Scanlan Center for School Mental Health
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Supporting Mental Health in Children with Autism

written by

Emily Shearer, MA

Skill Development
Teaching & Learning

April is World Autism Month! To create an understanding and inclusive classroom environment, it is important to consider the various supports needed by students with autism spectrum disorder (ASD).

Specifically, autistic children have unique needs when it comes to the area of mental health.

One important thing to consider is that there are two common ways to refer to this population: person-first language and identity-first language. 

  • Person-first language puts the person before their condition or disability (e.g. “children with autism”). 
  • Identity-first language puts a person’s condition or disability before the person (e.g. “autistic children”).

Preferences for person-first or identity-first language vary from person to person. While both are used in this post, you are encouraged to follow the lead of the individual student and their family in the language used in talking with them.

ASD and Mental Health  

A large percentage of students with ASD have a comorbid mental health diagnosis (i.e., a diagnosis of both ASD and a mental health condition).

In a recent study, almost 78% of children with ASD had at least one comorbid mental health condition, and nearly half had two or more mental health concerns.

Some of the mental health difficulties that are commonly found in autistic children include:  

  • Anxiety 
  • Depression  
  • Obsessive-Compulsive Disorder (OCD)  
  • Attention Deficit Hyperactivity Disorder (ADHD) 
  • Eating Disorders   

How To Support Students with ASD and Comorbid Mental Health Conditions  

While the suggestions below may offer a starting point, it should be noted that this is a diverse group of students with a variety of needs. It is important to determine the specific needs, strengths, and preferences of students when identifying appropriate interventions. 

#1 Emotion Recognition

Children with ASD often have emotion recognition deficits. Difficulties with processing and interpreting emotional cues make it hard to recognize strong emotions. Unfortunately, this often results in emotional dysregulation, which can take the form of intense bursts of emotion, self-harm, or aggression.

Teaching students how to recognize different emotions, such as recognizing thoughts or body sensations that often accompany such feelings, can help them understand and communicate emotions in a healthy way.  

#2 Understanding Triggers

When students with ASD demonstrate difficult behaviors, adults may assume it is a symptom of autism. However, behavioral outbursts might actually be the child’s emotional reaction to an unidentified trigger. 

Instead of ignoring or punishing such outbursts, identifying the trigger can get to the root of the problem, leading to reduced emotional dysregulation in the future.  

#3 Connecting with Interests

Many autistic children have intense, restricted interests, making it hard to engage them in non-preferred topics. Leaning into these interest areas can also be used to get these students more engaged in the classroom.

For example, if a student expresses high interest in trains, incorporating trains into word problems, reading materials, or science projects can motivate them to engage in learning. 

#4 Be Patient

Students with autism oftentimes have difficulties with processing speed. This means it takes them longer to perceive and process incoming information.

Comorbid mental health diagnoses, such as anxiety and ADHD, can compound these processing speed difficulties. Additionally, these students may easily lose track of time.

To avoid unnecessary frustration (which may trigger more intense behavioral or emotional dysregulation), allow students adequate time to think through an answer before responding. 

Providing verbal and non-verbal prompts, such as timers, visual diagrams, and outlines, can act as less intrusive reminders for completing an activity.   

#5 Be Flexible

Not all supports and interventions can be used as a one-size-fits-all approach to working with autistic children with comorbid mental health conditions.

As every student is unique, so is the combination of supports that they require. It is important to explore a variety of different strategies to best provide for each student.  

Emily Shearer is currently a student clinician at the Scanlan Center for School Mental Health Clinic and a doctoral student in Counseling Psychology at the University of Iowa College of Education.