70-80% of autistic children and adults experience or have experienced mental health problems. In this blog, we’ll take a closer look at some of the mental health difficulties that may arise and how to support autistic children and young adults when it comes to regulating their emotions.
There are a number of mental health difficulties that can coexist with autism. “Diagnostic over-shadowing” is the tendency for co-occurring mental health issues, such as anxiety, to be both attributed to and minimised by a diagnosis of autism. This potential for autistic traits to overshadow or obscure, for example, anxiety difficulties represents an ongoing clinical and empirical challenge.
Internal and external factors
It is thought that a combination of internal and external factors is likely to explain why mental health difficulties are so common in autistic people. Internal factors such as biological differences in brain structure and function, a history of social communication difficulties, and problems with finding flexible responses to apparent threats are all likely to contribute. There are also external factors that can contribute such as lack of, or lengthy delays for services, lack of specific training, and high levels of stigma about autism and mental health. Just 4% of autistic young people feel extremely confident in knowing who to ask for help, and two thirds said they did know but had little confidence they would get the support they need.
What is emotional regulation?
“Emotional regulation” is a term generally used to describe a person’s ability to effectively manage and respond to an emotional experience. Emotional regulation is also known as emotional self-regulation.
When supporting a child to regulate their emotions, you need to be aware of;
- Your own emotions – this is important to ensure you have self-regulated before supporting the child so that you can be a calming influence for them.
- Your reaction to these emotions; and
- How the above may affect the child’s emotions (also known as co-regulation)
The impact of sensory regulation in emotional regulation in autistic people
Putting together information from all of our senses allows us to participate in everyday activities. By integrating or combining all the information we get from our senses, we can ‘make sense’ of the world around us and successfully move through and interact in our world.
DSM–V lists “atypical sensory processing […] as one of the possible characteristics of autism. Hyper- and hypo-reactivity to sensory input and/or unusual interest in the sensory aspects of an environment are now included as a possible distinguishing characteristic”.
Some autistic people have higher tolerance levels of certain inputs (sensory seeking/hypo-responsive) and lower in other areas (sensory avoidant/hyper-responsive).
Understanding sensory needs and profiles is fundamental when exploring emotional regulation strategies. It must underpin pro-active, active, reactive and post-active strategies.
From coregulation to self-regulation
Younger children in particular will need support to regulate their emotions as they may be too young to understand the ‘big feelings’ they are feeling. This can also be true of older children, particularly in times of crisis. This is called ‘co-regulation’.
Stages of co-regulation:
- Self-check in. Are you in a space where you can provide a calm presence? If not, take the steps to regulate yourself first if you are able to
- Get close to your child and listen to them, tell them you are there for them.
- Let your child know that you want to understand the best that you can. Listen to them.
- Empathise and validate what your child is sharing. It can be helpful to give examples of where you may have experienced something similar, however be mindful to ensure that your child is the focus. Continue to listen.
- Remind your child that you are there for them, offer affection in a way that is appropriate for them and with their consent.
- Ask if they would like to have space, or suggest a calming activity. Remind your child that you are always there for them.
Learning to regulate emotions is a skill that helps children develop ways of substituting impulsive reactions with regulating activities that supports their mental health.
Shout and throw a puzzle on the floor when a piece doesn’t fit
Count down from 10 and take deep breaths
Shouting and swiping blocks to the floor from a table when someone else knocks over their tower
Taking deep breaths and telling the other child “I am playing”, “my tower” or seeking help from an adult
Zones of Regulation
To aid your child with this you can use a framework designed to help recognise feelings, and tools and strategies to help regulate them called Zones of Regulation. Zones of Regulation uses a systematic, visual structure to teach children skills to build awareness of their internal states. It provides a systematic approach to teaching regulation and helps children with a variety of strategies.
- Extremely heightened states of alertness and intense emotions
- E.g. anger, rage, devastation, terror
- Heightened states of alertness and elevated emotions (a person has more control than in the red zone)
- E.g. stress, frustration, anxiety, excitement, silliness, nervousness
- Low states of alertness and down feelings
- E.g. sad, tired, sick, bored
- Calm state of alertness where optimal learning occurs
- E.g. happy, focused, content, ready to learn
Introducing zones to children
- Think about your child’s starting point.
- Incorporate into everyday activities.
- Use visuals.
- Make the most of naturally occurring situations as teaching opportunities.
- Create ‘toolboxes’ of activities to help your child when he feels dysregulated.
- Be aware that self-regulation is hard for all young children – they may need additional help from adults at this stage.
Toolboxes include strategies to help regulate your child in each zone. These will be individualised and are best created as a guided activity with your child.
- Think about what makes your child happy when they are sad in the blue zone.
- Think about what wakes them up if they are tired in the blue zone.
- Think about what calms them down if they are silly in the yellow zone.
Talking about our emotions
It’s important to think about the language of emotions we are using, and how we are communicating this to our children. Our goal is to support the child in whatever zone they’re feeling – not to make them ‘green’ all the time. If the aim is to ‘get back to green’, our children may feel as though it’s not ok if they’re not in green. They might say they’re happy when they’re not.
Therefore, it’s important to acknowledge feelings and normalise all zones. If your child appears to be in a particular zone, you can comment on what you think this may be; “you look like you might be a bit worried, in the yellow zone. Do you want to try some of your activities?” We can normalise other zones by labelling them in ourselves. For example; “Mum’s feeling a bit tired today, I’m in the blue zone!” Use this opportunity to chat about how you might help yourself in the blue zone.
Regulating emotions can pose challenges for autistic children and young adults. Using some of the tips and strategies above, we can support learners to better understand their feelings and communicate their needs. It is important to always think about the individual’s preferred method of communication and considering the language you use around emotions to ensure all emotions are normalised. For more information on emotional regulation watch the recording below or head over to our resource hub where we’ve got loads of great resources on emotional regulation and mental health.
 Ambitious About Autism, 2017, Know your normal