Autism Spectrum Disorders and Phobias

ASD and PhobiasPhobias are fears that appear to be irrational to the outside observer, or are fears that seem to be out of proportion to the situation. People with ASD tend to have unusual fears and unusual responses to fear.

Sometimes these fears develop into full-blown phobias. Anxieties, if left untreated, may develop into phobias. About 85% of people with ASD suffer from anxiety. Phobias can be difficult areas to address with standard approaches that are language-based, as people with ASD often have difficulties processing language.

Often people with ASD develop fixed rituals as a way to cope with the phobia, which may interfere with treatment. Adapted approaches work best, and must be tailored to the individual. In some cases, standard desensitization approaches may be ineffective and may increase the phobia, as these approaches may assume a certain degree of language processing and emotional control. Treating phobias of someone with an autism spectrum disorder (ASD) may take an extended period of time as compared to their peers, as skills necessary to treat the phobia may have to
be taught.

Signs of phobia:
• Extreme avoidance or escape behaviours in specific situations.
• Increase in ritualistic behaviour in very specific circumstances.
• Fear is extreme and is persistent.
• The person appears very anxious or panicked.
• Often people with phobias try to hide the problem.

Phobias are treatable using adapted cognitive behavioural approaches in counselling. Treatment requires homework completion, and may involve using support people. Medication may be used to treat phobias, and their effectiveness is
enhanced by utilizing therapeutic counselling approaches as well. It is of note that many people with ASD do not respond well to medications and may have sideeffects. There are few, if any, negative side effects from utilizing cognitive
behavioural approaches aside from learning new tools to help cope with different situations.

Suggested reading: Paxton, K. & Estay, I. (2007). Counselling people on the
autism spectrum: A practical manual. London: Jessica Kingsley Publishers.

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