Sunday, March 16, 2014

Helping your anxious child

Anxiety and autism spectrum disorders go hand in hand as it does selective mutism. Since these are two of my current research areas, when I found Ronald M. Rapee, Ann Wignall, Susan H. Spence, Vanessa Cobham and Heidi Lyneham's book, Helping Your Anxious Child: A Step-by-Step Guide for Parents, Second Edition, I was intrigued with how it might be useful in my practice. The book is aimed at helping parents help their children. For children reluctant to work with service providers, this program could be remarkably helpful.

The book focuses on a couple of strategies:
  • Identifying anxious feelings with words and the strength of them
  • Linking feelings with thoughts and actions
  • Detective thinking to identify unrealistic thinking.
  • Assertiveness and social skills training for children lacking in these skills
  • Step ladders to plan desensitization
  • Relaxation training
Before teaching children how to engage in these activities, the authors propose that the parents engage in them, especially if they have anxiety issues themselves. This gives parents insights to the challenge of resetting behavior and helps them develop skills that they will be teaching their children. Worksheets to supplement the activities are available both in the book and online.

One of the pieces that I thought was particularly helpful was the section on parental reaction to anxious behavior. The authors identify excessive reassurance, being too directive, permitting or encouraging avoidance and becoming impatient as normal but not helpful reactions. They recognize rewarding brave, non-anxious behavior, ignoring unwanted behavior, prompting constructive coping and modeling brave non-anxious behavior as productive reactions. They also caution that consistency, emotional control and distinguishing between anxious and naughty behavior as essential to productive action.

I think the concept of distinguishing between anxious and naughty behavior is perhaps the most challenging. When is my teenage son acting like a typical teenager, pushing limits and resisting parental input and when is he acting like an anxious aspie? I know that I get this wrong sometimes, but I also recognize how critical this is. As a parent I need to set limits and have expectations. I also need to recognize that inappropriate behavior is sometimes caused by his disability. For him, tears are an indicator that this an aspie moment, but I do not want to push him to tears to check what we are dealing with on a consistent basis. Detective work on my part is important to know what typically is a challenge for him because of his disability and what is a challenge for him because of his teenagerness. I suppose one of the key features is to give myself permission to get it wrong sometimes because I will.

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