Why Anxiety Escalates in ASD Teens

Parenting at the best of times is hard work, but having a neurodivergent child is like parenting on steroids. Nothing works, you never feel like you can catch a break, and worst of all, you often feel like you’re not good enough.

If this sounds like you, this episode is going to help you find your mojo again. Dr. Olivia is joined by Dr. Melita Ash, a clinical psychologist and the director of Percuro Psychology, a specialist practice in assessing and supporting anxiety, neurodivergence and school-related distress.

Together, Dr. Olivia and Melita discuss:
 ✨ The challenges of identifying ASD in children, especially girls

 ✨ Managing overwhelm and emptying the stress bucket

 ✨ Social anxiety and autism

 ✨ The demand-capacity gap

 ✨ Patterns to look for in your neurodivergent children

🤝Contact Melita and the Percuro Psychology team at https://percuropsychology.co.uk/ 

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Transcript

Welcome To SEN Parenting

Dr Olivia 0:04

Welcome to the Send Parenting Podcast, focused on supporting, inspiring, and empowering parents and their neurodiverse children. I'm your neurodiverse host, Dr. Olivia Kessel. We'll be speaking weekly with experts in the world of neurodiversity. No topic is too big or too small for us to discuss. And most importantly, hearing the voices of other parents just like you. Looking forward to having you join us weekly as part of the SEN Parenting Tribe. So, welcome, Melita. It is such a pleasure to have you on the SEN Parenting Podcast. And I'm so excited to like unpick this topic today because, you know, why anxiety escalates in autistic teens and what is really driving it? There's so much to look at there. And I think a lot of my listeners who have autistic children who are in that kind of time frame of the teenage years, you know, it's a very hard place to navigate. So I'm really looking forward to digging into your brain and getting some really practical strategies that my listeners can use. But before we start on the topic, can you tell me a little bit about your journey?

SPEAKER_00 1:12

Yeah,

Melita’s Path And System Focus

SPEAKER_00 1:13

absolutely. So before moving fully into private practice, which I so I've been in private practice for a few years now, probably around 10 years, and I went fully into private practice a couple of years ago. But before that, I had over a decade working in children's services and particularly working with children in care. And during that time, I saw again and again how powerful and impactful the environment, the context, and the systems around the child are. So their parents and family, the school environment and society and government drives as well and policies. And I found I saw that when a child was truly understood and their needs were consistently met, they thrived. But I also noticed something else, which is as children move into adolescence, the expectations on them increase so much socially, emotionally, academically. And at the same time, the support around families often reduces. So parents suddenly find themselves navigating a much more complex stage and largely on their own. So as a psychologist, I already understood adolescence is a period of huge developmental change. You know, it's a stage where demands increase rapidly, and the systems that help regulate emotion and behaviour are still developing. And alongside my professional work, I'm also amongst teenagers myself. So I've seen up close just how complicated this stage can become. And for autistic teenagers whose nervous systems may already be working harder to process that sensory information, that social ambiguity, all the change that's happening, that increase in demand can just be enormous. So anxiety isn't appearing out of nowhere, although it might seem as though it is. It's a signal that the system's carrying more than it can manage. And that realisation is what led me to focus so much of my work in this area. So these days, I spend a lot of my time supporting families of anxious and neurodivergent teenagers. But this very often means working with the systems around them because teenagers don't exist in isolation. Their well-being is shaped by the environments they move through every day, their families, the schools, expectations placed on them. So a big part of my work now is on helping parents and schools to understand what's happening underneath the behaviour or what they're seeing to reduce that unnecessary pressure on the nervous system and to work together in ways that allow young people to feel safer and more able to engage. Because autistic teenagers, they're not fragile, they're often overloaded. So when the systems around them become more understanding and better aligned, that's when we start to see things shift.

Dr Olivia 4:47

Makes sense. Yeah, that makes a lot of sense. If we

Teen Brain Changes And Threat

Dr Olivia 4:59

look at like what is actually going on in a teenager's brain and why um why this kind of sets the scene of this turning point, you mentioned like, you know, everything's going all right in primary school and then secondary school. Can you take us through kind of what's going on in in those little teenage brains that is causing this uh havoc?

SPEAKER_00 5:19

Absolutely, and there's so much going on, you know, their brains are going through such a major reconstruction during this age. But at the same time, you know, they've got that increase in social intensity, so they're more socially aware, they're more needing to be accepted and approved of by their peers, and there's an evolutionary reason for that. You know, we're social animals, and if you think of adolescence as being that time between being a dependent child to hopefully an independent adult, to survive that, to become independent, they need to be accepted by a peer group. So it becomes very innately driven and neurologically rewarding to be approved by peers. So that fear of exclusion, that fear of being pushed out, feels really threatening. Um, so that really adds to that emotional load that they're experiencing. And then thinking about you know the emotions in the brain, their amygdala, so their threat detection system develops much more quickly than their prefrontal cortex. And I always think of this as like having a really sensitive fire alarm, so it just goes off at the slightest hint of any trouble, but they've got a fire extinguisher that's a bit old, not quite working properly, takes a bit of time to get out and to get, you know, to put that fire out. So they feel those emotions more quickly and more strongly, and it takes a longer time for them to calm down and to be able to manage those emotions. So sometimes I invite parents to kind of pause and ask themselves when their teen's smoke detector goes off, what happens in them? Because also during this period of time, well, all throughout, um, our nervous systems are so connected. And so your teenager will start to struggle during this stage. And as parents, anxiety feels urgent, doesn't it? We don't want to see our kids struggling, so then we want to jump in and we want to fix it and we want to kind of make it all okay. Um, and so we can end up with this dance of anxiety that that transfers between the teenager, the parent, and back again. And that's just because that's how our nervous systems work, they don't operate in isolation, so there's so much going on, and you know, if typical adolescence stretches the system, autism doesn't create a different picture so much, it amplifies every part of it.

Dr Olivia 7:54

Yeah, because

Peer Approval And Social Pressure

Dr Olivia 7:55

I can imagine, you know, you know, and I see this in my daughter's school as well. It's it's that wanting to fit in, that wanting to fit in with your social group and potentially not being able to communicate in a way that is reciprocated and then feeling left out. And, you know, it's you know, leading to kids actually dropping out of school because they they get so so much anxiety about it. And that then feeds into the parent getting more anxious about how can we resolve this, how can we fix this. So it's it it makes sense, doesn't it?

SPEAKER_00 8:25

It does. It absolutely makes sense. You know, if we think of when when children are smaller, a lot of their social interaction is play-based, so it's focused on a task, it's less demanding. And then as they get older, those social complexities just get more and more and more demanding. The social nuances, you know, having to infer what people are meaning when they say something, interpreting body language, it all just gets more complex, doesn't it? So if you've got a child that has those differences in social communication, that's going to become a lot trickier. And that's of course, sitting alongside that real need to be accepted by the peer group. So it's at the same time as it feels super important to get it right.

Dr Olivia 9:14

Yeah. And I, you know, I think that teenage girls, particularly, whether they're neurodiverse or neurotypical, it's it's challenging, you know, and it's it's that dynamic of wanting to fit in and maybe fitting in and then being excluded in school, and how that can flip up one minute you're friends, the next minute you're you're on the outside. And I don't, you know, if you come across this in your work as well, the kind of boy-girl, like, can I be friends with a boy or no, I can't be friends with a boy, all of that gets mixed into it as well, which leads to more anxiety.

SPEAKER_00 9:43

Yeah, absolutely. And again, I think, you know, when they're younger, they don't really mind or care, do they, whether their friends are boys or girls. Um, and then again, you know, I suppose it's part of that social identity development. You know, if you are a girl and you want to be accepted by your female peer group and you might look to them for ideas of how you want to be, how you want to look. But also you might want to, there might be romantic interests, or they might just want to be friends with boys. And again, how do you navigate that? Because it boys and girls are quite different, usually, aren't they? Um, so it can become a lot trickier.

Dr Olivia 10:26

Yeah, and I I don't know, my daughter's school, like if you even like talk to a boy, you're considered going out with him. I'm like, that's ridiculous. You know, like there's all those social cues and and all of that that you need to pick up on and understand. You can see that kind of social comparison of, you know, I'm this way, this person is that way. And when you're talking about autistic teenagers, that kind of unpredictability and that uncertainty of you know, it's not, you know, it's it's it's a changing environment day by day. Um, can you talk a little bit about that and how that puts more pressure on the system?

SPEAKER_00 11:00

Absolutely,

Uncertainty And Sensory Overload

SPEAKER_00 11:01

yes. If we think, you know, during for all adolescents, then they've got those increases in social demands, academic demands are increasing, there's that expectation to be more independent, you know, environments are getting noisier and more complex. And for our autistic teens, if we think about the different aspects of autism, what that brings to a young person's experience, so they may have differences in how they process um sensory input. So noise, smell, light levels, busyness, all of those things at the same time that those things are those sensory demands are increasing, so they're in a noisier environment, a busier environment, and it is a lot more unpredictable. There's so many more changes. So we know another aspect of autism is that autistic young people struggle with uncertainty of any level, keeping things predictable, keeping things the same, knowing what's going to happen, how it's going to happen, and having that general, I suppose, rhythm to their day where they know and they're in feel therefore more in control of what's going to happen, and that reduces their anxiety. But actually, they move into secondary school and they've got all of these changes happening through the day. They've got different teachers, they have to move about to different classrooms, a lot more subjects. So that's like the context. And then on top of that, we think about the social communication piece. So they're showing up in those peer relationships, and suddenly those social communication presentations are a lot more complex and a lot more unpredictable, and people are different from one day to the next. Um, and a joke might be said, and it doesn't mean what it's you know, it's not it's taken literally by an autistic young person. Um, so even things like just chatting to people becomes very unpredictable, and often as well, they're surrounded by a lot bigger of a peer group, aren't they, in secondary school? So those differences across different people and trying to make sense of all of that on top of the context, the environment that they're in. And I think added to that as well is often autistic young people struggle to identify what is going on in their body and what that means. So it can be things like you know, hunger and thirst, but it can also be those emotional signals. So our emotions very much show up in our body, you know, we feel, don't we, in our chest or our tummy when we're anxious. And for an autistic young person, they get that feeling, but they don't necessarily know what that means. And they also can struggle with expressing those emotions using words, so that's called lexothymia. So, on top of all of that, they've got all of these different feelings that are happening. And how do they make sense of that when they might struggle to interpret that what those signals are telling them?

Masking And The After School Crash

Dr Olivia 14:15

It's almost like a double whammy in terms of being able to process and to understand it. And you know, you hear a lot about masking nowadays, and and that's one way when when faced with this onslaught that you've just described of sensory overload, uh, social cues that aren't understood or being able to process, and then internal emotions that the individual can just use masking as a way to survive.

SPEAKER_00 14:41

Absolutely. You know, masking, so masking is the effort that autistic young people make to hide those differences, and it often becomes more apparent during these adolescent years because of this need to fit in, to not be seen as different, to meet those social expectations. Um, so they might copy peers, they might hide their natural reactions, or they might be carefully monitoring how they behave in different situations. So they might even do things like rehearsing conversations ahead of time, monitoring their voice tone. There's so much that that goes into it. Um, and this is very understandable because they don't, as I say, they don't want to stand out, they want to reduce that risk of being judged, they want to fit in. But the difficulty with masking is it takes such a huge amount of energy, you know. So it's another, it's another thing weighing on the nervous system. So a young person might look like they're coping during the school day, they might look like they're doing okay. And as I said at the start, often schools will say they seem fine here, but by the time they get home, their nervous system is so overloaded, they're so exhausted that they need somewhere safe to just let all of that go. So parents often tell me, you know, they've been fine all day in school and then they've had a huge meltdown when they've got home, or they've gone off to their room and they don't want to come out for dinner, you know, and it's because of this effort that this masking takes.

Dr Olivia 16:19

Yeah, it's they they they've reached the end of their rope, and then home is a safe place to just be yourself again. Um and doing that continually, day in and day out, you know, it leads to burnout. And I I run a community of moms as well who talk about this this cost that you're talking about, the cost that masking has, and then children just refusing to go to school anymore. Can you talk a little bit about how that progresses? And

Burnout And School Refusal Spiral

Dr Olivia 16:48

we will talk about strategies as well, but kind of painting that picture of understanding why that happens and why that is that progression from masking to burnout to school refusal.

SPEAKER_00 16:59

Yeah, I mean it comes down to I think it's not just about masking. I think it is, you know, again, that transition from primary to secondary school. So in primary school, you know, young people are often in one classroom, they've got one teacher, they've got a lot of scaffolding and support around them, they've got fewer subjects that they're learning. There's a lot more opportunity for those unstructured play times to become more structured. You know, there's often activities and things on that um they are supported to engage in, and then they move into secondary school, and it's quite sudden a change as well, isn't it? I know we have transition days and things like that, but you know, suddenly they find themselves in year seven in a really busy, noisy environment, that sensory load that's there. So there's all of that that's going on as well. They're managing all of those additional transitions across the school day. So, you know, going between different classes, sometimes even being with different peer groups in different classes, getting used to different teachers, having stand-in teachers quite often as well. Sometimes, as well, that expectation to independently get themselves to school and back, you know, it's another thing, isn't it? And often there's you know an increase in academic demands as well. So they're having to suddenly get used to, you know, managing their time during adolescence when those executive functioning skills are still very much developing. So there's all of that, and then the social piece on top of that. So that exhaustion, that impact on the nervous system means that they are holding so much every day. So if we think of you know the stress bucket analogy, are you aware of that? Where the stress goes into the bucket and then we poke holes in it, which is where we let the stress out. For an autistic young person, their stress bucket is usually sitting very close to the top, and it doesn't take much to tip them into overwhelm. And when you spend a long period of time in that hyper-aroused state, your nervous system is really triggered. You're in that fight flight for a long period of time. You know, it's a lot of effort, it's a lot of demand on the body, it's a lot of demand emotionally, and all through that time, they're still often trying really hard to keep going and keep managing. And over time, that leads to exhaustion. And of course, what do we want to do when we're exhausted and we're hugely stressed out? We want to remove the source of that stress, you know. So they don't want to go to school because that's what they see as being the source of that stress, and then of course, they don't go to school, they get that relief from the anxiety, and then that reinforces actually it's better not to go to school because I feel okay when I'm at home. Um, and then often they then have less opportunities to socialise and things like that. So it can kind of snowball if things are not put in place at an early point to support their needs.

Dr Olivia 20:19

Absolutely. And you know, um, I don't know if you've read the book Your Child's Not Broken by Heidi McVere. I haven't read that. It's it's a great book, and it kind of describes her son's journey not wanting to go back to school, and you know, the school saying, Oh, you must come and touch the the pole that you come and you know, but but that's not actually helping the situation because you're not dealing with what's causing the overload, you know, you're just to to make the child come back in again without changing the environment. Uh, another another great author as well described it as making them go back into a burning building. You know, you would never do that, but and that's kind of what's happening with them, with that overload, with that needing to mask, with that inability to decompress, we're asking too much of them. And, you know, it it brings to my mind like what, and and I want to get to our strategies and and solutions, but also I think, you know, what environment your child is in is also super important too. Sometimes we don't have a choice with that, but finding the right school, the right environment for your child is an important ingredient. Um, so let's talk, you know, we've we've kind of we've painted this picture of uh, you know, what's going on with a, you know, it's it's difficult for all teenagers, right? But then we we've talked about how it's that much more for an autistic child. Um, and there's different challenges with ADHD children and dyslexic children and all shapes and sorts. But what can parents do?

Signs Your Teen Is Struggling

Dr Olivia 21:46

How can they recognize, first of all, because maybe they're not understanding, or the child's masking at home, or how do how do parents first of all identify that their child is really struggling? And then what can they do?

SPEAKER_00 21:58

Yeah. So think and Terms of identifying what they're likely to see is I always say to parents, you know, you know your child the best. And so anything that's different to how they usually are, I mean, obviously they're changing every day anyway during adolescence, you know, it's such a fast, you know, the child you had yesterday is not the child you've got today. But if there's anything that you're noticing in your child that just is not, you know, part of their usual personality, you know, perhaps um they're becoming more withdrawn, perhaps they're laughing a lot less, perhaps they're struggling to sleep, or they're refusing food. Or another big thing is so when I when we talk about this difficulty with um managing uncertainty in autistic young people, if we think of uncertainty at one end of the spectrum, at the other end is absolute certainty. Yeah. So what often happens is when a young person is is really struggling with this unpredictability and uncertainty part, what they will try to do is reach for absolute certainty. So what you might see is a child that starts to really try and control. So they might be controlling themselves, you know, becoming really different to how they normally are. The masking might well go up, um, they might become controlling of other people, so they might start having friendship difficulties or trying to become controlling of their parents, and or might become controlling of their environment. So trying to make sure that everything is exactly how they need it to be, when they need it to be. And that is often a response to that real nervous system overwhelm because everything just feels so unpredictable, so chaotic, that they're just feeling hugely overwhelmed. And why wouldn't you try and fix that?

Dr Olivia 23:58

It's a coping mechanism. Absolutely. So when a parent kind of identifies that they they, you know, that they are struggling, where where where does one start in terms of finding the solutions? And I like how you you in the introduction kind of talked about how it's not just the child, it's the external factors. So, how how does a parent start to help their child to navigate this if they can see from what you've just said that their child is struggling?

Safety First Through Co Regulation

SPEAKER_00 24:24

So I always talk about this as being like a three-tier pyramid. So if I just talk you through each of the tiers, so at the bottom, so the first tier, you've got safety and co-regulation. So this needs to come first. So does your child feel emotionally and physically safe? And often, you know, we talked about school before, often there are things going on in the school environment that mean that they're not feeling safe. Perhaps they're having a hard time from peers, or even they're getting bullied, or you know, the academic demands are too high, or they need a bit of support to break down tasks that they're expected to do, or to manage those friendships, or just manage those transitions in school generally. And then the co-regulation. So if your child's nervous system is in that absolute overwhelmed state, they are unlikely to be able to do anything for themselves in terms of bringing that back down in terms of regulating. So often parents, you know, they're given coping strategies, you know, do this breathing technique with them, do this muscle stretching technique with them. That's not going to work when they're really dysregulated. You know, that thinking bit of their brain is offline, you know, they're totally in their body, they're they're emotionally driven right now, and they need a hand, they need support to bring that back down. So, as I say, part of that is thinking about safety emotionally, safety and physically sometimes if there's anything like bullying going on, lowering any unnecessary demands. So we can't take away all of the demands that our young people are facing, but are there things that can be tweaked or reduced and that just take that pressure off them, even if in the short term, while they sort of recalibrate and reset, validating what they're feeling. So remembering that autistic young people may struggle to identify and name their emotions, and that makes their emotions quite scary, actually. Um, so as a parent, if you can say, I can see that you're feeling really sad right now, or I can see that you're feeling really worried or really anxious right now, just as simple as that. You're giving them a word to describe what they're feeling, and you are letting them know that their feelings make sense. Like there's not something wrong with you here, you know, you are experiencing a normal emotional reaction to the situation and context that you're finding yourself in, and giving them that safe space to allow that mass to drop, that recovery time. So, you know, after school or after any social occasions or anything that feels difficult for your child, they might need a bit of time alone in their room under their duvet, doing not very much, and that's okay, you know, that's that's that's that time to allow their system to come down again. So that's sort of the base of everything.

Reduce Demands Before Teaching Skills

SPEAKER_00 27:31

And then the second tier is about thinking about reducing triggers and demands. So this is about thinking about that intolerance of uncertainty, so increasing predictability where you possibly can. So some young people quite like a visual timetable, and there's now loads of teen-friendly apps out there that are really good for this. So then it's not that chart on the wall where they might be saying, no, that's too baby-ish. No, don't want that. Um, so there's loads of apps out there now that can help with this. And also having that routine, even simple things like eating at the same time every day, having a routine for evening and bedtime, um, during weekends, even though it's the weekend, having a bit of a routine to the weekend so that they know what's going to happen, they know what to expect. So it takes that unpredictability out, well, it reduces it, takes it a little bit out of the equation. And then thinking about their sensory needs. So, you know, if they struggle with noise, are there ways to manage that in terms of reducing noise levels or using things that can help them to manage that? So things like loops um, you know, that you put in your ears. Can you communicate with school about perhaps them being able to transition from one class to another at a different time? Again, though, often in my experience, young people don't want to be seen as different. And so they might say, Well, I don't want to do that because you know, my friends will be asking why. So we always have to balance this stuff. But if there's any sort of low-key things that can be changed to manage that sensory load, then that's really good. Even sort of where they sit in class can make a big difference, and then you know, if they're going into any social settings that are not usual, so um, you know, perhaps if you're going to a family wedding or something like that, giving them some predictability within that. So, this is what time we will get there, this is what time we will leave. If you need to leave earlier or you need to take a break, that's fine, just let me know. This is where you can sit. Um, and they might not want to do those things, but it's just taking that pressure off them that they've got to make all of these many decisions in an unfamiliar environment. Um, so all of this really is about playing a bit of detective around what might be going on and what might be triggering this anxiety, and actually having that real understanding of autism and adolescence and the crossover can really help you to play that detective and work things out, bearing in mind your child might not be able to tell you what's going on. So, once all of that's in place, so we've got, you know, the first bit, which is the safety and the co-regulation, and then we've got reducing those triggers and demands where you can. The cherry on the icing on the cake is about coping strategies, and I can't emphasize that enough because so many times parents feel so stressed because they're trying so hard, they're doing all of these different techniques that they've been asked to do or they've found on the internet and things like that, and it's just not working, and then they feel like they're not doing it right and they're not a good, you know, doing a good enough job, and that makes me feel really sad actually, because it's not the case. But if all of those things are in place, your child's anxiety levels should be reducing anyway, and at this point, they're back up here in their heads, which means that they can process and they can learn. So they're more able to be able to engage with education, touching on what we said earlier, but also thinking about some of those anxiety management techniques like breathing, like progressive muscular relaxation, like problem solving, all of those things can be helpful and graded exposure, you know, that you kind of touched on earlier, but only when the environment is set up in a way that absolutely meets their needs. So, yeah, so it's it's about kind of emphasizing really that it's all that stuff under the surface first before we think about the pro the skills bit.

Dr Olivia 32:04

And one really tend to do it the other way around, don't we? Because it's something yeah, and it's well, I don't want to say easier, but it's it's it's oh, have you tried this? And oh, you know, and yeah, it seems like it could deliver quickly, but it oh it doesn't if you haven't put the other parts of your pyramid in place.

SPEAKER_00 32:21

Well, it's this demand capacity gap, isn't it? You know, that's what's happening during adolescence for autistic teens, is the demands have gone up and their capacity has gone down, and so there's that gap, and anxiety fills that gap. So if we can reduce those demands, that gives them more capacity then to be able to learn some of these skills that we might teach them. And you know, I'm not saying they're not helpful because they are, but it needs to be with that in mind and with that context in place. So things like you might have heard of zones of regulation to sort of think about zones of regulation. Yeah, yeah, absolutely brilliant, and it's a nice simple way of being able to understand and communicate what you are feeling, but it's something you have to learn, isn't it? So you need to be able to access your thinking brain to be able to access learning about zones of regulation.

Dr Olivia 33:20

So that's just an example, but yeah, and I would imagine, you know, with trying to decrease that gap between the demands and and the capabilities, a lot of stuff is probably easier to do in the home and to change. You know, how do you work with your clients in terms of what they can do at home versus what you can do at school and what the school can support on? Because it's you know, they spend a lot of time at school that then you have to deal with at home. But how, you know, how do you navigate kind of being able to do some of these strategies both at

School Adjustments That Actually Help

Dr Olivia 33:55

school? I can see how it's easier at home and you can reduce stuff at home to help with the increase at school, but how can people work with the schools to it's it's a fraught situation, isn't it? Because as you mentioned, they don't want to be different, they don't want to be wearing ear defenders in the classrooms, especially as a teenager. They don't want to be perceived as different. It's a time in life where they definitely want to be part of the pack. Are there any tips that you could give us in it for how schools can help? Or do you have to look at different school environments where maybe there are more autistic children there, or they are more inclined to um where everyone kind of has their needs met in a similar way?

SPEAKER_00 34:34

You know, all schools are different. Some schools naturally have an environmental setup that lends itself more to the needs of autistic young people. There's no getting around that. I think also schools are under such a tremendous amount of top-down pressure that's focused on attendance and attainment and doesn't leave, in my opinion, that much space, that much time, that much thinking, time and energy to be able to think about meeting these emotional and social and autistic needs. And so it is a challenge for schools. And I think in an ideal world, what we would be thinking about would be whole classroom approaches or whole school approaches, and a really simple example of that is to have you know uniform adjustments. You know, why do we need to put hair in a shirt and a tie in the 21st century? Um, and a lot of autistic people I meet really struggle with that sensory uh experience of that tight collar around the neck. Well, that's something that's simple, in my opinion, that's yeah that schools could change, you know, they could still have a uniform, but it could be something like a hoodie and a pair of joggers, you know, something soft, something comfortable. In terms of specific works, so I work a lot with schools. So whenever I'm working with parents and and we think that part of the picture is that stuff is happening at school where needs are not being met, and their child is therefore struggling, usually at home as well, as a result of that. I think we'll be able to go into schools and to think with them around what might be might realistically they be able to put in place. And again, it's thinking about what feels so the child needs to be at the centre of this, they need to feel in control and have a say on what things are put in place. Also, schools are operating, as I said before, within constraints themselves, you know, they've got a lot of demands on them themselves. But thinking about things like having somewhere that the child can go during, because often unstructured times are the trickiest, I find, you know, those break times, those moving along the corridor in the busy environment times. So is there somewhere that if the child wants to, they can go to for a bit of a breather, a bit of a kind of reset and time out? And then thinking about the the executive functioning part, thinking about whether that they have, particularly as they move further into school and things become longer and more complex, can they have written instructions to um go alongside the teacher talking? So there's less needing to process that verbal information when they might be anxious anyway and struggling to do that. So, can they have tasks broken down? Can they have information given in a written format? What happens when there's going to be a stand-in teacher? Is there a way of letting the child know, even if it's just a bit ahead of time, so they're not turning up to class and suddenly seeing a new face? You know, is there some way that they can be prepared for that and can expect that it's going to happen? And I think a really key thing is relationship as so having somebody in school who is not responsible for behaviour. So usually head of year is not a great choice. Um if there's a separate pastoral lead or somebody, or even a teaching assistant who doesn't usually teach, involved in teaching them, who can proactively check in with them just to check how they're doing, do they need anything, have any challenges that they've got, how to identify those and what thoughts might they need to be able to move forward from those challenges. But I think that requires building the safety within that and the trust within that relationship. So it would need to be hopefully a consistent person, somebody who's not responsible for managing behaviour, who can check in and who hopefully have a really good understanding of autism and autistic needs, who is able to provide that for them. You know, there's lots of other things that schools can do, but I think again, it's about thinking very realistically, and even small changes can make a huge difference for young people. Sometimes, if your child is already struggling with a school-based distraction, school avoidance, it might be about stripping things right that having a reduced timetable, and again, this would need to be done in conjunction with school, but the reasons are really reduced, means they can start from a place of this feels more manageable, and therefore they're more likely to go into school and feel that sense of I did it and it felt okay. So now I can build on that, and but all of this really requires you know good partnership working between parents and schools, which sometimes can be tricky.

Dr Olivia 39:53

Absolutely. And and that and that's where it goes back to the setting again, because there's some schools that are doing a phenomenal job in this area, and there are some schools that aren't. And I know um, you know, there is a kind of postcode lottery with a lot of things in the UK. School systems are is a similar one. And even the the I the send white paper that's just come out, how you know wanting everyone to be educated in the same setting, or having specialists like inclusion units and then coming back in and out. To me, it's it, you know, it's that environment of feeling safe that is so important, and that's what you're kind of describing here, and giving some of that control back to the child, too, so that when they're not feeling safe in the environment, they know where the emergency exits are, they know the person that can help them, and that decreases the anxiety because it it empowers them, so they're not just stuck in a situation that they have no control over.

SPEAKER_00 40:49

Yeah, and Olivia, if I underpound for every time a young person has come to me and they just feel trapped, you know, it's that feeling of I'm overwhelmed, I'm struggling, I'm anxious. And actually, you know, having a exit strategy in itself can really reduce that anxiety because it creates a sense of safety and control. And we all want that, right? We all want to feel safe, we all want to feel that we've got some control and we can remove ourselves from an environment if it doesn't feel okay. So absolutely having that is so important.

Dr Olivia 41:26

Yeah, and I mean I even do it with my daughter when we go out to environments where maybe she's embarrassed if she needs, we have a secret word, and so if you say that word, then I know what she means and I will facilitate uh whatever needs to be done because then and and she you know doesn't need to use it almost once she has that, because then you have that control and you know that it just decreases the anxiety level because you have a way out if you need it, and it doesn't involve you having to advocate for yourself for it. Absolutely. And and you know, as as they get older and as they, you know, as that prefrontal cortex starts to develop more, then you know, they will start to learn to advocate for themselves. But it's what structures you can put in place and to give them that kind of scaffolding while that brain is developing through the teenage years with all that increased kind of demand on them as well. So it's uh it's nice to hear that there are simple things that can be done in schools uh as a starting point. And I think also to our earlier conversation about identifying it, the sooner that you can identify that things are going awry and you can start putting these things in place, the better, because anxiety becomes a tumbleweed that gathers dust and lint and everything as it rolls along. So the sooner that you can start the scaffolding and the sooner you can get the school on board, the sooner you can do stuff at home, or when you're in external environments, the better.

Supporting Parents Through The Fear

Dr Olivia 42:46

In all of this, parents are having to navigate this too. And it can be really distressing. I'm, you know, as a parent, when you're kind of blaming yourself, you you don't have that control in the it in the school for your child, you know something's going wrong, and you feel kind of out of control, you might be being dismissed by the professionals where, you know, as you said earlier, they you know, oh, they're fine at school, but you know in your guts that they're not doing well. How can how do you help to navigate and empower parents during this period of time? Because it's it's very challenging. And I know because I'm also a mother of a teenager.

SPEAKER_00 43:23

Yeah, it is so challenging. And you know, I think as well, the more anxious your child is, the more anxious you are. You know, talking about what I said earlier about that nervousness, it's contagious, absolutely contagious, it really is. Um, and I think also parents are going through such a huge period of change themselves during these adolescent years. And if your child is autistic and maybe struggling, you might be worrying about what this means for their future, how they will be doing. And as parents, we always blame. ourselves when everything goes wrong and we blame everybody else when everything goes right. So true, isn't it? But you know, it if things are if your child's struggling, it does not mean that you've lost your parenting ability. It means the developmental context has changed, you know, and I think that is so important for parents to hang on to. So I think in order for parents to get back in touch with that internal compass to redevelop that confidence again, it's about really understanding what's going on underneath the surface for their child, really understanding those autistic needs so that when you are going to a school meeting or you know you're trying to apply for that EHCP or whatever it might be.

Dr Olivia 44:55

I just draw my eyes for the listeners who can't see us.

SPEAKER_00 44:58

But you can have that inner confidence that you know that you are speaking from the evidence base. You're speaking from what we know helps what we know is needed. And the other the other part of it is I think get some support as a parent. There's some really great organisations out there such as Ipsia which supports with the legal side of things. There's Sendyas um which can support with things as well there's there's autism UK there's there's lots and lots of different organisations out there that can help you and a lot of advocacy organisations actually as well. So I think don't try and do this on your own. At least gather your support network around your friends and family you know if if you don't access any outside organisations but always come back to you know your child if you're feeling that things are not okay, that they are struggling that's going to be right. Because you're there every day you see the stuff that other people don't see the stuff that school doesn't see the stuff their friends don't see and you are able to pick up on those really subtle cues as well that other people might not pick up on. So listen to that internal compass and it'll get louder and you will become more confident. So that's kind of what I support parents to do through the work that I do with them.

Dr Olivia 46:25

Yeah it's it's it's trusting your gut and realizing that you know we all have imposter syndrome and no one gives you like a manual to how to be a parent let alone how to parent a neurodiverse child which is like I think parenting on steroids so you know you're you're muddling you feel like you're muddling through it but actually you do if you listen to your gut and you you know your child you already know and then and then as you say reaching out to other parents I also find incredibly helpful which is part of the reason I started this podcast is because when you when you hear other people's stories and then you hear what they've done you can implement some of those things too you can learn from each other and it's it's a brilliant way you know you're not alone and I think sometimes you can feel very alone as a parent and you know you're not and there's lots of people navigating this and you're doing the best job that you can so you know I always say to moms and dads out there you know give yourself a pat on the shoulder you are doing the best that you can and you know teenagers teenage life is difficult but it is also what what is you know needed to grow up into an adulthood and don't worry about the tomorrows you know like you can catastrophize that they're never going to leave the house they're not going to pass their GCSEs it's all going to be terrible trust me I've been there and and when you let that go you know when you let it go it decreases your anxiety like I told my daughter I don't care if you pass the GCSEs. I said I really don't you can take I've run into people who've taken them five six seven eight times before they've passed and I'm like so you know this might just be the first the first time we're doing it and I and she you know she said to me you know what I figured it out mommy you know I can just become an entrepreneur. You don't need GCSEs for an entrepreneur. I said yes that's true I said but what you learn with going through the GCSEs that you know studying that putting the effort in um that trying hard those are all important life skills and so I want you to do this and try your hardest you know we don't have to be anxious about it because we know we can retake it again you can become an entrepreneur but we are learning good life skills along the way here so you know just trying to decrease that anxiety but it had to start with me first because I had to let go of the fact that oh my God what if she doesn't pass her GCSE, she can't even become a hairdresser ah and then you know and then children pick up on that. So uh you know we lead by example and I think the first you know one of the things that we need to do with our children is decrease our anxiety so that they can model what we're feeling as well.

SPEAKER_00 48:50

So yes a hundred percent and that that is a core part actually of the work that I do with parents is helping them to I call it the 4 a.m disaster party because so many parents are like I was awake at 4 a.m again thinking they're going to be homeless on the streets at the age of 35. And it's about peeling that back you know the story isn't over yet your child is 14 15 whatever age they are they are so young there's so much opportunity out there and there's so much you know once they're if they're struggling with school they're going to come to the end of their school years and then they might find a job that really really meets their autistic needs you know if they've they've got that real autistic monotropic attention where they can deep dive into something learn so much about it they will be an absolute asset to an employer you know so the story isn't over yet that's I think that's a a great uh way to end except I have one final question for you which is what are your top three tips that you can give to my listeners who have an autistic teenager at home who is anxious?

Three Tips For Calmer Days

SPEAKER_00 50:04

I only have three I'll try and be concise. So if I had to leave parents with three things. So first during adolescence the demands of the world around their young person is often beginning to exceed what their nervous system can comfortably manage. You know it's not that anything's going wrong it's a developmental process. So please don't panic. Second when the nervous system becomes overloaded the most helpful starting point is often to reduce those demands and increase safety. So not pushing those coping strategies before those things are in place because regulation comes before resilience. And third even when this stage feels messy or frightening the relationship between you and your teenager is far more resilient than it can sometimes feel and it will hold through this. So remembering that your steady presence matters far more than getting everything

Closing And Where To Get Help

SPEAKER_00 51:09

right.

Dr Olivia 51:09

And the story isn't over yet I like that that is those are those are great words to end on and thank you so much for sharing with us um so many good tips today and I'll be putting your your contact details in the show notes for um parents who might want to get in contact with you for some extra help that goes beyond this uh podcast today but thank you very much for your time today thank you for having me