Teaching Relaxation Techniques to Kids on the Autism Spectrum: 5 Essential Modifications
Updated: Jun 2, 2019
Co-occurring anxiety disorders are common in Autism and this is just as true for children as it is for adults (e.g. Leyfer, et.al, 2006).
In a previous article, I discussed some of the factors that contribute to the high rates of anxiety in children on the spectrum. Identifying the causes of anxiety is important as it can lead to effective accommodations to reduce that anxiety.
Setting up supports to prevent anxiety from occurring in the first place should still be a first-line approach. However, no amount of support or environmental prevention strategies will fully eliminate anxiety across all settings and situations. Life is just too unpredictable and there are a myriad of factors that can fuel anxiety in autism.
Thus, It is important to equip children with coping tools they can use when feeling overwhelmed. This is true for all children and there is no reason that kids on the autism spectrum shouldn’t also be afforded the opportunity to learn these skills.
What kind of relaxation skills should be taught?
Effective relaxation skills work by preventing our nervous system from spiraling into a state of panic. Once we have interrupted this chain of events we can then begin to redirect our nervous system from a state of anxious arousal to a state of calm.
There are relaxation strategies that target the body, strategies that target the mind, and activities that address both.
Full descriptions of these techniques are available in the stress managment workbook that I have developed for kids with autism and related needs. Brief descriptions from some examples:
Diaphragmatic/Belly Breathing: When we become anxious our breathing becomes rapid and shallow. This kicks off a chain of physiological events that can fuel panic. To reverse this process, a child can learn to take slower, deeper breathes from the belly. Lowering the diaphragm muscle on the inhale (resulting in the stomach expanding outward) allows for greater expansion of the lungs and, thus, more oxygen.
Progressive Muscle Relaxation (PMR): Muscle tension sets in at the earliest stages of distress. Although this tension can maintain anxious arousal, it often occurs beyond our awareness. With PMR, a person is instructed to go through various muscle groups-first tensing and then relaxing them. With practice, it becomes easier to detect and reverse muscle tension.
Relaxing Imagery: The mind can concoct all kinds of vivid, scary scenes that can both cause and worsen anxiety before and during stressful situations. The use of pleasant imagery is a way to counter these scenes. When we can hold a pleasant image in our minds the nervous system will follow suit.
Meditation: When anxious, the mind tends to dwell in a future that is full of “what ifs”. Meditation can help to bring awareness back to the present.
Activities that Combine Mind and Body
Activities that combine mind and body techniques such as Yoga or Tai Chi can reinforce the practice of techniques and serve as a holistic means for long-term stress management.
Kids on the spectrum are far more similar to other kids than they are different and many teaching strategies will remain the same. However, there are modifications for the autistic child that are essential to be aware of.
1) Justify the Technique: The child on the spectrum needs to know why they are being asked to learn something. Learning needs to be relevant and make sense. I find that scientific explanations help. The terms and depth of concepts will vary depending on the developmental level of each child. However, for most kids, it is useful to go into how the nervous systems responds to fear and anxiety and how this results in physiological symptoms. I then explain how relaxation techniques reverse this process. Such explanations can kickstart motivation.
2) Use Visual Supports: Autistic children tend to be visual learners. There are numerous ways to incorporate visuals into teaching relaxation including charts, graphs, drawings, and videos. You can, for example, visually display how the nervous system changes in response to tension or relaxation. Visuals also help to demonstration techniques (for example, a visual of the stomach rising and falling during diaphragmatic breathing). Visual supports can also be used to prompt and remind the child when to use a technique (e.g. a cue card with a line drawing of a child looking calm as a reminder to use coping skills).
3) Be Wary of Abstract Terms: Speak accurately but plainly when teaching techniques. Avoid abstract, metaphorical language such as “be cool as beans” or “breathe in the goodness”. When comparisons are needed concrete phrases work best (e.g. “your stomach should expand like a balloon filling up with air”)
4) Be Aware of the Stressors Associated with Autism: Clinicians who work with kids on the spectrum should be aware of the many different stressors associated with autism. These include understanding how change and transition can cause anxiety, the impact of sensory overload, challenges with language processing, the strain of being in social situations, and frustration that can occur when being asked to learn in a way that is not in tune with the child’s natural learning style. Knowledge of these stressors will help clinicians to appreciate the many different situations in which relaxation skills can be employed.
5) Emphasize Generalization: When teaching a skill it is important to emphasize when and how to implement that skill across different settings and situations. Don’t assume that this will occur automatically. Instead be sure to provide specific, real-life examples and clear guidance on when and how to use techniques. Enlist the help of parents, teachers, and other support persons in the child’s natural environment to remind and prompt the child to use techniques when necessary.
Relaxation techniques can help any child to cope better with stress and anxiety. With some modifications, children on the autism spectrum can also acquire these valuable coping skills.
Leyfer, Ovsanna T., et al. "Comorbid psychiatric disorders in children with autism: interview development and rates of disorders." Journal of autism and developmental disorders36.7 (2006): 849-861.