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Social Anxiety in Autism



Autism spectrum disorder (ASD) is a neurodevelopmental condition that displays as social disorder. It is also widely known that children with ASD experience social anxiety (SA) at a higher rate (50%) than non-ASD children (7-13%). On top of the risk factors of anxiety for non-ASD individuals, individuals with autism have additional factors: difficulty interpreting behavioral and social cues. Their difficulty in engaging in fluid conversations and social skill deficits may derail the conversation. Moreover, one of the distinguishing features of ASD, repetitive movements or behaviors, may appear odd and be subjected to rejection and bullying. Altogether, these factors contribute to social isolation and withdrawal. The negative self-thought can lead to belief in inferiority or being the odd one out. On the other hand, not only does social skills, but sensory sensitivities may affect the development of social anxiety. Sensory stimuli, such as light, sound, or any sensation, may be distracting and anxiety-provoking in social situations. The avoidance caused by anxiety can lead to more withdrawal, which further impairs successful social communications. Because of the numerous difficulties these individuals go through, it is very important to raise awareness, especially to children, since social anxiety occurs at a high rate in children. It is important to be aware that just because someone with autism does not understand social norms does not mean they do not want to have social bonds.


It is important for clinicians to be proactive about assessing SA in individuals with ASD. Because of comorbid disorders such as alexithymia, difficulty in reflecting on own feelings, it is crucial to assess these individuals thoroughly and at the correct timing, especially when they experience huge transitions (i.e. to college). However, it is difficult to assess SA correctly because some characteristics, such as cognition, are more difficult to observe than behaviors. Studies that utilize multiple methods to assess SA are more effective in understanding each individual. Moreover, adults who are familiar with each individual are more likely to notice subtle changes, which can also aid in assessing SA. The assessment and intervention on individuals with SA is a necessary area of research, especially because anxiety occurs at a significantly higher rate for those with ASD.



Reference:

Spain, D., Sin, J., Linder, K. B., McMahon, J., & Happé, F. (2018). Social anxiety in autism spectrum disorder: A systematic review. Research in Autism Spectrum Disorders, 52, 51–68. https://doi.org/10.1016/j.rasd.2018.04.007

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