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Be Well, Think Well: Supporting Individuals with Anxiety and Autism

Overview

This resource, part of the Be Well, Think Well resource collection, provides information about supporting individuals with anxiety and autism through panic attacks and various relaxation techniques such as deep breathing, imagery, progressive muscle relaxation, and grounding techniques.

Tips for Working with Individuals with Autism and Anxiety

  • Be aware of stressful environments.
    People with ASD are often nervous or anxious in new places. People can get easily upset by places that are noisy or crowded. or anxious in new places. People with ASD can also feel easily upset by crowded places and places that are very noisy.Think about the environment you are going in and prepare for stress ahead of time. Bring soothing objects, headphones, or technology to help the person cope better with stress.
  • Prepare the person for a change in their routine as much as possible.
    Some people may feel more anxious when their schedule is changed. Tell the person about changes in their schedule ahead of time to help them to feel ready for it.
  • Give simple directions when the person you are working with is really anxious.
    Make sure your directions are clear. Try giving one direction at a time. Give them plenty of time to think about what you said. Remember, people with ASD need to be given longer to understand and respond.
  • Know their coping skills.
    Some people find distractions, music, games or a comfort item helpful when they are anxious. Know what works for the individual that you are supporting. Make sure there are multiple calming strategies in case one item or activity is unavailable.
  • Teach skills to decrease anxiety.
    Help them practice coping skills even when they are calm. You can do this by acting it out or using social stories. Other strategies include: teach deep breathing and how to control their breathing, how to ask for a break from an activity, and how to ask for other things that help them feel calm.

Know where to get help.

  • Think about who else might have a good relationship with the individual. Family members, other staff members, and supervisors can be good people to help with more tips.
  • Talk with your supervisor about other ways you can help in crisis situations. Ask if there is training available to improve your own skills.
  • If needed, help the person to make an appointment with their primary doctor, psychiatrist, or therapist. Let the doctor know about the problems with anxiety.
  • Put emergency numbers (like a family members, number, the crisis hotline or 911) somewhere the individual can easily find them. It may be helpful to hang them on the wall near a phone or to save them in a cell phone’s contact list.

Supporting Someone Through A Panic Attack

Panic attacks can be scary and overwhelming for both the person experiencing it and those around them. The information below explains how to help someone who is experiencing a panic attack.

Remain calm

It’s important that you appear calm and relaxed in order to avoid escalating the person further. Appearing calm can also help model behavior that you want the person to follow. Keep your voice quiet, relaxed and talk slowly. Although panic attacks are intense and can look scary, they are not life threatening. Keeping this in mind may help you remain calm and be a positive support for the individual.

Talk to them

People get lost in their thoughts when having a panic attack. Talking can help distract them from their thoughts. Ask them questions, but keep them brief and simple. You don’t want to overwhelm them. Ask them to describe what they see or hear around them in that moment. You can also ask what you can do to help to make sure you’re providing them with the type of support they need.

Walk them through coping skills

A person may have racing thoughts when experiencing a panic attack, making it difficult to remember to use their coping strategies. One way you can help support them is by reminding them of strategies that help them relax. Prompting them to take slow, deep breaths and modeling it for them may be helpful. Remind them that they are safe. Prompt them to think of a place that makes them happy and have them describe every detail.

Reassure them

A little comfort can go a long way in a panic attack. Remind them that what they’re experiencing is not dangerous and it will not last forever. Be sure to be positive and give positive feedback about how they’re handling the attack. Keep your statements short and clear.  They can only handle so much while they’re experiencing panic symptoms.

Stick with them

Being alone can be frightening during a panic attack. Staying with them as they gradually come out of the panic attack will help them get through it and may also help strengthen your relationship with that person. Once the panic attack stops you’ll want to acknowledge how difficult the experience must have been and praise them for getting through it.

Relaxation Techniques

If you experience anxiety or stress, you may have heard someone recommend relaxation techniques. There are many types of relaxation techniques that are used to help anxiety and stress. Everyone is different and not all relaxation techniques will work for everyone.

Breathing is the only bodily function that we do both voluntarily and involuntarily, meaning that you breathe on your own without thinking, but are also able to change your breathing when you want to.

During times of stress, there may be changes in body functions – heart rate rises, sweating occurs, muscles tense, and breathing becomes rapid and shallow.

These physical changes, this can affect how people think and feel. If a person is anxious and their breathing becomes faster, this can make them feel even more anxious. To help get rid of those feelings, individuals can practice deep breathing, also called abdominal or diaphragmatic breathing.

Steps for Deep Breathing

  1. Be relaxed in a quiet, comfortable place with eyes closed.
  2. Place one hand on the chest and the other on the stomach.
  3. Take a slow, deep breath in through the nose for a count of between 5 and 10. The
    hand on the stomach should move first and further than the one on the chest. This shows that the diaphragm is pulling air deep into the lungs.
  4. Hold the breath for a count of between 5 and 10, but not so long to be uncomfortable.
  5. Exhale slowly through the mouth for a count of between 5 and 10. Gently squeeze the stomach muscles to completely remove the air from the lungs.
  6. Repeat this cycle four more times for a total of 5 deep breaths.
  7. Should be done at least twice a day to start, or whenever a person notices signs of anxiety

Anxiety and stress can cause a person to think negatively and imagine the worst happening. Imagery can help them focus on positive and pleasant memories and experiences and help combat negative thoughts. Focusing on these types of mental images can help the person feel relaxed.

Steps for Using Imagery

1. Be relaxed in a quiet, comfortable place with eyes closed.

2. Think of a calming place in your mind. Don’t just think of the place briefly, but imagine every detail about it. Go through each of the senses – sight, sound, touch, taste, and smell – and imagine what someone would experience in that place.

3. Here’s an example using a beach.

  • Sight – sun in the sky, sand under your feet, crystal clear water, calm waves rolling in
  • Sound – rustling waves, seagulls in the sky, wind blowing
  • Touch – sand or water under feet, warm sun on skin, wind on skin
  • Taste – saltwater in your mouth, cool glass of lemonade
  • Smell – ocean air and salt water, sunscreen

4. Imagine this scene for as long as possible or at least until anxiety begins to lower. If negative thoughts or imagines try to pop up, return thoughts to the calming place and try to stay focused on the relaxing image.

When people feel anxious, their muscles may get tense and make them feel stiff or sore. Progressive muscle relaxation teaches people to relax their muscles and lower tension. It also helps people learn to identify when they are experiencing stress so they can handle it better.

Steps for Using Progressive Muscle Relaxation

  1. Be relaxed in a quiet, comfortable place with eyes closed.
  2. Tense muscle groups, one by one. Use the diagram and instructions below as a guide, starting from the top and moving down the body.
    • Forehead: raise your eyebrows
    • Eyes: clench your eyelids tightly shut
    • Mouth: open your mouth wide to stretch the hinges of jaw
    • Neck and shoulders: raise your shoulders to touch your ears
    • Chest: tighten by taking a deep breath
    • Stomach: suck in your stomach
    • Arm: tighten your biceps and “make a muscle”
    • Hand: clench your fist
    • Buttocks: tighten by squeezing your buttocks together
    • Leg: squeeze your thigh muscles
    • Lower leg: tighten your calf muscle by pointing toes up
    • Foot: curl your toes under
  3. Hold the tension for 5 seconds for each body part, then release.
  4. Notice how the muscles feel when you relaxed.
  5. This should take about 15 minutes to complete, and be practiced twice a day to start.

A diagram used for Progressive Muscle Relaxation highlighting ways to move forehead, eyes, mouth, neck and shoulders, chest, stomach, arm, hand, buttocks, leg, lower leg, and foot.

Panic attacks can be scary. You might feel overwhelmed. You might feel like you can’t breathe. You might feel like you are having a heart attack. This resource will teach you strategies that you can use to help you cope with your panic symptoms. These strategies are called “grounding” techniques. Grounding techniques can help you calm down quickly.

Steps for using Grounding Techniques

1. Scan the Room
Take a look around you. Reminding yourself that you’re safe can reduce the panic and help you return to normal.

2. Relax Your Body
It’s sometimes easier to relax your body than it is to relax your mind. Relaxation techniques can help your body relax and calm your mind. Take slow, deep breaths. Breathe in through your nose. Pay attention to the feeling of your lungs getting bigger as you breathe in. Then breathe out through your mouth. Repeat this for a minute or two and feel the tension leaving your body.

3. The 5-4-3-2-1 Grounding Technique
During a panic attack, people can get stuck in their thoughts. Try to focus on things that are going on around you. Pay attention to all five senses. To do this, concentrate really hard. Name five things you can see around you. Name four things you can feel. Name three things you can hear. Name two things you can smell. Name one thing you can taste. Repeat until you’ve calmed down.

4. Picture a Calm Place in Your Mind
Think about a place where you feel totally calm. Maybe it’s a beach, a forest, or a special place you go that makes you feel calm. Take a few moments and take some deep breaths. Close your eyes. Imagine yourself in your calm place. Think about all of the details. Imagine the sights, smells, noises, and temperature. Really try to imagine what it would be like if you were there. Imagine yourself in your calm place for a few minutes before you open your eyes.

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Other downloads

Name Description Type File
Be Well, Think Well: Deep Breathing Relaxation Technique This resource provides information about one relaxation technique, Deep Breathing. pdf Download file: Be Well, Think Well: Deep Breathing Relaxation Technique
Be Well, Think Well: Imagery Relaxation Technique This resource provides information about one relaxation technique, Imagery. pdf Download file: Be Well, Think Well: Imagery Relaxation Technique
Be Well, Think Well: Progressive Muscle Relaxation This resource provides information about one relaxation technique, Progressive Muscle Relaxation. pdf Download file: Be Well, Think Well: Progressive Muscle Relaxation
Be Well, Think Well: Supporting Someone Through A Panic Attack This resource provides some techniques to help others cope with panic attacks. pdf Download file: Be Well, Think Well: Supporting Someone Through A Panic Attack
Be Well, Think Well: Tips for Working with Individuals with Autism and Anxiety This resource provides some tips and suggestions that staff can use to recognize when someone is anxious and help lower their anxiety. pdf Download file: Be Well, Think Well: Tips for Working with Individuals with Autism and Anxiety
Be Well, Think Well: Grounding Techniques for A Panic Attack This resource will teach you strategies that you can use to help you cope with your panic symptoms. These strategies are called “grounding” techniques. Grounding techniques can help you calm down quickly. pdf Download file: Be Well, Think Well: Grounding Techniques for A Panic Attack

This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.