The common causes of stress and anxiety in childhood – bullying, family upheaval, friendship difficulties and trauma – are often the same for neurodivergent and disabled children. But they may also suffer anxiety specific to their different wiring. 

For example, autistic children often do not like changes to their routine, whereas developmentally delayed children may struggle with difficult tasks. For children with FASD, unrealistic expectations placed on them can cause enormous stress.

Common causes of anxiety in neurodivergent and disabled children

• ‍Changes in routine – New people and environments present new stimuli and demand different behaviours, which can be challenging for children who often already find the world a confusing and overwhelming place‍
• 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 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 and disabled children considerable stress and anxiety.‍
• Difficulties with focus/attention – Pre-schoolers don't have long attention spans, but their ability to concentrate increases with age. However, this is not the case for children with 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.

Top tips for parents

Children are very sensitive to your feelings and reactions, so it’s important not to give your child the message that their anxiety is worrying you, as they may think this means there’s something wrong with them. Take a curious, rather than emotional approach when asking your child about what frightens them and why.

Don’t ask your child repeatedly how they’re feeling, or send them texts asking where they are, or use a GPS locator to pinpoint their whereabouts. You and your child both need to be okay with sometimes not knowing.

Don’t protect your child from challenges. This will only undermine their self-confidence in pursuing goals. It may also lead to them relying on others to keep them safe. Help your child embrace their shortcomings as well as their strengths. Every child needs to learn how to cope with disappointment and failure. The only thing any of us truly have control over is our own attitude and behaviour. Let them know we all make mistakes and ask them what they could do differently next time.

Be supportive, but don’t over-praise your child. When they’re away from you and other people don't praise them in the same way, their self-esteem may suffer as well as their trust in your judgement. Too much reassurance can also be undermining, as children become less able to handle doubt, and ironically, become more anxious in the process. Retain your highest praise for when your child manages to do something hard despite their anxiety, rather than pursuing an ‘anxiety-free’ life. Encourage your child to tell you about how they overcame a challenge and how that made them feel.

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Ways to address your child’s anxiety

1. ‍ 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 child's worrying thoughts. The first step of CBT is to identify your child’s fears – including what situations, people or activities trigger their fears. 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 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.
2. ‍Adapt or avoid stressful situations – Children with sensory issues will need you 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.‍
3. 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.‍
4. 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.‍
5. 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.‍
6. Confront separation anxiety – Whether your child likes it or not, sometimes they cannot 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 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. Do this again, setting the timer for 40 seconds. Keep doing this until you gradually build up to 30 minutes or an hour. ‍
7. 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. ‍
8. 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.‍
9. 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.

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Key messages for children to hear

• Making mistakes and feeling embarrassed is as normal as having fun and being happy
• Taking risks is a good thing – they make you braver and stronger
• Nobody’s perfect
• No one knows what’s going to happen tomorrow, next week or next year and that’s okay. Don’t avoid doing things just because they make you feel a little scared.
• YOU’RE in control of your life, NOT your anxiety. 
• Finally, encourage your child to have a kind and compassionate attitude towards themselves, and to everyone else in their lives.

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, you might find the resources below useful, which includes books from the IHC Library as well as helpful website and helpline numbers.

You can also contact the IHC library directly to have a chat about what you need on 0800 442 442 or email Librarian@ihc.org.nz

Helpful websites and helplines

• Time Timers available at www.autismresources.co.nz‍
• Anxiety New Zealand: 0800 269 4389 (0800 ANXIETY)
• 1737: Free call or text 1737 to talk to a trained counsellor
• 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