We spoke with our Safeguarding Officer, Kirsty, about the mental health challenges autistic children face and how to support them. In this blog, she shares key strategies, common misconceptions, and practical tips for parents, caregivers, and schools to create a supportive environment.
What are common mental health challenges faced by autistic children?
Autistic children often face heightened mental health challenges, particularly when they have negative lived experiences such as bullying or difficult circumstances at school or home. Puberty can further impact mental health, as many autistic children struggle with identifying, understanding, and developing strategies relating to their emotions. These challenges may lead to changes in presentation, increased dependence on a parent or another familiar person, and heightened sensitivity to triggering situations. For example, a child might exhibit fight-or-flight responses to stimuli like being touched or exposed to loud noises, such as a crying baby. Regulation is the key to helping an autistic child improve or keep their positive mental health.
How does school environment affect the mental health of autistic children?
Environment is key for an autistic young person. It needs to be welcoming, structured and meet the individual’s sensory needs so that it is not too overstimulating. Visual aids and timetables can help with understanding of routine and structure, along with a quiet or regulation area in or near the classroom, access to regulation tools such as fidget tools and providing opportunities for movement breaks as required.
Many Autistic people experience alexithymia, which is a difficulty identifying, differentiating, describing and recognising emotions. There are many different tools that might be helpful to support a young person to identify and share their feelings including Autism Level UP! energy meters, interoception body checks, emotions wheels, feeling thermometers, Zones of Regulation and The Galaxy’s Guide to Running My Rocket.
The Interoception Curriculum (Kelly Mahler) can help to build interoceptive awareness, which can support a person to increasingly recognise their body signals and is an important part of self-regulation skill development.
How can parents and caregivers identify early signs of mental health issues in autistic children?
Parents and caregivers can spot mental health concerns in autistic children by noticing changes in their usual behaviour. Signs to watch for include shifts in:
- sleep patterns,
- eating habits,
- or overall mood and behaviour.
Since every child is different, understanding what’s “normal” for them is key.
When changes occur, there may be an underlying reason, such as a shift in routine, puberty, a family bereavement, or transitioning to a new class or school. Even if the cause is clear, the child’s mental health may still be affected, and extra support might be needed.
If parents are concerned, they can speak to the school, which may suggest contacting a GP or, in some cases, refer them to CAMHS (Child and Adolescent Mental Health Services), or signpost parents to other support services. Parents can also use our ‘Hub of Hope’ on the school website by entering their concern and postcode to find nearby support services.
How can parents create a supportive home environment to boost their child’s emotional health?
Creating a familiar and calming environment at home is essential for helping autistic children regulate. Parents can access bursaries through their local authority, charities, or funding programmes to help develop these spaces. The school’s family liaison officer may also be able to assist in finding and applying for these.
What challenges do parents or caregivers face in supporting the mental health of their autistic child?
Supporting an autistic child with their mental health can be overwhelming for parents, leading to feelings of isolation, exhaustion, and even impacting their own well-being. Not knowing where to find support can add to this stress.
To help, our school provides resources like the ‘Hub of Hope’ on our website, where parents can find local support services. We also offer guidance through the Wellbeing Officer (Kirsty), Therapy Team, and Youth Mental Health First Aid-trained staff, who can signpost parents to helpful services or a GP.
Tools such as ‘Talking Mats’ can support a young person to share their thoughts and feelings regarding different topics with a communication partner. Talking Mats are an evidence-based visual communication tool developed by Speech and Language Therapists. For example, a Talking Mat could be used to check-in with a young person to see what is going well or not well in their lives. From the information shared in a Talking Mat we can then act to provide additional support e.g. amending timetables, increasing therapy support, creating safe spaces, and incorporating preferred activities to support regulation.
If these steps aren’t enough, we may then refer parents to a GP or other specialist services.
What resources or support systems are available for families navigating these challenges?
The school provides ongoing support to families through check-ins via phone, email, or in person, as well as regular meetings to discuss concerns and next steps. We also collect observation data that parents or carers can share with a GP or specialist if needed.
To support the child at home, we may send visuals and social stories, which can also be used in school if required. School staff are always available to listen and offer support to both parents and children, ensuring open communication between home and school.
How can society improve understanding and support for autistic children’s mental health?
While awareness of both autism and mental health has grown over the years, the connection between the two is often overlooked, especially when talking about autistic individuals or those with mental health challenges.
There’s a need for greater understanding and awareness, as well as the development of services tailored to neurodivergent individuals. Most existing services are designed for neurotypical people, but the way neurodivergent individuals show signs and symptoms, as well as how they respond to treatment and medication, may differ. This highlights the need for more research and focused attention in these areas. Many Autistic individuals who have experienced mental health challenges are sharing their experiences with the world (e.g. through books, blogs, social and mainstream media) which offers powerful insight into this – it is important to listen to autistic voices in relation to this topic.
What misconceptions about autism and mental health need to be addressed?
Mental Health is a part of autism:
There are many misconceptions about autism and mental health, with the most common being that mental health issues are just part of the autism. Families and school support staff understand the child’s baseline and can often tell when something is off. However, professionals sometimes dismiss these changes as simply being part of the autism, rather than considering the possibility of an underlying mental health concern.
Individuals with Pathological Demand Avoidance (PDA – often referred to as Pervasive Drive for Autonomy) or a PDA profile, may face additional challenges with their mental health needs being recognised due to their different presentation and support needs. ‘Traditional’ autism support strategies such as high levels of structure and visual support may not be helpful to their needs. For those with a PDA profile, everyday demands trigger their nervous system’s highly sensitive fight/flight/freeze/fawn response – even for things the individual really wants to engage with. To support and advocate for these individuals it is important to understand PDA and use alternative support strategies such as providing autonomy, working collaboratively with the individual, reducing demands, strewing, using declarative language and focusing on anxiety management.
The MMR vaccine causes autism:
Another misconception is that the MMR vaccine causes autism. This is false. numerous studies have proven there is no correlation between the MMR vaccine and autism, but this is still commonly believed by many today.
How can communities build inclusive spaces that promote emotional well-being for autistic individuals?
Creating clear, clutter-free, and welcoming environments, along with quiet times/ areas and clear signage using photos or colour coding can be very helpful. For example, places like Subway are well-organised, with choices broken down into manageable steps: first choosing bread, then the filling, followed by salad, sauces, drinks, and snacks. This structure makes things easier to navigate and manage. However, it’s important to remember that not every approach works for everyone. Some autistic children might find being asked so many questions overwhelming, so it’s essential to understand and adapt to what works best for each individual.
What does current research say about the connection between autism and mental health?
Just like everyone, autistic people can have good mental health. However, according to the autism research charity Autistica, seven out of ten autistic people have a mental health condition such as anxiety, depression, or obsessive-compulsive disorder (OCD). Autistic people are also more likely to report symptoms of post-traumatic stress disorder (PTSD)(Rumball, 2022).
There is little research into why this is, but it may be because autistic people:
- can struggle to try to fit into or make sense of the world, which can lead to feelings of depression and anxiety
- may face delays in getting their mental health problems diagnosed
- are more likely to face stigma and discrimination
- are less likely to have appropriate support available. For example, group therapy might not be suitable for some autistic people, or therapists might not know how to adapt their approach to helping an autistic person.
Masking plays a major role in an autistic individual’s mental health. Masking refers to camouflaging or suppressing natural autistic traits (either consciously or unconsciously) to fit into a non-autistic world. This can include things like forcing eye contact, suppressing stimming, mimicking neurotypical social behaviours and enduring uncomfortable sensory experiences. A high intensity of masking over prolonged periods can come at a significant cost to mental health, including increased anxiety and depression (Hull et al., 2017), autistic burnout (Raymaker et al., 2020), feelings of isolation and low self-worth (Bradley et al., 2021) and higher risk of suicidal thoughts and behaviours (Cassidy et al., 2018). Instead of encouraging masking and encouraging autistic people to behave neurotypically, we should create environments where autistic people feel safe to be their authentic selves, teach self-advocacy skills and encourage self-acceptance.
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References
Rumball, F. Post-traumatic stress disorder in autistic people. The National Autistic Society. (2022). https://www.autism.org.uk/advice-and-guidance/professional-practice/ptsd-autism
Hull, L., Levy, L., Lai, MC. et al. Is social camouflaging associated with anxiety and depression in autistic adults?. Molecular Autism 12, 13 (2021). https://doi.org/10.1186/s13229-021-00421-1
Raymaker DM, Teo AR, Steckler NA, Lentz B, Scharer M, Delos Santos A, Kapp SK, Hunter M, Joyce A, Nicolaidis C. “Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew”: Defining Autistic Burnout. Autism Adulthood. 2020 Jun 1;2(2):132-143. doi: 10.1089/aut.2019.0079. Epub 2020 Jun 10. PMID: 32851204; PMCID: PMC7313636.
Bradley L, Shaw R, Baron-Cohen S, Cassidy S. Autistic Adults’ Experiences of Camouflaging and Its Perceived Impact on Mental Health. Autism Adulthood. 2021 Dec 1;3(4):320-329. doi: 10.1089/aut.2020.0071. Epub 2021 Dec 7. PMID: 36601637; PMCID: PMC8992917.
Cassidy, S., Bradley, L., Shaw, R. et al. Risk markers for suicidality in autistic adults. Molecular Autism 9, 42 (2018). https://doi.org/10.1186/s13229-018-0226-4
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