Autism and Anxiety

1. Autism and Anxiety • High levels of anxiety – as norm • Increased anxiety states for specific reasons • Global levels of high anxiety due to environmental factors • Possible as high as 90% of individuals have a recognisable anxiety disorder

2. Secondary Psychiatric Disorders • Not a primary mental illness • Result of environmental factors • High level in people with Autism compared to peer groups • Better support should lead to a better prognosis and reduction in secondary conditions

3. Specific Reasons for Anxiety • As a result of specific neurological differences in Autism: • learning processes • communication • social interaction • Theory of Mind • Executive Functioning • emotional recognition • Sensory processing • Central Coherence • obsessions

4. Learning Processes • Direct learning vs Indirect learning • Examples of indirect learning / development: • Theory of Mind • Social skills • Social cues • Non verbal communication

5. Verbal Communication • Accurate interpretation • Metaphor / sarcasm / irony • Need for accuracy / lack of tautology • Echolalia / palilalia / delayed echolalia • Delayed processing • Meaning transferability • Expressive vs receptive skills

6. Non Verbal Communication • Prosody • Facial expression • Body posture • Inference • Contextual information

7. Social Skills • Recognising the ‘unwritten rules’ • Assessing situations • Reacting appropriately to the PNT social circumstance • Adapting social skills to the PNT situation

8. Social Cues • Conversational turn taking • Following the leads of others • Understanding ‘friendships’ • Group settings • Sharing • Participating in game scenarios

9. Theory of Mind • Alexithymia • Mentalising abilities • Empathy • Trust • Appearance of rudeness

10. Executive Functioning • Planning • Impulse control • Sequencing • Scripting

11. Central Coherence • Identifying the pattern or underlying rules • Attention to detail • Knowing what is relevant and redundant • Recognising the 'big picture'

12. OBSESSIONS • Can be socially inappropriate • Need boundaries around obsessive behaviour • Must recognise that obsessive behaviours can be used as coping mechanisms • Obsessions may be misinterpreted

13. Sensory Differences • Neuro-physiological differences in filtering processes • Can have major impact on behaviour • Environmental aspects can influence

14. Global Reasons • Resistance to Change • Environmental factors • Trust • Sense of self/diagnosis • Physical

15. Hypothesis - resistance to change Individuals with Autism have significantly lower ‘stability rates’ in their day to day lives than the neurotypical This may lead, in part, to an explanation of ‘resistance to change’

16. Dependent on: • Communication • Understanding other people • Social awareness • Predictability • Fulfilled expectations • Shared sensory environment Stability

18. Bullying • Individuals with Autism are highly vulnerable: • don't 'fit in' • will not necessarily follow traditional social convention (fashion, etc.) • problems with adhering to social rules within society (classroom, playtime, employment, social arenas, etc.) • communication problems • poor PNT ToM

19. EDUCATION • PROBLEMS INCLUDE • Cognition can hide core defects • Peer group • Lack of understanding from staff • Transference of problems (home to school/work/service and vice-versa) • Academia takes preference over social and emotionaldevelopment. Can lead to... • Isolation • Poor self-esteem • Poor motivation • Depression • Unrealised potential

20. Ethics, Morality, and Normalisation It is essential that individuals with Autism are treated with respect for their way of thinking and behaving, and that ‘normal’ value bases are not enforced upon them