Aug 11 / Jeff Sabo

Research to Practice: Autism, Anxiety, and Music Learning

When I talk with other music teachers, I often hear that it’s becoming more and more common to encounter students with high levels of anxiety. We all know that anxiety is a normal part of life, but many teachers feel unsure about what to do when students become anxious during lessons. We’ve already talked about anxiety more generally in another article. Here, we’re going to focus on how anxiety specifically affects students with autism spectrum disorder (ASD). More specifically, we’ll look at what research says about why anxiety can be particularly challenging for these students and how it can affect their learning. 

Anxiety and autism:

When you think of autism, the first things that come to mind may be social challenges and repetitive behaviours. However, research tells us that anxiety is another big challenge for many children with ASD. It turns out that about half of children with ASD are also diagnosed with an anxiety disorder (1). Many kids with ASD experience heightened anxiety but do not have an additional diagnosis of an anxiety disorder. When taken together, close to 80% of kids with ASD experience high anxiety (2). High anxiety can affect ASD kids of all ages, from very young (3) up to adolescents (4), and it’s been found to be more common in kids who are considered to have “high functioning” ASD compared to others (4). 

The impact of anxiety:

It can be difficult to identify when ASD kids are anxious because they often have difficulty understanding and communicating their feelings. Still, anxiety can have a huge impact on their daily lives, sometimes even more so than the traits we usually associate with ASD (5). For example, anxiety in ASD kids has been associated with poorer academic performance (6), poorer social skills (7), and less participation in activities both in and out of the home (8). When kids with ASD do participate in activities, anxiety can make it harder for them to engage (8). It can also lead to many negative behaviours and make it difficult to adapt to changes in their environment (9). 

Why this can happen:

So why is anxiety such a challenge specifically for kids with ASD? One key aspect of this is what researchers call “intolerance of uncertainty” (10). Kids with ASD commonly perceive things as uncertain, and it makes them feel very uncomfortable (10). This can happen in part because their brain has a harder time using past experience as a reference point for what is happening in the moment (11). Instead of understanding new information as similar to something they’ve done before, it feels totally new. Children with ASD are also more likely to see things negatively and think about them in a “black and white” way (12). So that information doesn’t just feel new, it feels threatening and too difficult for them to take on. All of this can lead to high anxiety in learning situations, where presenting students with new concepts and activities is a regular part of how we help them improve their skills. 

Another element of this is that many kids with ASD struggle to recognize and regulate their own emotions (13). While many people can recognize that they are uncomfortable and just “hang in there” until the moment has passed, kids with ASD can become overwhelmed quickly when they are presented with a lot of new and challenging information. If they have difficulty expressing themselves verbally, they may communicate their discomfort behaviourally, often in ways that teachers consider disruptive or problematic (5). 

An example:

Imagine your student with ASD has just finished learning a piece in their book. You turn to the next page and ask them to play a new piece from the beginning. Instead of doing that, they just start improvising on the instrument. You ask them to stop and go ahead with the piece. The student responds by starting to talk about something that happened at school today. Then, they jokingly knock the book on the floor. As teachers, we could see these behaviours as the student being “distracted” or “not following instructions”. In that case, we might be missing what is really going on: the student has been asked to take on a task that feels new and overwhelming. Even though it is just the very next piece in the book, which seems like it should be an easy transition from the previous one, the student’s brain is having trouble connecting the skills needed to play this piece with what they’ve already learned. They feel overwhelmed and unable to get started without some additional support. Instead of telling you how they feel, they are behaving in a way that prevents them from having to continue feeling uncomfortable.

What teachers can do:

Here are some things teachers can do and some resources you can check out to help support your ASD students with anxiety:

Identify how the student is feeling. As we covered in the example, the first step to supporting students with anxiety is understanding. When your students encounter learning or behavioural challenges, you can investigate whether or not anxiety may be causing that challenge. This sometimes takes a bit of detective work though, so it’s important to stay open minded and be willing to explore many possible causes. If you’re interested in learning more about how to decode and address challenging student behaviours, you can check out our mini-course.

Help them regulate their emotions. Because kids with ASD have trouble with self-regulation, teachers often need to help them with that. You can check out our previous blogs on strategies for anxiety and also the importance of movement activities. Helping with self-regulation also includes supporting the student’s sensory needs, so you can check out our blog and webinar for tips on how to do that. 

Think about your communication style. Some kids with ASD struggle with verbal comprehension, so they may get overwhelmed by certain types of instruction. Our blog on communication could help you reconsider how you might adapt your communication to make learning more accessible.

Adapt tasks to the student’s abilities. It’s important to note that many kids with ASD also have intellectual or learning disabilities (14), so these could create additional challenges that leave them feeling anxious. You can think about adapting the material or scaffolding to support them. You can also use spiral design to reinforce old materials regularly. To learn more about these, you can also see our webinar on adapting for students learning disabilities.  

There are lots of other things you can try as well! If you’re looking for a deeper dive on the topic of ASD and music learning, you may be interested in our mini-course on ASD or our Certification Level 1 course.

 

Happy Teaching!


References:

  1. Rodgers, J., & Ofield, A. (2018). Understanding, Recognising and Treating Co-occurring Anxiety in Autism. Current Developmental Disorders Reports, 5(1), 58–64. https://doi.org/10.1007/s40474-018-0132-7
  2. Wijnhoven, L. A. M. W., Creemers, D. H. M., Vermulst, A. A., & Granic, I. (2018). Prevalence and Risk Factors of Anxiety in a Clinical Dutch Sample of Children with an Autism Spectrum Disorder. Frontiers in Psychiatry, 9, 50. https://doi.org/10.3389/fpsyt.2018.00050
  3. Vasa, R. A., Keefer, A., McDonald, R. G., Hunsche, M. C., & Kerns, C. M. (2020). A Scoping Review of Anxiety in Young Children with Autism Spectrum Disorder. Autism Research, 13(12), 2038–2057. https://doi.org/10.1002/aur.2395
  4. Van Steensel, F. J. A., Bögels, S. M., & Dirksen, C. D. (2012). Anxiety and Quality of Life: Clinically Anxious Children With and Without Autism Spectrum Disorders Compared. Journal of Clinical Child & Adolescent Psychology, 41(6), 731–738. https://doi.org/10.1080/15374416.2012.698725
  5. Ozsivadjian, A., Knott, F., & Magiati, I. (2012). Parent and child perspectives on the nature of anxiety in children and young people with autism spectrum disorders: A focus group study. Autism, 16(2), 107–121. https://doi.org/10.1177/1362361311431703
  6. Ambrose, K., Simpson, K., & Adams, D. (2021). The relationship between social and academic outcomes and anxiety for children and adolescents on the autism spectrum: A systematic review. Clinical Psychology Review, 90, 102086. https://doi.org/10.1016/j.cpr.2021.102086
  7. 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
  8. Adams, D., & Emerson, L.-M. (2021). The Impact of Anxiety in Children on the Autism Spectrum. Journal of Autism and Developmental Disorders, 51(6), 1909–1920. https://doi.org/10.1007/s10803-020-04673-3
  9. Wigham, S., Rodgers, J., South, M., McConachie, H., & Freeston, M. (2015). The interplay between sensory processing abnormalities, intolerance of uncertainty, anxiety and restricted and repetitive behaviours in autism spectrum disorder. Journal of autism and developmental disorders, 45, 943-952.
  10. South, M., & Rodgers, J. (2017). Sensory, Emotional and Cognitive Contributions to Anxiety in Autism Spectrum Disorders. Frontiers in Human Neuroscience, 11. https://doi.org/10.3389/fnhum.2017.00020
  11. Pellicano, E., & Burr, D. (2012). When the world becomes ‘too real’: a Bayesian explanation of autistic perception. Trends in cognitive sciences, 16(10), 504-510.
  12. Stark, E., Stacey, J., Mandy, W., Kringelbach, M. L., & Happé, F. (2021). Autistic Cognition: Charting Routes to Anxiety. Trends in Cognitive Sciences, 25(7), 571–581. https://doi.org/10.1016/j.tics.2021.03.014
  13. Conner, C. M., White, S. W., Scahill, L., & Mazefsky, C. A. (2020). The role of emotion regulation and core autism symptoms in the experience of anxiety in autism. Autism, 24(4), 931–940. https://doi.org/10.1177/1362361320904217
  14. Ibrahim, I. (2020). Specific Learning Disorder in Children with Autism Spectrum Disorder: Current Issues and Future Implications. Advances in Neurodevelopmental Disorders, 4(2), 103–112. https://doi.org/10.1007/s41252-019-00141-x
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