If your son or daughter is on the autism spectrum, he or she may also exhibit symptoms of anxiety, obsessive-compulsive disorder (OCD), depression or another mood disorder. These co-existing mental health issues with ASD, or autism spectrum disorder, may be preventing your children from engaging in day-to-day activities, overcoming challenges or just being the happy, healthy kid they used to be.
More than 50 percent of youth on the autism spectrum also have significant anxiety. “There are many reasons the rates are so high,” says Josh Nadeau, PhD, clinical supervisor, Rogers Behavioral Health–Tampa Bay. “Often high functioning kids on the autism spectrum realize they act differently in social situations than other children, and this becomes a major source of stress and anxiety. Many of these kids are also developing feelings of sadness, as they believe that no matter what they do, there’s no way they can fit in.”
What to look for in your child
The symptoms of co-occurring mental health problems vary depending on the disorder, but Nadeau says common signs include:
- Significant amounts of time spent discussing people, places, or activities that cause distress
- Unusually avoidant or “clingy” behaviors, or difficulty separating from loved ones
- Compulsive or repetitive behaviors
- Significant fears of different situations
- Worry that is difficult to stop
- Increased irritability or unusually cranky behavior
- Decrease or loss of interest in previously enjoyed activities
- Unexpected changes in weight or appetite
- Sleeping less or sleeping all the time, for at least several days
- More fidgety than normal, or moving and talking very slowly
- Unexplained increase in feelings of worthlessness, guilt, or negative self-talk
“When you see things like these, it’s a sign that you and your child should consult a professional,” says Nadeau.
A prevailing characteristic of youth on the spectrum is a rigidity towards schedules or family routines; however, this also happens to be a characteristic of anxiety. How can you tell the difference?
“Generally speaking, it depends on how your child feels about what they’re doing. For example, if he or she very much enjoys having a schedule or routine, and gets irritated when things aren’t going the way they’d hoped or expected, this is more likely a core symptom of ASD,” he says. “But if it seems like your child is agitated or scared any time they do not have a schedule or routine to follow, and does all that he or she can to gain a greater understanding of what’s about to happen, that’s more likely a symptom of anxiety or OCD. Kids with anxiety or OCD don’t want to engage in these behaviors, but they feel they must do so to prevent something bad from happening.”
Comprehensive and individualized care
In Tampa Bay and in many communities across the country, families and professionals are struggling to find the right kind of treatment. Nadeau and Eric Storch, PhD, clinical director, Rogers–Tampa Bay, are involved with federally funded research through the University of South Florida, which is focused upon identifying effective treatment techniques for youth with ASD and various co-occurring mental health issues.
“Youth on the spectrum have unique needs, and the traditional programming that’s available through most professionals does not meet these needs,” says Nadeau. “Working with hundreds of families of children and adolescents with ASD, we have found many strategies that help us really reach these youth and significantly improve their lives, and the lives of their families.”
For this reason, Rogers–Tampa Bay will begin offering a new treatment option through the Anxiety and Mood Disorders for ASD partial hospital program for children and adolescents. The program will offer treatment to youth ages 6-18 who are on the autism spectrum and also have anxiety, obsessive-compulsive disorder (OCD), depression or other mood disorders.
“It’s important to know we’re not treating autism through this program, but we’re giving kids the skills and resilience they need to decrease their anxiety or depressive symptoms,” says Nadeau. “We’ll also give parents a lot of information about their child’s mental health and will help prepare them to work with their child in a more effective way.”
What to expect in treatment
Depending on your child’s unique situation, programming will include a variety of treatment components that have proven to be effective.
- Exposure therapy
- Cognitive therapy
- Family therapy
- Behavioral activation
- Dialectical behavior therapy skills
- Social skills training
- Experiential therapy
- Psychiatric assessment and medication management
- Patient and family education
“Social skills training is based on the idea that one of the best ways to learn is by doing,” says Nadeau. “For our purposes, social coaching helps your child practice social skills in an applied situation. For example, instead of just teaching him or her the process of introducing themselves, they’ll learn about where and when it’s appropriate to do so.”
As in all of Rogers’ programs, family also plays a key role in helping patients be successful. “In this program, parent involvement is critical,” says. Nadeau. “We model for parents the therapeutic skills they need to use with their children, allow the parents to practice it at home, and receive feedback the next day about how it went.” Under this design, parents will understand the reasoning behind their child’s behavior and why the techniques taught in treatment are the most appropriate response.
To learn more about the anxiety and mood disorders for ASD partial hospital program for children and adolescents, or other treatment options at Rogers Behavioral Health–Tampa Bay, visit rogersbh.org or call 813-498-6400.
Originally published in the February 2017 edition of Tampa Bay Parenting Magazine.