Anxiety and management in asd
This presentation is the property of its rightful owner.
Sponsored Links
1 / 36

ANXIETY AND MANAGEMENT IN ASD PowerPoint PPT Presentation


  • 225 Views
  • Uploaded on
  • Presentation posted in: General

ANXIETY AND MANAGEMENT IN ASD. Dr Clodagh Doyle Consultant Clinical Psychologist NHSCT. Aims of Session. Definition of anxiety Prevalence of anxiety Anxiety and ASD Symptoms Strategies. ANXIETY. What is anxiety?

Download Presentation

ANXIETY AND MANAGEMENT IN ASD

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Anxiety and management in asd

ANXIETY AND MANAGEMENT IN ASD

Dr Clodagh Doyle

Consultant Clinical Psychologist

NHSCT

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Aims of session

Aims of Session

  • Definition of anxiety

  • Prevalence of anxiety

  • Anxiety and ASD

  • Symptoms

  • Strategies

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety

ANXIETY

  • What is anxiety?

  • Anxiety is a NORMAL EMOTION – it helps us cope with difficult, challenging or dangerous situations.

  • Anxiety is COMMON – there are times when we all feel worried, anxious, uptight or stressed.

  • But anxiety becomes a PROBLEM WHEN IT STOPS YOUR child from enjoying normal life by affecting their school, work, family relationships, friendships or social life.

  • This is when ANXIETY TAKES OVER and your child has lost control.

    (from Paul Stallard : Anxiety)

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

Definitions

  • Fear – reaction to real environmental threat that is focused on a specific object, individual or circumstance eg chased by a dog. It’s a normal emotional response essential for survival

  • Worry – thoughts and beliefs about possible problems that may occur in the future ie focused upon distal events

  • Anxiety – a general, frightened response to a source that is not readily identifiable and may be out of proportion to environmental threats –ie excessive worry re common life situations

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

Prevalence in the general population

  • Anxiety disorders represent the most common type of psychological distress in school-age children (eg Kashani & Orvaschel, 1990)

  • 25.7% 8 yr olds meet diagnostic criteria for an anxiety disorder

  • Anxiety in childhood is most common risk factor for depression in adolescence and early adulthood

  • Anxious children are more likely to be anxious adults ie anxiety disorders have a persistent course

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and asd

Anxiety and ASD

  • 84.1% of children with pervasive developmental disorder met the full criteria of at least one anxiety disorder

    Muris et al (1998)

    35% of children with ASD met criteria for an anxiety disorder (Wood & Sze, 2007)

  • 65% of young people in clinic presented with clinically significant levels of anxiety (Atwood, 2004)

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and asd1

Anxiety and ASD

  • Why?

    - rigidity of thought and behaviour

    - difficulties with change; transitions; social situations

    - communication and language difficulties

    - sensory difficulties

    - difficulty recognising signs of anxiety

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

Anxiety and ASD

  • Poor copings /resource strategies

  • Hypervigilance to things/people in their environment

  • Difficulty recognising and discriminating between others feelings

  • Difficulty predicting outcomes

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and asd2

Anxiety and ASD

  • Risk factors:

    • Awareness of difference

    • High trait anxiety

    • Family tension

    • Bullying/victimisation

    • Adverse life events

      • (Tantam,2000)

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and asd3

Anxiety and ASD

  • Anxiety and fear are factors in behaviour difficulties and challenging behaviours.

  • Anxiety more common in those with diagnosis of Aspergers Syndrome or High Functioning Autism (White et al,2009).

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Symptoms of anxiety

Symptoms of Anxiety

  • Exercise: think about what the symptoms of anxiety are.

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

Symptoms

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

Components of anxiety

  • Affective – feelings of fear, panic, agitation, nervousness

  • Cognitive – worry, negative thoughts, poor concentration, attentional biases

  • Physiological – increased heart rate, stomach aches, muscle tension, perspiration, sleeping difficulties

  • Behavioural – flight, fight, freeze, reassurance seeking

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

Body cues for Anxiety Symptoms

  • “FLIGHT–FIGHT” reaction:

  • • shortness of breath

  • • tight chest

  • • dizziness or light-headedness

  • • palpitations

  • • muscle pain, especially head and neck pain

  • • wanting to go to the toilet

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

  • • shakiness

  • • sweating

  • • dry mouth

  • • difficulty swallowing

  • • blurred vision

  • • butterflies or feeling sick.

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


What do we do

What do we do?

  • Tool–box: promote self-regulation

  • Relaxation

  • Distraction

  • Create predictability – visual schedules, visual cues/symbols

  • Emotional education – teach about emotions; signs of anxiety

  • Social stories

  • CBT type approach

  • Social skills training

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

TOOL BOX

PHYSICAL ACTIVITY TOOLS

THINKING TOOLS

SOLITUDE

SPECIAL INTERESTS

SOCIAL TOOLS

RELAXATION TOOLS

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

Relaxation tools – slow release of emotional energy

  • Breathing

  • Relaxation training

  • Repetitive action

  • Lego/Drawing

  • Music – listening/playing

  • Sleep

  • Reading

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

Physical Activity Tools – quick release of physical energy

  • Exercise – eg trampoline

  • Sport

  • Creative destructive

  • Swing

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

Social Tools

  • Spend time with family member or friend

  • Seek advice

  • Solitude

  • Be with a pet

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

Thinking Tools

  • Put event in perspective

  • What would you like to do

  • Flexible thinking eg •“It might have been an accident. I should check before I get angry”

  • Social story

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

Relaxation

  • Relaxation allows child to change their physiological arousal

  • It counteracts the physical feelings of anxiety

  • Taught to a child when they are feeling calm

  • Individual and group exercises

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

Types of relaxation

  • Progressive muscular

  • Visualisation/imaginative

  • Breathing exercises

    Group exercises

    - relaxation

    - breathing

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Relaxation

Relaxation

  • Group exercise

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

Distraction

  • Distractions are mental operations – typically mindless

  • Goal is to engage mind in something simple or routine that the worry thoughts are prevented

  • ie distraction helps to take your mind of the negative/worrying thoughts

  • It helps you take control of your thoughts by thinking about something else

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

Additional techniques

  • Worry time

  • Worry box/safe

  • Therapeutic stories

  • Talking back to worries

  • Turning volume down on worry thoughts

  • Turning the tape off.

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Cognitive behaviour therapy

Cognitive Behaviour Therapy

  • What is COGNITIVE BEHAVIOUR THERAPY?

  • Cognitive Behaviour Therapy (CBT) is based on the idea that how we feel and what we do are due to the way we think.

  • Focuses on relationship between

    • Cognitions – what we think

    • Affect – what we feel

    • Behaviour – what we do

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

CBT

ENVIRONMENT

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

CBT

SCHOOL PLAYGROUND

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

CBT

  • Monitoring and identification of thoughts, feelings an behaviour

  • Psychoeducation

  • Learning alternative ways to manage anxiety/unpleasant emotions

  • Challenging the unhelpful thoughts

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

CBT

  • Coping and positive self talk

  • Learning new behaviours

  • Coping plan/target setting

  • Practice

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

CBT

To summarise:

  • STOP Plan

    • S = pay attention to signs of anxiety

    • T = pay attention to anxious thoughts

    • O = think of other helpful thoughts

    • P = praise and plan for next time.

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Modifications of cbt for young people with asd

Modifications of CBT for Young people with ASD

  • More concrete and visual: worksheets, pictures, social stories, thermometer, feelings diary

  • Use of special interests

  • Adapt to suit developmental level

  • Include social skills training

  • Use a written schedule

  • Concrete language

  • Creativity

  • Questioning though use of role play or give choices/alternatives

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Summary

Summary

  • Young people with ASD are vulnerable to anxiety

  • Emotional education is key.

  • Use “tool-box” for helping strategies

  • CBT useful – requires modifications

  • Parents have important role

  • UNDERSTAND AND SUPPORT

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


Anxiety and management in asd

Thank you for listening

Dr Clodagh Doyle, Consultant Clinical Psychologist, NHSCT


  • Login