Autism and Anxiety

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." That makes sense when you think about it.  If you have a neurological disorder which affects speech and language, relating and communications, and which includes repetitive behaviors and sensory dysfunction, then there is plenty to be confused and befuddled by in the "neurotypical" world.

In an article recently published to the Journal of Autism and other Developmental Disorders, the authors (Shulamite A. Green and Ayelet Ben-Sasson) discuss the concurrence of Autism Spectrum Disorders and anxiety and/or sensory over-responsitivity (SOR). In children with ASD, rates of anxiety are estimated to be 18-87% (3-24% in typically developing children). The rates of SOR are estimated to be 56-70% as compared to 10-17% in the general population of children. SOR has been linked to anxiety in children with ASD in three studies. Anxiety disorders in people with autism may add to functional impairments which impact their ability to engage in everyday activities and social interactions with others. In this article the authors presented three theories to explain the association and also discussed the implications these theories have on the treatment options.  Autism Community



I knew that autism and anxiety often go hand in hand but thought I had escaped that when Monkey Man didn't show any signs of anxiety by the time he was six.  I was dead wrong.  It all started on a wednesday night.  It was just him and I having a bed time snack.  We were talking and all of a sudden he got this scared look on his face, something I had only seen when he was asked to do something that he knew was scary because he had done it before (like go on a ride at an amusement park, which he did once and he knew was scary), and he said, "There is going to be a tornado tonight."  Now there hasn't been a tornado in our area since before he born, there hasn't been a tornado warning this year at all, and I had no idea where this was coming from.  I explained to him that there wouldn't be a tornado and if one ever did come we would hear the sirens and know to go to a safe place. And where we would go and what would happen, etc. 
He seemed satsified with the information and went to bed without incidence.  On Thursday night he seemed a little anxious before bed but again went to sleep without incidence.  Now comes Friday night and I can tell you it was horrifying.  I put him to bed like usual, following his bedtime routine.  He comes out of his room two minutes after I laid him down and says he wants the light down the hall off.  First of all the light doesn't shine into his room and second that light is always on incase I have to get to one of the kids in the middle of night or incase one of them have to go to the bathroom.  So I tell him no, that the light will stay on.  He goes back to bed only to come back out about two minutes later.  He says, "If the light is on I will cry."  At this point I tell him to go to bed and I would see him in the morning.  Another couple of minutes pass and I hear him crying, actually crying, not the ugly fake cry he has, the tears and all kind. 
At this point I am not sure if he is just trying to stay up, which he normally doesn't do, or if he is actually freaking out about a light being on.  So I tell him that if he doesn't go to sleep he won't be able to play his DS the next day, which is a huge motivator for him, and I walk back into the livingroom.  A few minutes later I hear him say, "I can't breath."  So I bring him out into the living room with me so he doesn't wake up his little brother who he shares a room with.  He lays down on the couch for a few minutes and calms down.  All of sudden he sits up and starts freaking out, yelling, "This isn't my life. This isn't my life."  In tears I go over to him and just hug him.  Eventually he says something about being scared of having a night mare.  When I asked him when the last time he had a night mare was, he told me a long time ago.
Now how sad is that, your six year old telling you this isn't my life.  It's just not something that a six year old should say. I don't let him watch drama movies or anything that is above his maturity level (which at this point is mostly cartoon type shows). He is never dramatic about anything but here he is freaking out.   I have never seen him act like this, or be fearful of things that could happen but probably won't.  And seeing him like this just breaks my heart.  There is nothing I can do for him besides hug him and try to be reassuring.
Saturday night was uneventful, I'm thinking mostly because his cousin was spending the night and they were both sleeping in Monkey Man's bed.  Sunday night we were back to pretty much the same thing that happened on Friday night but it was not as bad and he eventually went to sleep in his bed with about 15 stuffed animals around him, his weighted blanket and his star chewie.
By Monday morning I was becoming increasingly concerned so I called his pediatrician and made an appointment, they got him in on Wednesday morning. Monday night and Tuesday night were pretty much the same as Sunday night, he would eventually fall asleep with all of the animals and blanket, etc.
Wednesday morning finally arrives and I tell the doctor what has been going on and that I was thinking he was having panic attacks, because of the fear and him saying he couldn't breath.  She agreed and suggested that he see's a counselor who has experience with children on the spectrum and anxiety issues.  Then she offered to make an appointment for him with someone that she knew.  The appointment isn't for another month but it's something and the panic attacks seem to have lessened for the moment as long as he has his stuffed animals, weighted blanket and star chewie he can fall asleep.
So here I was thinking that we had escaped the anxiety part of autism and it was hiding, getting ready to rear its ugly little head in the form of panic attacks.  I wouldn't have believed that a six year old could have panic attacks but here we are living with them.