Issue One - Tom experiences a high level of anxiety.
What does the research say about this issue?
One significant issue that many students with ASD experience is anxiety and stress. It affects their daily lives and can lead to further morbidity (Van Steensel, Bogels & Perrin, 2011). Numerous studies have revealed that between 11% and 84% of children with ASD experience some degree of impairing anxiety such as social phobia, separation anxiety, panic disorder and specific phobias (Chalfant, 2011). For example, de Bruin, Ferdinand, Meester, de Nijs & Verheij (2006) reported that marginally more than 55% of the sample experienced at least one form of anxiety disorder, whilst the study by Simonoff, Pickles, Charman, Chandler, Loucas & Baird (2008) revealed that almost 42% of children were diagnosed with an anxiety disorder. Anxiety can make it exceptionally harder for children with an ASD to engage in day-to-day normalities such as, making friends, going shopping, and attending school (Alfano, Beidel & Turner, 2006). This is due to the incapacitating internalizing symptoms of disproportionate worry and fear that accompanies the anxiety (Van Steensel et al., 2011).
Children with an ASD generally have a much harder time recognising their anxious symptoms and therefore, are unable to communicate to others how they are feeling (Alfano et al., 2006). Consequentially, externalising symptoms such as muscular tensions and acting out behaviours may be the best indicators that students are anxious or stressed (Van Steensel et al., 2011). It is imperative that teachers are knowledgeable and compassionate about the complexities of ASD’s so they are empowered to support students in attaining the best out of his or her classroom experiences.
How Does Anxiety Affect Tom and His School Experience?
At present, Tom generally has difficulties telling others when he is feeling anxious or stressed and will often demonstrate an increase in challenging behaviours and symptoms. These can include a frequent need for reassurance, stimming, obsessive behaviours, meltdowns, avoidance or withdrawal, agitation or aggression and hand biting. Specific events can also trigger his anxiety and stress, such as a change in routine and the environment, lack of structure, increased sensory input, and unfamiliar social situations. During these times, Tom cannot focus or follow instructions, and this results in a considerable amount of learning time lost for Tom and the other students.
Tom’s anxiety and stress is heightened because of his social skill impairments and limited theory of mind (ToM) ability. This unfortunately inhibits his ability to create and maintain friendships. Research indicates that children with an ASD with middle of the range symptoms, who desire friendships, but do not have the skills to make them work very well, may be at risk for greater anxiety and stress as a result (Alfano et al., 2006).
STRATEGY 1: Visual Supports
One potential strategy to target Tom’s anxiety and stress would be to incorporate visual supports. Visual supports are visually presented tools that aim to teach and increase targeted positive behaviours and diminish or remove inappropriate or non-adaptive behaviours (Rao & Gagie, 2006). Therefore, by incorporating this appropriate intervention, it is possible to reduce Tom’s anxiety and to support him in managing his anxiety. To ensure maximum effectiveness, the visual supports will be incorporated in a variety of ways and settings to foster Tom’s ability to generalise the skills. This is important because children with ASD typically experience difficulties generalising skills across settings, tasks, and with different adults (Goodman & Williams, 2007).
A daily visual schedule will be incorporated so Tom can independently track events and activities. Tom would be comforted by concretely seeing what activities he will be engaging in during the day and in what sequence. Research consistently reports that this is an effective strategy because most children with an ASD experience anxiety as they transition from one activity to the next (Chalfant, 2011). Additionally, as Tom experiences anxiety and stress in busy environments, a visual support to be used during rotational activities would also be beneficial. A visual support with images and text conveying explicit directions and procedures would support Tom in understanding expectations required at each activity.
Click on the photos below for examples of visual supports that can be used in the classroom.
One significant issue that many students with ASD experience is anxiety and stress. It affects their daily lives and can lead to further morbidity (Van Steensel, Bogels & Perrin, 2011). Numerous studies have revealed that between 11% and 84% of children with ASD experience some degree of impairing anxiety such as social phobia, separation anxiety, panic disorder and specific phobias (Chalfant, 2011). For example, de Bruin, Ferdinand, Meester, de Nijs & Verheij (2006) reported that marginally more than 55% of the sample experienced at least one form of anxiety disorder, whilst the study by Simonoff, Pickles, Charman, Chandler, Loucas & Baird (2008) revealed that almost 42% of children were diagnosed with an anxiety disorder. Anxiety can make it exceptionally harder for children with an ASD to engage in day-to-day normalities such as, making friends, going shopping, and attending school (Alfano, Beidel & Turner, 2006). This is due to the incapacitating internalizing symptoms of disproportionate worry and fear that accompanies the anxiety (Van Steensel et al., 2011).
Children with an ASD generally have a much harder time recognising their anxious symptoms and therefore, are unable to communicate to others how they are feeling (Alfano et al., 2006). Consequentially, externalising symptoms such as muscular tensions and acting out behaviours may be the best indicators that students are anxious or stressed (Van Steensel et al., 2011). It is imperative that teachers are knowledgeable and compassionate about the complexities of ASD’s so they are empowered to support students in attaining the best out of his or her classroom experiences.
How Does Anxiety Affect Tom and His School Experience?
At present, Tom generally has difficulties telling others when he is feeling anxious or stressed and will often demonstrate an increase in challenging behaviours and symptoms. These can include a frequent need for reassurance, stimming, obsessive behaviours, meltdowns, avoidance or withdrawal, agitation or aggression and hand biting. Specific events can also trigger his anxiety and stress, such as a change in routine and the environment, lack of structure, increased sensory input, and unfamiliar social situations. During these times, Tom cannot focus or follow instructions, and this results in a considerable amount of learning time lost for Tom and the other students.
Tom’s anxiety and stress is heightened because of his social skill impairments and limited theory of mind (ToM) ability. This unfortunately inhibits his ability to create and maintain friendships. Research indicates that children with an ASD with middle of the range symptoms, who desire friendships, but do not have the skills to make them work very well, may be at risk for greater anxiety and stress as a result (Alfano et al., 2006).
STRATEGY 1: Visual Supports
One potential strategy to target Tom’s anxiety and stress would be to incorporate visual supports. Visual supports are visually presented tools that aim to teach and increase targeted positive behaviours and diminish or remove inappropriate or non-adaptive behaviours (Rao & Gagie, 2006). Therefore, by incorporating this appropriate intervention, it is possible to reduce Tom’s anxiety and to support him in managing his anxiety. To ensure maximum effectiveness, the visual supports will be incorporated in a variety of ways and settings to foster Tom’s ability to generalise the skills. This is important because children with ASD typically experience difficulties generalising skills across settings, tasks, and with different adults (Goodman & Williams, 2007).
A daily visual schedule will be incorporated so Tom can independently track events and activities. Tom would be comforted by concretely seeing what activities he will be engaging in during the day and in what sequence. Research consistently reports that this is an effective strategy because most children with an ASD experience anxiety as they transition from one activity to the next (Chalfant, 2011). Additionally, as Tom experiences anxiety and stress in busy environments, a visual support to be used during rotational activities would also be beneficial. A visual support with images and text conveying explicit directions and procedures would support Tom in understanding expectations required at each activity.
Click on the photos below for examples of visual supports that can be used in the classroom.
STRATEGY 2: Self-Calming Techniques
A second strategy that has been explicitly chosen for Tom, is to encourage the development of self-calming techniques. This is important because it will help him regulate excessive stress by preventing episodes and minimising escalation (Lipsky, 2011). Thus, reducing interruptions in learning and social engagement and danger to self or others (Lipsky, 2011).
Tom can learn self-calming when the elements of relaxation are broken down into a set of teachable skills (Lipsky, 2011). Firstly Tom needs to understand the different types of emotions, their names, and how they can make you feel, physiologically and psychologically (Lipsky, 2011). To achieve this, explicit activities and visual supports will be incorporated such as the Minion’s emotions games exemplified below.
Secondly, physiological practices such as breathing techniques, yoga postures, and progressive relaxation will be incorporated (Lipsky, 2011). This can be a whole class activity, as all students would immensely benefit from learning a variety of practical and fun stress reduction techniques. For example:
The following activities can be incorporated during the day:
- Deep Breathing Exercise (Belly Breathing)
- Progressive Muscle Relaxation (Deep Muscle Relaxation)
- Simple Meditation.
The instructions are included below if the teacher would like to lead the students.
Or there are a variety of YouTube clips, as exemplified below, that can be played to guide the students through these practices.
An extensive collection of relaxation techniques that the teacher can lead students through.