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How Can We Help Children with Autism with Their Phobias?

For a child with ASD, situations that could be bearable for the majority of regular kids could be upsetting or terrifying.

Tantrums and meltdowns share some traits and can be difficult to manage, but their underlying reasons are extremely different, making it important to handle them differently. It's crucial for people with autism spectrum disorder and their caretakers to comprehend these disparities.

Children and adolescents with autism spectrum disorder (ASD) frequently co-occur with anxiety disorders. Most studies show that roughly half of children with ASD satisfy criteria for at least one anxiety disorder, despite prevalence rates ranging from 11% to 84%. Specific phobias are the most prevalent anxiety disorder type, with prevalence estimates ranging from 31% to 64%. The prevalence of phobias among children in the general population, however, is thought to range from 5% to 18% (White, Bray & Ollendick, 2012).

For a child with ASD, situations that could be bearable for the majority of regular kids could be upsetting or terrifying. Additionally, children with autism may not react to other sensations, such as pain, strangers, or separation anxiety, and they may appear unconscious of evident threats (White, Bray & Ollendick, 2012).

The key to treating phobias is to develop a sequence of incremental steps that include bearable amounts of exposure to each feared aspect of the trigger event, while also include measures to assist the kid feel less distressed at each stage of that exposure (Johnson & Rodriguez, 2013).

1.       Determine whatever elements of the event the youngster fears. While certain phobias may initially only have one scary element for the child, as was previously said, most eventually have many "bundled" elements.

Other phobias are more complicated and have many bundled anxiety-inducing elements from the beginning. For instance, a youngster who fears attending birthday parties at school can also fear the schedule adjustments that the festivities entail and the sensory elements linked to the singing and clapping. Therefore, fear-inducing experiences' sensory, emotional, and associational components are all likely to be the cause of anxiety (White et al, 2009).

Even if one is unable to identify all of the feared components involved in a child's phobia, it is important to identify as many as possible because "unbundling" or breaking down feared events into their individual components and desensitizing the child to each one is more likely to be successful than attempting to desensitize a child to a bundle package of multiple fears (White et al, 2009).

2.       Choose self- and/or co-regulation techniques and put them to use to lessen the child's anxiety during guided exposures to the feared event. Depending on the child and the circumstance, different techniques work best for assisting a child in unwinding. Co-regulating techniques, or those that involve another person, such as sharing jokes with a beloved adult or peer, especially when the jokes feature elements of the feared event or adult-led relaxing techniques, are beneficial for many youngsters.

Deep breathing, relaxation techniques, and other sensory activities are examples of self-regulation techniques. Favorite books, music, and even electronics can help a child cope with anxiety and tolerate brief exposures to the fearful environment (Teresa Garland, 2014). Co-regulating and self-regulating techniques can be blended.

3.       Choose the methods or approaches to employ for desensitizing the youngster to each aspect of the event, and then combine them with anxiety-relieving techniques. Choosing the right methods and tactics can initially be confusing. The objective is to find strategies to gradually increase exposure so that each stage is not frightening for the youngster and might even be enjoyable. To enhance child interest and reduce anxiety, it is crucial to closely observe the child's reactions to these tactics and adapt your approach as necessary (Teresa Garland, 2014).

The following are a few instances of methods and tactics that can be utilized to gradually desensitize the youngster to various aspects of the feared circumstance or event:

1.       Role play and pretend play using increasingly real props. The child’s doctor or dentist can supply real accessories such as a tourniquet and plastic tubing to use on dolls or stuffed animals or on the adult caregiver (Moore & Russ, 2006).

2.       There are YouTube or other web videos that caregivers may find useful for the most feared scenarios.

More and more, there are kid-friendly, entertaining apps accessible to address common phobias. Additionally, there are websites on the Internet that offer a variety of terrifying sounds that can be utilized in desensitization exercises. Another option is to record oneself, a friend, or an instructor doing the terrifying thing. The actor can "ham it up," for instance, by jokingly seeming to be initially terrified, which allows the audience member to experience incremental exposure to the terror while having a good time (Nelson et al, 2015).

These experiences can be modified by the adult to fit the circumstance. For instance, start off watching videos with the youngster without any sound, then let him or her manage the volume by progressively turning it up. Audio tapes that are originally scarcely audible can be treated the same way. The grownup can then demonstrate their discomfort by covering their ears (Nelson et al, 2015).

3.       Create realistic simulations of the dreaded situation or occurrence without the offensive components. For instance, take the kid to the doctor's office when they don't have an appointment, or have a snack in the school cafeteria with only them and one other kid (Elmore, Bruhn & Bobzien, 2016).

In conclusion, phobias and anxieties can be quite crippling. However, they can be treated, which in some circumstances can cause the fear to disappear and in others will cause it to lessen. I will give numerous particular instances of how to treat different phobias using the paradigm and techniques outlined above in the following two parts of this series.


Elmore, J. L., Bruhn, A. M., & Bobzien, J. L. (2016). Interventions for the reduction of dental anxiety and corresponding behavioral deficits in children with autism spectrum disorder. American Dental Hygienists' Association, 90(2), 111-120.

Johnson, N. L., & Rodriguez, D. (2013). Children with autism spectrum disorder at a pediatric hospital: A systematic review of the literature. Pediatric Nursing.

Moore, M., & Russ, S. W. (2006). Pretend play as a resource for children: Implications for pediatricians and health professionals. Journal of Developmental & Behavioral Pediatrics, 27(3), 237-248.

Nelson, T. M., Sheller, B., Friedman, C. S., & Bernier, R. (2015). Educational and therapeutic behavioral approaches to providing dental care for patients with Autism Spectrum Disorder. Special Care in Dentistry, 35(3), 105-113.

Teresa Garland, M. O. T. (2014). Self-regulation interventions and strategies: Keeping the body, mind & emotions on task in children with autism, ADHD or sensory disorders. Pesi Publishing & Media.

White, S. W., Oswald, D., Ollendick, T., & Scahill, L. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical psychology review, 29(3), 216-229.

White, S. W., Bray, B. C., & Ollendick, T. H. (2012). Examining shared and unique aspects of social anxiety disorder and autism spectrum disorder using factor analysis. Journal of autism and developmental disorders, 42, 874-884.

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