Autism and anxiety can appear to be very similar conditions, but they are not one and the same. Autism, or autism spectrum disorder (ASD), is a neurodevelopmental disorder, while anxiety is a mental health condition. To make it a bit more confusing though, they do often go hand-in-hand, as those living with autism can be prone to having bouts of anxiety.
Board-certified pediatric neurologist Dr. Dilip Karnik recently shed light on these two common disorders affecting children and teens for an article in Healthline.
Some symptoms he mentions that both conditions might share include:
- Fear of separation from someone (Separation Anxiety)
- Struggling in social settings (Social Anxiety Disorder)
- Difficulty with changes in routine or environment
- Extreme nervousness
- Tendencies toward OCD, or Obsessive Compulsive Disorder
Dr. Karnik says if your child exhibits any of these behaviors, or is experiencing challenges at school or with friends, it may be time to seek a formal diagnosis for either autism or anxiety.
Diagnostic testing typically involves a comprehensive evaluation of their medical history with a neuroscience expert or psychologist, along with an honest discussion about any social or generalized anxiety, as well as any specific phobias.
“Anxiety and ASD symptoms [often] overlap, therefore careful screening is needed in these cases,” says Dr. Karnik.
Experts like him agree that an early diagnosis followed by swift intervention are the keys to successful treatment and positive outcomes for children struggling with either autism or anxiety.
How do you treat autism and anxiety?
Dr. Karnik advises that “children with either anxiety and autism will respond better with multimodal therapy that includes behavioral therapy or talk therapy, cognitive behavioral therapy (CBT), good nutrients, and medications for anxiety as needed.”
Additionally, children with sensory integration disorder might also benefit from OT, occupational therapy, or speech therapy to improve challenges with things like touch, taste, and loud noises.
Additional knowledge shared by Dr. Karnik on this connection between autism and anxiety, but separate from the Healthline article, is below:
Why is anxiety more prevalent in autistic people?
It is common to see anxiety in children with autism, ASD. Studies have shown this number to be between 50 to 84% as compared to 18 to 20% among the non-ASD population. About 30% of those with anxiety will have a phobia. Others will have Social Anxiety Disorder, Separation Anxiety, and Generalized Anxiety Disorder. Panic disorders make up a small portion as well (2%).
One of the common reasons that children with ASD have anxiety is their tendency to have sensory integration issues such as oversensitivity to sound, touch, light, and other sensory stimuli. Children with these types of sensory issues produce exacerbated defense responses. It is not uncommon to see a child with ASD reacting differently with a loud blender or vacuum — the sound causing them to cringe, scream or put their hands over their ears. This may lead to other anxieties — new places or new foods — and that eventually triggers an anxiety disorder.
How does anxiety feel different in people on the spectrum than those not on it? Any potential similarities?
Anxiety in children with ASD manifests differently in each child. Some children may act out their behaviors with temper tantrums, showing aggression, or avoiding certain social situations such as sports games, get-togethers, or have trouble interacting with others. Children with anxiety may exhibit restricted or repetitive behaviors or even seem addicted to electronic devices. In most non-ASD children, excessive worrying is the common presentation of anxiety. When ASD children have anxiety they may have self-injurious behaviors, show aggression, or depression as a symptom of anxiety, and are less likely to have “worry” as the main feature.
Some similar anxiety symptoms among ASD and non-ASD children include separation anxiety, difficulty transitioning to new environments, and anxiety over meeting new people.
How might social/emotional impact their anxiety?
Social and emotional factors influence anxiety in children with ASD. This could be because of developmental variation in the brain areas that control emotions. Studies have shown that children with ASD have difficulty with emotional awareness, and difficulty identifying and describing their own emotional state, which is called Alexithymia. A high level of this issue is seen in children with ASD. It has been found that many children with ASD have underdevelopment with emotion-controlling areas of the brain, prefrontal cortex, anterior cingulate cortex, and this dysfunction affects the degree of anxiety in children with ASD. As a result, children with ASD react differently than normal children in very similar situations.
In addition to autism, Child Neurology Consultants of Austin has experience treating a wide range of neurological conditions in children and teenagers from 0 to 21 years old.
To make an appointment with one of our board-certified pediatric neurologists, please contact us here.