All the usual reasons for stress and anxiety in childhood – bullying, family upheaval, friendship difficulties and trauma – apply to neurodivergent and disabled children too. That said, neurodivergent and disabled children may also suffer anxiety specific to their different wiring. 

Autistic children often do not like changes to their routine. Developmentally delayed children may struggle with difficult tasks. Unrealistic expectations placed on Fetal Alcohol Spectrum Disorder children can cause enormous stress.

Common causes of anxiety in neurodivergent and disabled children

Changes in routine –When the world is a confusing and overwhelming place, changes in routine that involve new people, present new stimuli and demand different behaviours, can be particularly challenging.

Difficulty in making and maintaining friendships – Being ‘different’ in any way can be tough for young children, when making friends. Add to the mix an inability to understand social cues, body language or to fully participate in games, and ‘fitting in’ becomes especially hard.

School environment challenges – School resources are often stretched, and many neurodivergent and disabled children struggle to keep up with their peers and the expectations of their teachers.  Undiagnosed children have added challenges, as their behaviour and academic performance are not filtered by awareness of their condition.

Separation anxiety – The parent/child bond can be particularly strong when a child is neurodivergent and/or disabled. Many very young children experience separation anxiety in the pre-school years, but for neurodivergent/disabled children separation anxiety can persist for much longer.

Sensory issues – Crowded spaces, loud noises, bright lights and even rough clothing can cause distress. hypersensitive and hyposensitive children can become easily bored and fidgety when under-or over-stimulated.

Demanding tasks – Daily tasks that many children accomplish easily – getting dressed in the morning, mastering their times table, reciting a poem in front of the class – can cause neurodivergent/disabled children considerable stress and anxiety.

Difficulties with focus/attention – Pre-schoolers are not expected to have long attention spans, but with age their ability to concentrate increases. This is not the case for children with Attention Deficit Hyperactivity Disorder (ADHD) or Fetal Alcohol Spectrum Disorder (FASD), for whom some tasks will always be difficult.

Negative reactions from others – All children are sensitive to how others perceive them, and negative reactions can have a serious impact on self-esteem. Neurodivergent and disabled children are as aware as their neurotypical peers and are often highly sensitized to negative or excessive attention.

Ways to address your neurodivergent/disabled child’s anxiety

Cognitive Behaviour Therapy (CBT) – Child therapists recommend CBT to parents as the most effective strategy to address children’s anxiety. The aim of CBT is to challenge the worrying thoughts the child has that maintains a high state of anxiety.

The first step of CBT is to identify your child’s fears – talk to your child with an attitude of calm, curiosity about what frightens them. This may not be possible if your child is non-speaking. For these children keep a diary, notice what situations, people or activities trigger their fears.

With neurotypical children and some neurodivergent/disable children, the next step is to gradually expose them to the things that frighten them, by creating a ‘fear ladder’. The child has control over how slowly or quickly they move up the ‘fear ladder’, until they eventually reach the point where they can face the situation that causes them the most fear. They should never be coerced or pushed.

With neurodivergent/disabled children it may not always be possible or desirable to habituate them to a scary situation. If this is the case, you may decide to adapt or avoid certain situations – as described below.

Adapt or Avoid Stressful Situations – Children with sensory issues will need you to act on their behalf to modify stressful environments. Provide hypersensitive children with noise-cancelling headphones for example, and don’t force them to go to noisy environments such as children’s birthday parties, amusement parks or busy shopping centres. In the case of hyposensitive children, meet with their teacher and arrange for them to be able to take regular breaks to run around, listen to music, or jump on a trampoline to get rid of the ‘fidgets’. Do this at home too.

Provide plenty of routine and predictability – All children benefit from the security of knowing what is going to happen next in their daily or weekly routine. As parents of neurodivergent/disabled children, you need to ‘double-down’ on this concept. Use easy-to-understand wall charts and diaries to remind children what is going to happen during their day, and from one week to the next. Visual timers can also be useful for children who cannot tell the time, by using shapes or colours to show time passing.

Modify difficult tasks – Break down tasks into small easy steps, with frequent praise for each achievement. Consider limiting the number of tasks you first show the child and let them do each one in their own time. Your child’s confidence will grow as they master each step.

Develop a consistent approach between school and home – Keep a dialogue going with your child’s school, especially with the teachers they see daily. Let them know what strategies work for reducing your child’s anxiety at home, and ask if they can use the same techniques at school.

Separation anxiety – Whether your child likes it or not, sometimes they cannot and should not be with you.  Your child needs to know that they will be okay when you’re not there, and also that you will be coming back to them. Using a timer is one way to build up this trust. Leave your child with a trusted friend or family member and set a timer to 20 seconds. Tell your child you’ll be back when the timer goes off and return when the time is up. Does this again, setting the time for 40 seconds. Keep doing this until you gradually build up to 30 minutes or an hour.  For more detailed advice on separation anxiety, see our panui ‘My child is very anxious, what can I do?’.

Stimming  - When autistic children are anxious they may use stimming (for example, flapping hands, repeating phrases over and over, walking in circles) as a self-soothing strategy. It is fine to let your child calm themselves in this way, especially as stimming can also be an expression of happiness. However, if your child is banging their head or hitting themselves or other people, this is a sign of distress and you should intervene immediately.

Active calming – Being active, physically, mentally and socially is good for all of us. Make sure your child gets plenty of exercise according to their abilities (jumping, running, skipping), start a hobby, join a club or simply spend time with the family pet.

Quiet calming – Breathing exercises, listening to music and guided meditation and yoga for children. Your child may need help with some of these activities initially, but once they’re familiar with the steps involved, it’s important they learn to self-soothe.

Keep in mind each child is unique, and so is their anxiety! Experiment with the strategies above to find out which ones work best for your child.

For more on anxiety, other articles are available on Awhi Nga Matua. You might also find the resources below useful, which includes books from the IHC Library as well as helpful website and helpline numbers. Or contact the IHC library direct to have a chat about what you need on 0800 442 442 or email: Librarian@ihc.org.nz.

Helpful websites:

Time Timers available at www.autismresources.co.nz

Depression NZ: www.depression.org.nz

Helplines:

Anxiety New Zealand: 0800 269 4389 (0800 ANXIETY)

1737: Free call or text 1737 to talk to a trained counsellor

Depression.org.nz: 0800 111 757 or text 4202

Kidsline (for people up to 18 years): 0800 543 754

Whats Up (for 5 to 18-year-olds): 0800 942 8787

thelowdown.co.nz , Web chat, email chat or free text 5626

Youthline: 0800 376 633, free text 234, email talk@youthline.co.nz

Lifeline: 0800 543 354

Samaritans: 0800 726 666

Suicide Crisis helpline: 0508 828 865 (0508 TAUTOKO)