If your child has Autism Spectrum Disorder (ASD) and you’ve noticed frequent worry, overwhelm, or stress, you’re not imagining it. Anxiety is very common in children on the autism spectrum—and it doesn’t always show up in the ways we expect. Understanding how autism and anxiety overlap can help you notice patterns earlier and take meaningful steps toward support.
At Lepage Associates, we work with families navigating both autism and anxiety. Our goal is to help you recognize the signs, understand what’s happening beneath the surface, and explore effective strategies that support your child’s well-being.
Why Anxiety and Autism Often Go Together
Autism is a neurodevelopmental condition that affects how a child interacts, communicates, and experiences the world around them. Many children with autism also live with anxiety disorders at the same time. Research suggests that anxiety may affect a large portion of autistic children—sometimes in ways that overlap with core autism traits.
When anxiety co-occurs with autism, it’s important to understand that it’s not just “part of autism”—it’s a separate experience that deserves attention and thoughtful support. Anxiety can influence your child’s day-to-day life, even when they don’t use words like “worried” or “scared.”
How Anxiety Can Look Different in Autistic Children
Anxiety often shows up differently in children on the spectrum. Because autism affects communication, social understanding, and sensory experiences, signs of anxiety may be behavioral or physical instead of verbal.
Some common ways anxiety may appear include:
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More intense repetitive behaviors (like pacing, rocking, or hand-flapping)
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Avoidance of particular environments, people, or situations
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Increased distress around changes or transitions in routine
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Sleep difficulties or trouble settling at night
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Heightened sensitivity to sensory input (like loud noises or certain textures)
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Behavioral shutdowns, withdrawal, or irritability
These behaviors can be confusing because they sometimes look like autism features themselves. That’s why context matters—when these responses become more intense, frequent, or interfere with daily functioning, anxiety may be playing a role.
Why Anxiety Can Be So Common in Autism
There isn’t a single cause for anxiety in autism, but several factors can contribute:
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Sensory overload: Everyday sounds, lights, or crowds may feel overwhelming and stressful.
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Social demands: Interpreting social cues and expectations can be exhausting and anxiety-provoking.
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Predictability and change: Unexpected changes can trigger strong fear responses.
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Self-awareness: Some children with autism notice they experience the world differently from peers, which can fuel worries about acceptance or fitting in.
These experiences don’t mean your child is failing at something—they mean their nervous system is trying to help them stay safe in a world that can feel unpredictable.
Helping Your Child Manage Anxiety
You don’t have to wait for a crisis before supporting your child. There are many practical approaches that help children with autism feel more grounded and resilient.
Create Predictability
Children with autism often do best when they can anticipate what comes next. Simple routines and visual schedules can reduce daily stress and make transitions easier.
Name Emotions Together
Some autistic children find it hard to put feelings into words. You can help by gently naming emotions as they arise—“It looks like the noise made you feel uncomfortable”—so your child gradually builds awareness and language for what they’re experiencing.
Practice Coping Skills
Teach small, concrete tools your child can use when anxiety arises, like taking deep breaths, using a favorite calm object, or moving to a quiet space. Practicing these skills together — not just during stress — can make them easier to use when it matters most.
Celebrate Brave Moments
Even small steps toward a challenge are progress. Whether your child stayed in class a little longer or tried a new activity, acknowledging effort builds confidence.
Focus on Support, Not Punishment
When anxiety drives behavior—like a meltdown or withdrawal—it’s tempting to respond with frustration. Instead, try to notice the fear behind the behavior. Supporting your child through that fear teaches safety and trust.
When It’s Time to Reach Out
If anxiety is interfering with your child’s ability to enjoy school, connect with others, or manage daily life, reaching out for professional support can make a real difference.
Therapeutic support can help your child learn skills in a way that’s individualized, respectful, and tailored to their needs. This may include adapted approaches like modified cognitive-behavioral strategies that meet your child where they are.
You Don’t Have to Do This Alone
If your child’s anxiety feels overwhelming or confusing, support can help it become more manageable.
Lepage Associates offers compassionate, evidence-informed care for children with autism and co-occurring anxiety. We’re here to support families in Durham, Raleigh, and Chapel Hill, and through telehealth across North Carolina.
With the right tools and support, your child can feel safer, more confident, and better equipped to handle everyday stressors. If you’re noticing signs of anxiety alongside autism, it’s okay to take the next step. You don’t have to hope it goes away on its own—support can make a meaningful difference.