Work anxiety and autism

This response is by autism educator Peter Gerhardt, an internationally respected expert on helping adolescents and adults with autism succeed in education, employment and residential or community living. Dr. Gerhardt is also the executive director of the EPIC school (Educational Partnership in Instructing Children), in Paramus, New Jersey.

Our daughter is 23. She has autism, can express herself and respond, has made great strides in her development and now has a community job though a day center. But she seems less happy lately and has begun hum a lot when something bothers her. When the humming is not enough, she’s also started speaking in jargon phrases that she hasn’t used since she was 3 or 4 years old. Should we leave her alone and not suppress these outlets for her stress? Is this sort of thing common when children who have autism become adults?

While most adults experience anxiety and stress in their daily lives, anxiety disorders are particularly common among those on the autism spectrum. In fact, anxiety disorders are the most common co-occurring disorder among young adults with autism.

Unfortunately, many adults with autism lack the skills needed to deal with the anxiety and stress they experience on a day-to-day basis. In the absence of effective coping strategies, it’s natural to resort to behaviors that – in the past – had a calming or relaxing effect.

Helping with autism and work anxiety

Not knowing your daughter, I can’t say for certain, but it sounds like your daughter is using her best-learned responses – humming and jargon phrases – to cope with stress. The stress might relate to boredom, unhappiness about something in particular or an underlying anxiety disorder.

Leaving her alone to cope with her unhappiness may work. But at best, I would view that as a short-term solution. For a lasting solution, I recommend that your daughter work with a cognitive behavior therapist in your area – someone who has experience working with young adults who have autism.

Cognitive behavioral therapy

A growing body of research shows cognitive behavioral therapy (CBT) to be very helpful in treating anxiety disorders in more cognitively capable individuals on the autism spectrum. By cognitively capable, we generally mean verbal and without significant intellectual disability.

Cognitive behavioral therapy is a widely accepted psychological approach for breaking severe cycles of anxiety. The first step of the process involves identifying what’s causing the anxiety. As a hypothetical example, let’s say it turns out that the anxiety is stemming from a new person in your daughter’s workplace.

Next, the therapist may help your daughter logically and/or literally approach her fear in a safe way. Take our hypothetical example. Together, the therapist and your daughter may develop a plan where she gradually spends more time around the person and/or says something to him. This kind of gradual exposure can provide the evidence she needs to put her anxieties aside and feel safe.

Looking for anxiety triggers

Alternately, there may be something about the workplace environment that is provoking anxiety. We know, for example, that many people on the autism spectrum are sensitive to minute changes in the environment or to certain environmental conditions – for example to fluorescent lighting or distracting sounds. It might be possible for the therapist and your daughter to identify such triggers and work with her employer on an accommodation.

Cognitive behavioral therapy is not a quick solution. It will require time and active participation on the part of your daughter. However, the approach has the potential to help her deal with other anxiety-inducing situations in the future. Its benefits are lasting and potentially life changing. In other words, I would say “well worth the effort.”

I hope this is of some help. 

Related resources:

• Managing anxiety in children with autism
• Easing anxiety in kids with autism and limited verbal skills
• The Autism Speaks Employment Tool Kit
• The Autism Speaks Transition Tool Kit
• Contact the Autism Speaks Autism Response Team (ART)

Editor’s note: The above information is not meant to diagnose or treat and should not take the place of personal consultation, as appropriate, with a qualified healthcare professional and/or behavioral therapist.