The Impact of Anxiety in Children on the Autism Spectrum
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ORIGINAL PAPER
The Impact of Anxiety in Children on the Autism Spectrum Dawn Adams1,2 · Lisa‑Marie Emerson3
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract The recognition of anxiety as one of the most commonly co-occurring diagnoses for individuals on the autism spectrum has led to increased research on symptomatology and treatment, but there is limited research documenting the impact of this anxiety. To address this, this study reports on the Child Anxiety Life Interference Scale (CALIS, parent version) in a community sample of 121 parents of children on the autism spectrum. Scores indicate that the anxiety is impacting upon the child’s engagement in activities both in and outside of home as well as impacting upon parent life. Explanatory variables differed for CALIS subscales. As the child’s difficulties with uncertainty and parent level of anxiety were the variables that explained the most variance, these may be important foci for effective interventions. Keywords Autism · Anxiety · Mental health · Uncertainty · Interference Autism spectrum disorder is a neurodevelopmental condition with a current prevalence estimate of one in 59 children (Baio et al. 2018). The DSM-5 diagnostic criteria (American Psychiatric Association 2013) describe differences or difficulties with social communication and the presence of restricted and repetitive behaviours. In addition, it is now well recognised that children on the autism spectrum experience elevated levels of anxiety. Meta-analyses reveal that 40% of children on the spectrum meet the criteria for at least one DSM-IV anxiety disorder (van Steensel et al. 2011), with a further 30–40% demonstrating subclinical anxiety levels that impact upon daily functioning (Strang et al. 2012; Vasa et al. 2013). These anxiety levels are greater than those of neurotypical children, children with externalising problems, and children with other developmental problems, with these differences increasing with age (van Steensel and Heeman 2017).
* Dawn Adams [email protected] 1
Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Messines Ridge Road, Mount Gravatt, Brisbane, QLD 4122, Australia
2
Griffith Institute of Educational Research, Griffith University, Brisbane, Australia
3
School of Applied Psychology, Griffith University, Menzies Health Institute Queensland, Gold Coast, Brisbane, Australia
Given this recognition of the elevated prevalence of anxiety in autism, it is understandable that research into this area has increased tenfold over the past decade (Vasa et al. 2018). Earlier research tended to focus upon identifying anxiety levels and diagnostic rates in autism using measures developed for typically developing children, such as the Anxiety Disorders Interview Schedule—Child and Parent Interview Schedules (ADIS-IV-C/P; Silverman and Albano 1996) and the Spence Children’s Anxiety Scale—Child and Parent Forms (SCAS-C/P; Spence 1998). Although these measures are able to capture a DSM-
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