Photo of Maddox getting his first and ONLY haircut where he sat in the chair by himself.

Many times when you see photos of Maddox his hair is pretty long. He doesn’t get hair cuts on the same schedule as other children, luckily he has a natural hairline so even without getting lined he still is a handsome guy (his brother on the other hand has no hairline so if he didn’t get regular haircuts…whoa). Maddox hates haircuts, even getting him to walk in the barber shop is a challenge he starts walking really slow, and his body gets really heavy…if you aren’t holding his hand, he would be gone! He won’t sit in the chair alone (his first haircut however, he sat in the chair with NO PROBLEM alone…1st Birthday before his MMR vaccination ***controversial statement*** but I can only give you facts and our experience). He cries, screams, tries to push the clippers away, moves his head around, tries to get down out of the grip of the person that pretty much has to put him on a semi headlock to get it done, and usually walks away with a haircut with no lining around the back and sometimes a few spots that are unavoidable mishaps. The reason for these adventurous trips to the barber, anxiety…a comorbid condition with autism.

Anxiety is very common in people with autism, about 84% of people with autism have anxiety symptoms. The most common form of anxiety synonymous with people with autism is social anxiety. Part of the reason is some of the social difficulties people with autism have, communication difficulty, poor eye contact, problems understanding social cues, awkward body movements all things that may be awkward to typically developing individuals. This discrepancy can cause teasing, bullying or simply someone choosing to not to befriend someone with autism. These things can cause anxiety for the person with autism in social settings.

Of course social anxiety or any type of anxiety for that matter is not limited to those with autism, anxiety is a normal part of human development, we all overcome fears in a daily basis. However, the symptoms and behaviors that accompany the anxiety can be more intense and require special interventions to help. Many times as typically developing people, when we have fears or anxieties we can overcome them with a pep talk or by mentally telling ourselves “everything will be ok” or “you got this”. This typically is not the case in people with autism, in most cases behavioral therapies must be used. Something called “shaping” is used often times with some type of reward system. For instance, if a child has anxiety about taking medicine from a syringe, the goal would be to shape the child’s behavior to the ultimate response of taking the medication through the syringe without a challenging behavior (pushing it away, clinching their mouth closed, spitting the medication out, etc). The protocol over time might be; taking an empty syringe and getting the child to put it to their lips for 3 seconds…then rewarding them with a preferred item once they reach the goal. Then moving up to 5 seconds…reward, then getting then to open their mouth…reward, then adding water to the syringe, etc, etc. Until in the end the goal is mastered and hopefully the skill translates into their everyday home life and not just in the clinical setting. This shaping process can take days, weeks, months…it is all dependent on the person. This of course is one of the preferred methods of getting over some of these anxieties. However, when it comes to some of the more severe anxiety disorders such as severe OCD sometimes medication is the only intervention.

If you are wanting to determine if your child may struggle with anxiety some of the typical behaviors you may see in a typical child would be restlessness, worry, hyperactivity or fear.  If your child is on the spectrum, they might display the symptoms a little differently; self-stimulatory behaviors such as repetitive body movements (rocking, hand flapping, twirling, etc), repetitive movement of objects (lining things up, repeating a pattern with objects, etc).  They can also engage in self injurious behavior, such as head banging, another cue can be if they consistently have a hard time getting and staying asleep.  Of course as with anything, one of these behaviors alone should not cause alarm.  Just keep in mind how serious and debilitating fear and anxiety can be for you as an adult, imagine what these children go through on a daily basis…ciao for now!  Monica