For most students, the experience of being under stress, whether it be for short periods or longer, is undesirable and to be avoided if possible. The regular challenges and differences students with ASD experience in the areas of socialisation, communication, regulation, flexible thinking and sensory processing often result in them experiencing extreme stress more frequently than their same-aged peers.
Students with ASD respond to stress in exactly the same way as anybody else:
- they find it extremely unpleasant
- they try to reduce or avoid it
- it adversely affects their ability to learn and function well.
The presentation of stress and anxiety in students with ASD
Stress is very much a barrier to a student's access and participation to learning and constructive problem solving. When students with ASD experience high levels of stress or anxiety, like anyone experiencing such sensations, they can become overly aroused and agitated, under aroused and withdrawn, attempt to flee or avoid the stressful environment, and/or unable to process suggestions and support offered by others.
This may present as:
- fatigue, irritability, difficulty attending and/or a reduced ability to concentrate
- constant questioning or the increased need for reassurance and predictability
- an increase in repetitive or controlling actions and an inflexible approach to activities
- fear of new or unfamiliar situations, activities or environments
- physiological symptoms such as sleep disturbance, headaches, changes to bowel and dietary habits, difficulties maintaining a calm state, and muscle tension
- the presentation of difficult or unusual behaviours at home while appearing to maintain calm or being withdrawn at school
- changes in sensory processing such as an increased and/or decreased response to sensory stimulation and reduced ability to regulate sensory information consistently (e.g. students may actively seek to avoid or gain sensory feedback via activities which block out sensations or activities which provide heightened or calming sensations for the student).
Knowing your student's stress triggers
The stress triggers for each student are unique. Students with ASD generally find it more difficult to recognise their personal stress triggers and responses, and are also less likely to know how to plan and manage their response to stress than their same aged peers.
It is therefore important for teachers supporting students with ASD to collect, collate and consider the student's individual stress triggers in order to maximise learning and minimise the debilitating effects of extreme stress and anxiety.
- The environment: Where does stress escalate? Where is the student not stressed? What are the sensory and social characteristics of the environment?
- The activity: During which activities does stress escalate? During which activities is the student not stressed or most successful? What is challenging about this activity?
- Resilience: Has stress been building? How many activities can the child complete and still maintain calm? How often does the student require access to calming or preferred activities?
- The demands: Are the instructions clear and achievable? What motivates the student to manage his or her stress in this activity? Are there too many challenging components in this demand?
- Physiological considerations: Is the student tired, affected by changes to diet, medication or not well? Is the student alert and attending or difficult to engage? What sensory tools (such as a movement break) can be used to calm the student or increase alertness as necessary?
- A communication breakdown: How can I check the student is getting the information they need? Can they process whole class instructions? Can the student predict what is going to happen next? Which information or instructions appear most useful or necessary for the student to maintain calm? What extra support or cues can I provide to support comprehension and expression? How does the student ask for help or a break?
Minimising and managing stress and anxiety in students with ASD
When considering strategies for minimising stress and anxiety for student's with ASD, it is important to consider the students learning strengths and preferences, such as what does and does not appear to work well for them.
Student profiles are useful for collecting and collating information regarding the unique learning preferences of the student. As no two students are alike, it is necessary to consider the individual strategies, considerations and preferences to maximise participation and engagement and minimise stress and anxiety.
The following strategies may be useful for some students experiencing stress:
- the use of routine and structure to provide predictability and reduce uncertainty
- changing the environment to minimise sensory challenges
- teaching the student to begin to recognise some simple signs of stress in themselves by highlighting the physical sensations of stress and linking these to specific concrete activities, examples or experiences
- teaching the student to take and ultimately request a break
- teaching the student to request assistance, items or help from significant others
- changing the expectations to increase the likelihood of success
- the provision of clearer, more concise and concrete instructions
- the use of visual cues and support to augment comprehension and increase expressive communication attempts or the ability to get their message across to others
- consideration of alternate methods of communicating a dislike for an activity, environment, interaction or situation to minimise anxiety
- the development of safe break areas in the classroom and playground
- opportunities to access preferred or strength-based activities on a planned and regular basis to ensure success and maintain confidence and calm.
Dealing with stressed and anxious students
When a student is experiencing high levels of stress or anxiety, this is not a 'teachable' moment but rather a time to manage the situation to ensure the emotional and physical safety of all involved. Strategies for supporting the student should focus on strengths and interests and accessing activities which will support the student to begin to calm. Information also needs to be gathered regarding how long the student is likely to take to calm to a degree where adults are able to begin to intervene.
Strategies for students experiencing stress
The following strategies may be useful for some students experiencing stress:
- Remember that the communication capabilities of all students decrease when under stress. In students with ASD who already experience communication difficulties, this can be significant and must be considered.
- Reduce all interactions and particularly minimise or avoid spoken instructions and demands as these usually add to the student's stress. If possible, remove the student from the source of their stress to avoid escalation and allow for significant recovery or repair time if necessary.
- Ensure access to calming or strength-based activities to help the student maintain calm and or manage stress.
- Consider which sensory-based activities will provide calming feedback for the student.
- Adapt expectations if stress is building. Provide opportunities to experience success or reduced demands to support the maintenance of a calm state. Remember stress affects our capacity to engage and learn.
- Consider safety. Where can the student go to calm down, what do they need to help them calm down, does the student need to be removed from other students in the room, who do you call for back up?
- Use non-invasive teaching strategies to minimise the chance of escalation, for example redirect, ignore if possible, praise good choices, provide extra processing or work time.
- Stay calm and in control of your own emotions.
- Provide sufficient personal space so that the student is not likely to become increasingly agitated by the presence of others.
- If language is necessary, use helpful scrips such as "let's sort this out" or "I will help".
- Avoid arguments and any discussions regarding an incident while the student is stressed.
- Alert other staff members of potential issues by using a stress barometer as a visual measure of the severity of the incident or moment.
- Gather information regarding the student's individual stress triggers, calming activities, strategies and environments, the time needed for the student to calm to avoid re-escalation, and steps for safety and debriefing the issue with the student later if needed or appropriate.
- Remember the importance of debriefing with witnesses of any issue or incident, including peers who many need assistance to understand what has happened and that it is now okay.
- Significant and persistent anxiety can be immobilising for the student with ASD and must be discussed with the student's educational team and parents. An
allied health professional may be able to provide further individual assistance, support and information for the team supporting students experiencing ongoing and debilitating anxiety and stress.
Sensory processing and stress management
It is important to consider and understand the role of sensory processing in stress management for students with ASD. Irregular sensory registration, modulation and integration can produce extreme stress in students with ASD as they may attempt to avoid, screen out or gain access to specific sensations. Students with ASD may also have increased difficulties consistently processing sensory information once stressed. That is, sensations they previously coped with may become unbearable once the student is anxious or stressed, leading of course to further stress.
On the other hand, sensory-based activities may be used very effectively to teach students with ASD to calm them selves and ultimately manage stress and engage for longer periods with the curriculum and others.
The role of sensory processing in managing stress is significant and unique to the student and must be considered.
Tips for understanding and addressing sensory processing difficulties provides further information regarding the sensory processing implications for students with ASD.