A Scoping Review of Anxiety in Young Children with Autism Spectrum Disorder

Abstract

Research on anxiety in children and adolescents with autism spectrum disorder (ASD) has burgeoned in the past 15 years. Most of the research has focused on school-age children, ages 6 to 18 years. Yet, recent studies suggest that anxiety can emerge in young children, under 6 years, with ASD. This scoping review synthesized the literature on anxiety in young children with ASD. Three domains of anxiety research were reviewed: (a) prevalence/severity, phenomenology, and course; (b) correlates; and (c) treatment. Four online databases were searched from the start of the database until March 2020. Keywords pertaining to anxiety, autism, and young children were entered. The search identified 44 articles for inclusion. These studies varied with respect to sample source, informants, and measures to assess anxiety. The overall prevalence of anxiety ranged from 1.6 to 62%. Sixteen of 17 studies found that young children with ASD had higher levels of anxiety compared to various control groups. A variety of DSM anxiety symptoms and disorders were present in young children with the most common symptoms being specific, social, and generalized fears. Correlates of anxiety included sensory over-responsivity, sleep disturbance, aggression/defiance, and attention deficit/hyperactivity disorder. Three cognitive behavioral treatment studies for anxiety and one developmental intervention targeting ASD symptoms showed promise in reducing anxiety. Findings indicate an early emergence of anxiety in some children with ASD. Further research on the measurement, pathophysiology, and treatment of anxiety in early childhood is critical to improving outcomes in children with ASD.

The relationship between sensory reactivity, intolerance of uncertainty and anxiety subtypes in preschool-age autistic children

“…Anxiety symptoms develop early (i.e. before the age of 6 years) and are enhanced in autistic children and increase over time (Vasa et al, 2020). Thus, there is an imperative need to identify early risk factors.…”

“…Targeting risk factors for anxiety in its earliest stages is important to improve later outcomes (Rapee et al, 2010; Yap et al, 2016). Ages 3–5 years are a critical time when sensory reactivity differences and anxiety symptoms are emerging in autistic children, and early interventions for anxiety already show efficacy (Ben-Sasson et al, 2007, 2008; Driscoll et al, 2020; Green et al, 2012; Vasa et al, 2020).…”

The relationship between sensory reactivity, intolerance of uncertainty and anxiety subtypes in preschool-age autistic children

“…As well as presenting with traditional anxiety symptomology, autistic people can also present with some unique symptoms; such as unusual phobias, sensory fears, social distress unrelated to fears of negative evaluation, and compulsive behaviours that are not driven by distress relief (Kerns et al, 2014(Kerns et al, , 2017South & Rodgers, 2017). Anxiety symptoms develop early (i.e., before the age of 6) and are enhanced in autistic children and increase over time (Vasa et al, 2020). Thus, there is an imperative need to identify early risk factors.…”

“…Fundamentally, the links between sensory reactivity, IU, and anxiety has only been explored in autistic children above the age of 6, without intellectual disability (ID) and with proficient language skills, and research on in preschool-age autistic children (age 3-5 years) is yet to be done. Sensory reactivity differences and pre-clinical anxiety symptoms are present from a young age (Ben-Sasson et al, 2007, 2008Vasa et al, 2020) and anxiety symptoms have emerged in autistic children by the age of 3 (Green et al, 2012). Therefore, ages 3-5 years is a critical time when anxiety symptoms have emerged whilst preceding the age that anxiety disorders transpire in children, typically in middle childhood (Beesdo et al, 2009).…”

Psychological Preparations Affecting the Emotions of Children with Developmental Disorders Toward Hospitals

“…The hospital environments sometimes overwhelm their sensory perceptions. 14 They tend to feel intense anxiety and fear in the hospital 15,16 and exhibit inappropriate rejection, escape, or panic reactions during medical examinations or treatments. 17 These developmental disorders are often complicated by other neurological or physical disorders, therefore these children visit clinics or hospitals more frequently than typically developing children.…”