Assessment for unusual fears in those with autism deemed “critical” by a study

Many children experience fears on their road to independence from birth onward and as they learn to engage with the world around them. Fear of dogs, bugs, thunderstorms, or just plain old fear of the dark are pretty common for most children at some point in their lives. Unusual fears, however, have long been recognized as one of the characteristics for many of our children on the spectrum, but little research had been done on the topic since it was first recognized 70 years ago by the “father of child psychiatry” Dr. Leo Kanner in his paper Autistic Disturbances of Affective Contact . In his paper, Dr. Kanner interviewed a number of children with autism, and noted that they “reacted with horror” to specific loud noises or moving objects…including tricycles, swings, elevators, vacuum cleaners, running water, gas burners, mechanical toys, egg beaters, and that “even the wind…could bring about a major panic”.

In a study published in Research in Autism Spectrum Disorders  is looking into the issue more thoroughly.  The study looked at over a thousand children, and found that 41% had what was deemed an unusual fear. The most common fear was one of toilets, followed by mechanical things, heights and weather. The study concluded that events that most children can ignore, or don’t notice, can distress those with autism to the point where it impairs functioning.

“Children with autism perceive, experience, and react to the world differently than children without autism. What is tolerable for most children (e.g., clouds in the sky, a change in activity or routine, sensory input, or a performance request) might be terrifying, distressing, or infuriating for a child with autism.”

Assessment for unusual and common fears deemed “critical” by study

The study found that most children with autism experience common and unusual fears, and that those fears have a role in further impairing functioning. Its finding was that clinical assessment was essential for those with autism, as there is proven and effective treatments available to help most of them. Having to face fear over daily objects or events can be a root source of anxiety, and anxiety (along with sensory overload) is one of the leading causes of autistic meltdowns.

While dealing with your child in a state of panic can cause despair for parents, don’t lose hope.  Most children can learn to manage their fears if given the right tools, and help.

Some ways to help your child with autism manage their fears

1. Learn to recognize when your child is afraid, and what their fear triggers are. That famous line: if you’ve seen one child with autism, then you’ve seen one child with autism works here. Each child is going to have different fears, and they might express fear quite differently from you or other children. Look for heightened behaviours or signs of stress like repetitive movements, etc. Each child will be different, so you will have to learn to read yours.
2. Acknowledge their fear. While it might seem irrational to you, to your child it’s very real. Telling them that it’s “just a vacuum”, or “just a heating vent” is not going to help your child when that vacuum or heating vent is triggering a panic – I’m unsafe – response. Let them know that you understand they are afraid, and that you could see why it might be frightening.
3. If you can, investigate the fear in small doses. “Let’s walk up to the vent together”, “how about if I walk up to the vent, and then you can join me if you want to”. Build confidence over time, but take it slowly.
4. If you can’t, try to mitigate the fear. If it’s a thunderstorm, maybe they need a safe place, or special noise dampening earphones. If it’s something you can avoid and that’s the better option for the moment, avoid it.
5. Find ways that work for your child to help manage stressful moments. There are a list of resources at the bottom of this post, and different things work for everyone. Sometimes a hand held video game helps to soothe or music. For some children it’s a “stress toy” or fidget, etc. Whatever you would normally do to help alleviate anxiety can help with fear.
6. Model ahead of time. Let them see charts, or try out the action or idea before they are expected to do it. Sometimes role playing what will happen helps if the fear is over going to a new place or doing a specific activity.
7. Don’t be afraid to seek professional help. There are many therapists and therapies that work well for dealing with both common and unusual fears.

For further reading, have a look at:

Attacking Anxiety – A Step-by-Step Guide to an Engaging Approach to Treating Anxiety and Phobias in Children with Autism and Other Developmental Disabilities

Overcoming Anxiety in Children and Teens

What to Do When You Worry Too Much: A Kid’s Guide to Overcoming Anxiety