Understanding mental health in autistic children

People with autism often experience a higher incidence of mental health conditions such as anxiety and depression, than their neurotypical peers.

Recognising the signs and providing individualised therapies and strategies is the first step to helping support them. 

For many children, including those on the autism spectrum, growing up is a period filled with transformation. It's not just about physical growth but also significant emotional and psychological development. This period can be particularly challenging for autistic children who may find the many changes and transitions overwhelming due to their preference for certainty and predictability.

Mental health in autism can be influenced by many factors, including;

  • Sensory sensitivities: Adjusting to how sensory information is received can cause discomfort and anxiety, making daily interactions challenging.
  • Social communication:  Navigating social interactions can be complex and often leads to feelings of isolation or misunderstanding.
  • Routine and structure: A strong preference for predictable environments can lead to distress when unexpected changes occur.
  • Cognitive processing: Managing information overload is crucial as difficulties in processing can lead to stress and anxiety.

Recognising signs of mental health issues

It's important to distinguish between typical child behaviour and signs of potential mental health issues. Some Indicators that your child might need more support include:

  • Withdrawal: Losing interest in activities they once enjoyed or withdrawing from social interactions.
  • Changes in communication: Noticeable shifts in how they interact with friends and family. Becoming secretive and avoiding communication.
  • Behavioural changes: Unexplained irritability, mood swings, or changes in school performance.
  • Risky behaviour: Engaging in activities that are uncharacteristic and potentially harmful.
  • Physical changes: significant weight gain or loss, changes in appetite.
  • Sleep patterns: changes in sleep patterns or insomnia.
  • Self-harm: engaging in any form of self-injurious behaviour or harm. 
  • Suicidal thoughts: any indication that your child displays suicidal behaviours or thoughts. 
Grid of nine icons illustrating signs of mental ill-health, such as anxiety, depression, emotional outbursts, and sleep problems.

Diagnosing mental health challenges in children with autism

Diagnosing mental health issues in children on the autism spectrum can be particularly challenging due to several factors. Autism presents differently in each child, making standard assessments less straightforward. The overlap of symptoms between autism and mental health conditions like anxiety or depression can make it difficult to identify the root cause of certain behaviours. Interpreting these behaviours is further complicated by the various biological, social, psychological, and environmental factors that impact autistic children differently. Communication barriers also play a role, as many autistic children struggle with self-reflection and expressing their emotions, making assessments more difficult. Unfortunately, there is a shortage of healthcare professionals specifically trained in autism-related mental health care, and access to funded services is often limited by long wait times.

However, none of these factors should prevent you from seeking help if you have concerns about your child’s mental health. Early intervention is key in addressing mental health issues. If you notice major changes in your child’s behaviour or mood, seek professional advice and support quickly.  Discussing your concerns with your child can reassure them that they are not alone and that help is available.

Start by speaking with your GP or paediatrician and get a referral to a psychologist. They can provide the necessary assessments to help understand your child’s mental health needs. 

Evidence-based mental health therapies 

Effective mental health interventions for autistic children are tailored to meet their unique needs and preferences. Some of the most common therapies include: 

Cognitive Behaviour Therapy (CBT)

This structured talking therapy is designed to help individuals make connections between their thoughts, emotions, physical sensations, and behaviours. For young people with autism, CBT can be adapted to assist in managing anxiety and other mental health conditions. 

Mindfulness-based therapies

These therapies aim to improve present-moment awareness. Mindfulness practices have shown promise in helping autistic children improve self-awareness, reduce repetitive negative thoughts, and cope better with anxiety and stress.

We encourage families to have a good paediatrician and, ideally, a good child and adolescent psychologist on their side. Psychologists are highly trained and qualified professionals who can work with you and your family to address your child’s needs.

There’s no one-size-fits-all approach, and your psychologist will work with your family to tailor the best therapy to support your individual situation.

Supporting mental wellbeing

There are many simple and effective strategies parents/carers can adopt to help reduce stress and promote wellbeing for the whole family. These include:

  • Establish routines: Creating a predictable environment, where possible, with structured daily routines can help reduce anxiety and provide a safe space for autistic children. 
  • Encourage flexibility: While maintaining routine is essential, gradually helping your child to adapt to changes can enhance their ability to cope with new situations.
  • Develop social skills: Encouraging the development of social skills and friendships can provide essential support and reduce feelings of isolation.
  • Teach resilience: Teach your child strategies to build their resilience and confidence, ensuring they know how to seek help when needed.
  • Special Interests: Developing special interests and hobbies can provide an outlet for expression and achievement, boosting confidence and self-esteem.
  • Healthy lifestyle: Support habits that promote good physical health, such as balanced eating and regular exercise, which can also benefit mental health.
  • Open communication: One of the most important things you can do is keep communication open and honest. Be empathetic and understanding without being too pushy or intrusive.

Emergency mental health support for children