People with ASD can find transition and social times extremely stressful for various reasons such as the noise, smells, confusion of so many people in one area; others touching them as they pass by; as well as the everyday social and communications difficulties that they have. For children at school, unstructured breaks and lunch times can be particularly difficult and will often raise their anxiety. For example, they may have difficulties chatting with their peers, they may not understand the unwritten rules of games, and may become confused when different children change the rules and play in different ways.
Some children with ASD may appear as loners, not wanting the company of others. However, other people with ASD do want to join in, but lack the intuitive skills to do so. They can find it hard to make friendships and will become very stressed when such friendships do not work out, or a chosen friend does not keep in touch, or has other friends. People around them may not realise the reasons behind their difficulties and will leave them out of activities all together. Inevitably, this will lower their self-esteem, as they think others do not want to be with them and that nobody likes them. Some people with ASD like to spend some time alone after trying to conform to other's rules. They may just need time to be 'autistic' and flap their arms (or similar behaviours depending on the person); to have space to calm and de-stress after a busy/noisy time, or do something linked to their special interest. These behaviours should be respected, as they help the person with ASD to help manage their anxiety.
Low self-esteem can be due to the fact people with ASD often set themselves high targets, which may be unachievable, for example, to complete a piece of work without mistakes. When they do not achieve these targets they can feel unworthy and low about themselves. Added to this, they are often bullied for being different.
Many with ASD will worry about things years into the future. For example, a junior school child might worry about what they will study at college; a child starting secondary school might worry about exams and then college; a teenager might worry that they'll never marry; children may worry about how they will manage when Mum and Dad aren't there, etc. People with ASD can also worry about something they have seen or heard from another source, which is not related to them, will actually happen to them or their family and friends. They may need help to get these concerns into perspective by someone, perhaps explaining the situation factually and in clear language or by visual supports to explain something.
It is common for children with ASD to have sensory difficulties such as being hyper-sensitive to noise/touch/light or they may be under-sensitive and seek loud noises or firm touch. They may also have sensory issues regarding their diet, e.g. food colours, textures, flavours, etc. All thes can make them become very anxious about new situations and environments.
Unexpected changes in routines, timetables, people who work with them, food they like, clothing, etc. can cause huge stress and behaviour problems.
Visits to new places, hospitals, theme parks, things which to us are mundane like going to the shops, can all cause people on the spectrum to become highly anxious. They may well refuse to leave the house or they have a huge meltdown when they get there.
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