Autism: A New Perspective
Autism: A New Perspective
Autism and Anxiety
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The Positive Side of Anxiety with Autism

Feeling anxious, especially when beginning autism remediation, is common among both children and their parents, but anxiety can have a positive side. It can often make us more responsive and more creative.

Anxiety can actually help us to:

  • Prepare ahead of time
  • Do what needs to be done, and in a timely manner
  • Think things through carefully
  • Feel calmer in the long run

Helping Your Autistic Child to Manage Anxiety

When it comes to helping our children manage anxiety, giving your child a demonstration of what an upcoming event or experience might be like can be very helpful. Practicing can also help. This can be as simple as taking walks with your child, and slowly making changes – the pace of your walk, where you go, adding in other activities to your walk time, etc.

In this episode of Autism: A New Perspective, Dr. Sheely talks about anxiety in both children and parents and why there can sometimes be a good side to anxiety.

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Kat Lee: Welcome back to Autism: A New Perspective, the podcast show where we help you understand what is going on in the mind of your child and we always encourage you that growth for your child is possible. I’m Kat Lee and in this week’s podcast, Dr. Sheely talks to us about anxiety in both parents and children. Let’s listen in. Well, Dr. Sheely, I’ve had so many people recently talk to me about why is it that when they go to work with a child or sometimes professionals who go to work with children, they feel anxiety, and I’m always kind of struck by that because I’ve heard that a lot over the years of working with parents and their children that one of their obstacles was anxiety. Why do we feel anxious? Do you know what causes us to feel anxiety? It’s something I hear often.

Dr. Sheely: Yes, I know. I feel anxious. I think I feel anxious because I don’t know exactly what’s going to happen. I don’t know the parents. I don’t know the child yet. And so there are all of these unknowns and as much as I prepare and I give a lot of thought to a family before they come in, especially the first time, I still feel that anxiety, what don’t I know? How do I know what I don’t know? And so those kinds of things make me feel anxious. But I would also say that I think there’s a good side to anxiety. And I think the good side to anxiety is that it alerts us that we need to prepare a little harder, that we need to think a little more carefully, that we need to be relaxed. We need to do what we can do ahead of time. I think without that tinge of anxiety, many of us would say, I’ve done this a hundred times. Just go in. But every family is unique and every family is different. Every child is unique and different. So that taking the time to even just calm yourself before you go in and prepare for that first session or hypothesis testing or whatever, I think is important. And I think parents think, why would I be anxious working with my own child? But we’re asking them to find that edge for themselves, not just the edge for the child, but the edge for themselves. And in finding that edge, there’s going to be some anxiety because they haven’t done it before.

Dr. Sheely: And they’re stretching their child in a way that they have probably decided they won’t do because they figured out how to keep the child calm. So they don’t want to rock the boat.

Kat Lee: I think it has to be reassuring for parents who are just starting out to hear you, who have worked with children in the field for so long say that you feel anxious. I think that’s very comforting as a parent.

Dr. Sheely: And I think part of the anxiety, Katherine, also comes because we want to do our best. We really want to impact the lives of the families we’re working with, the lives of the children that we work with, and so we don’t want to get it wrong.

Kat Lee: And I think it’s that parallel process that you’ve talked about so beautifully. As parents, we don’t want to get it wrong. We want in on that next level. I know you’re a parent or a grandparent on that next level of not wanting to get it wrong, right? 

Dr. Sheely: And I think one of the things that creates anxiety is, we may be at a point where something really wonderful is happening and we don’t recognize that it’s something wonderful happening because people aren’t smiling and laughing. For example, I had a boy say to his parents, I don’t understand calculus. So this is a part of the guiding relationship that we love. We love it when the child is saying, this is what’s going on in my life. I need some help with it. So it’s a good apprenticeship situation. But the parents said, you’re getting As. He said, but I don’t really understand it. And that was the most wonderful moment. But because it didn’t make sense, everybody started feeling anxious about it. So what he was saying is, I know I’m getting As, but there’s something about this that I’m not getting. And so the parents got really anxious about school. He got anxious about school. The teacher at school got anxious. Everybody was anxious. But it was one of those pivotal moments when the cognitive growth was so clearly coming to this boy, that ability to reflect on himself. Everything we want to see in apprentice was in that moment. And yet it causes great anxiety because they hadn’t been there before.

Kat Lee: What a pivotal moment, and yet you can feel even from your description that it was being missed because of the anxiety by everyone in his life. And I think that is such a beautiful example that I can say as a parent, that feeling of you can’t do this. You don’t know this. It can be kind of a trigger for that anxiety that holds over from your past experiences. I think recognizing that is incredibly important.

Dr. Sheely: I think it’s important also because one of the things that makes a person a good apprentice is to recognize that they don’t know something, or they can’t figure something else, or they want to broaden what they’re doing, or the parent wants to help them begin to act independently. So all of these things, it’s new. It’s all new. And when something’s really brand new, we don’t know what’s going to happen. We prepare as much as we can. But there’s that newness of it that makes us question, did I prepare enough? Did I prepare the right things? Have I thought about it enough? And then, oh, yes, you’ve done the best you can. [chuckle] You have. You have. And so that ability to say, I don’t know if I’ve done it. But all of those things prime us to move forward. So there is, if we can think about anxiety, at least in a couple ways, like a good anxiety and a bad anxiety, I think we can get more comfortable sometimes with the anxiety that we feel that is helping us be more creative, more responsive.

Kat Lee: Have you seen where maybe anxiety actually prevented parents from guiding? Like they intended to be guiding and getting involved in RDI, but they just couldn’t get past that anxiety of going and engaging with their child? 

Dr. Sheely: We have. And I know a lot of people are talking about trauma now, but I do believe that it’s one of the indicators that the anxiety is getting triggered by something that’s happened, a memory that has occurred. And so the parents can’t move forward. Let’s say they’ve had a child who’s tantrumed for hours on end, and they were unable to calm that child. The child was unable to calm himself. They get ready to do something with the child, and somehow they remember that tantrum that lasted all that time and how they’ve been able to avoid it now. They figured out, you’re not going to rock the boat, but we’re saying to them, we’re going to rock the boat, but we’re going to do it in a way that is good for everybody. It’s going to feel okay. But they’ve never done that before. They’re saying, I can’t do it. I just can’t do it. So yeah, I have seen that.

Kat Lee: And while you were talking, I was thinking about the child and just how it’s that, again, that parallel process, because there’s a child who has anxiety too. And I think sometimes I’ve seen or heard that the anxiety is, it’s not discounted exactly, but folks really don’t understand that the child has experiences that are leading to anxiety for the child as well, correct? 

Dr. Sheely: Yes, of course. I mean, when you were saying that, I was thinking about a little boy who came to Houston one time before we were online, [chuckle] and people had to fly in and he came to Houston and he had been forced to sit at a table for long periods of time and do work at the table. So as you know, part of our RDA is at the table. And the parents said, don’t bring out the table because if you bring out the table, we’re not going to be able to do anything. So we didn’t, we trusted them and we didn’t use the table. We improvised a little bit, but the child was just doing so well that I brought out a table because there was something I wanted to do at the table and everything fell apart because of that memory that got triggered. And I think memories are something that we want to be able to use in a way that helps us prepare for the future. But we have to also understand that there are certain memories that trigger anxiety, trigger response that’s an unhelpful response. And we have to trust parents when they tell us don’t do that. And it doesn’t mean that we’ll never do it, but I certainly made a mistake when I brought it out because I thought this is not a big deal anymore, but it was still a big deal because of what it triggered.

Kat Lee: So we’ve got anxiety for the children, for the parents, for us as professionals. Tell us how we go forward. How do we get, go, I don’t know, go past, go through? How do we do that? 

Dr. Sheely: I think the way I’d be interested in how you do it, because I’m so impressed and appreciative of the work that you do with parents. But I’ll start. [chuckle] But one of the ways that I do it, as I said, is preparation and thinking through what’s going to happen during a session, how I’m going to help the parents feel that what we do with their child, what we show them how to do is going to be manageable for them. And one way I like to do that is, I like to go ahead and demonstrate. So demonstrate maybe something with the child, because I feel like if it’s not going to work, I would rather have it not work with me than not work with the parent. So the preparation, the demonstration, being there to jump in, particularly in the first few sessions when everybody’s feeling a little uncomfortable as is the child. So I think preparation is key. And I would say that the preparation is probably, I was going to say more important than what you do, but that’s not true. But it’s as important as what you do during the session. That preparation, maybe you’ll be spending a lot of time with the parents with the child not there. Maybe you’ll have the parents try something with a child who’s not on the spectrum, a sibling, a cousin, until they begin to see that, hey, I can do this. And then they’re not practicing on their own child. They practice on their brother’s child.

Kat Lee: What about you? I am the same. But one of the things that I think has really been key is, we can blow things up into our minds really big. The children can, we can as parents, we can as professionals. And what I really find is that when we downsize things and see a value in little things first and short periods of time together that can grow, so many times, and then maybe we’re just made this way as people, people want to jump in. They feel like I just got to jump in. It has to be big and it has to be bold and it has to be complicated. And that is only going to add to everybody’s anxiety. When it’s simple and it’s not complex and it’s just being, sometimes it’s just being. I’ve had parents who needed to just be, like be able to sit on a bed with their child, be able to just be in that space. That’s a little big thing. And that’s one of the things I try to communicate to parents that the things that will be the biggest are those little things. And then those lead to our ability to really go on into some of those other goals. So I think that’s one of the reasons anxiety gets big is because the thing gets big in our minds, Dr. Sheely.

Dr. Sheely: And as you know, and as I know, one of the earliest mantras of RDI was just noticeable differences. And so rather than coming in with a lot of equipment, a lot of stuff, a just noticeable difference, what could be something as simple as walking out to the garage together and walking slower and maybe faster, or maybe just walking together. Getting that feel, getting that feel of the rhythm. I was just reading a book. I can’t find it. I’m sorry. I was turning around here. But the book is something called Too Small to Fail. And the doctor is talking about habits and rather than starting out and saying, okay, this is 100 calories a day for me and that’s it. No, you choose something that is too small to fail. And once you’ve mastered that, you choose the next thing that is too small to fail. And I think it’s another description of what you were saying, that we start with what we know we can do, and then we add onto that as we’re able to do it. I feel like there are some people who are just genetically anxious too. And so that’s something a little bit different. And sometimes it might be a co-occurring issue that needs to be addressed with their doctor. But for the most part, I think anxiety is something that we’re all dealing with because it’s the unknown. And I love what you said about starting where you can start, starting where everybody’s most comfortable.

[music]

Kat Lee: And thank you for joining us for Autism: A New Perspective, the podcast show where we help you understand what is going on in the mind of your child. And we always encourage you that growth for your child is possible. I’m Kat Lee. See you next time.

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