of distracting activities to do (e.g., draw a picture, help dad with yard work, play a game, play music, read, run up and down the stairs, sing a song, take a pet for a walk, etc.), and post the list in a prominent place for all to see.

8. Never try to convince your youngster that her anxiety is unjustified. She’ll just become more convinced otherwise as she tries to prove to you that her worries are real. Instead, help her think about things realistically. For example, if she is worried that you might die, say something like, “Daddy is very healthy. I take good care of myself. I will be living a very long time.”

9. Practice deep breathing with your youngster at bedtime to provide her with a technique to use under stress (e.g., take a deep breath, hold it for a count of three, exhale through the mouth, then repeat). However, bear in mind that it won’t work to introduce deep breathing in the middle of a stressful situation. Your youngster needs to practice so that it becomes a natural response.

10. Don’t chastise your youngster for worrying or resisting something because he’s afraid. He needs your support and reassurance. However, excessive reassurance (e.g., delivering a constant stream of “You’ll be OK” …or “You can do it” …or “There’s nothing to worry about) can make your youngster feel even more fretful. So, don’t offer a bunch of false reassurance.

11. Use social stories, games and puppets to help your youngster learn to relax and manage stress and anxiety.

12. If all else fails, seek support and counsel from a professional who works with children on the autism spectrum.

If you’re concerned that your youngster’s worry is excessive, it’s important to recognize how often he or she experiences distress, how much anxiety it causes, and if it interferes with his or her everyday activities. The crucial issue is not that children worry; rather, it’s the combination that they worry – and it impairs their functioning. By using some of the tips listed above, you can help keep your child’s fretfulness to a minimum.

More resources for parents of children and teens on the autism spectrum: