Autism and School Anxiety: How to Help Your Child

Written by Dr Lucy Russell DClinPsyc CPsychol AFBPsS
Dr Lucy Russell Clinical Psychologist Founder of They Are The Future
Author: Dr Lucy Russell, Clinical Psychologist

School-based anxiety in autistic children and teens is a huge issue.

For example, in the UK, 8 out of 10 autistic children experience some level of anxiety about attending school.

So if your child is anxious about going to school or finds it very stressful, you should feel reassured that actually, it’s mostly not about them, it’s a much wider issue.

an anxious little girl - close up

The Link Between Autism and School Anxiety

Sadly, schools can be stressful places for all children, but autistic children in particular. Sometimes schools are large or inflexible (or both).

Children are expected to fit a specific mould and the system can’t flex to their individual needs.

In my twenty years of experience as a child psychologist I have worked with many fantastic schools who have supported children in overcoming their school anxiety. It can be done!

I’ll outline some strategies that you, your child and their school can work towards together. The goal is to overcome your child’s anxiety and help them flourish at school.

I’ll share some case studies based on my experiences (these case studies are based on an amalgamation of my experiences, they are not real-life case studies).

School, Anxiety and Trauma

The school environment, with its sensory overload and social demands, can trigger a “fight or flight” response in autistic children.

This intense reaction is not just about fear. It’s about feeling overwhelmingly unsafe in a setting where they are expected to learn and socialize.

When an autistic child is constantly in a state of high alert, their ability to learn is significantly compromised. The brain focuses on survival rather than new learning.

The usual buzz of a classroom—be it the flickering lights, the shuffle of papers, or the unpredictable social interactions—can become insurmountable barriers.

This relentless stress can lead to trauma, as the school environment feels hostile, and the child feels permanently misunderstood or unsupported.

It’s crucial for schools and parents to recognize these signs and work together to make school a safe and supportive space for learning.

Does this sound like your child? Or are you worried that this could happen to your child? Read on for my advice.

Eight year old boy talking to his teacher

School Anxiety: Your Child’s Situation

Maybe they’re school refusing (known as Emotionally Based School Avoidance or EBSA), or it’s affecting other areas of life such as sleep. Maybe they’re going in but you can see it’s traumatising them.

School staff may be at different levels of awareness.

Maybe your child’s school has made lots of accommodations already (in which case consider if it’s the right environment for them).

Perhaps the lack of understanding is contributing significantly to the anxiety.


What Are Your Child’s Anxiety Triggers at School?

Recognizing common triggers for school anxiety is crucial in helping your child manage their feelings.

By identifying specific situations or activities that cause your child to feel anxious, you can work together to find ways to make those experiences more manageable.

For example, if social interactions are a trigger, you can explore strategies to help your child navigate social situations with more confidence and ease.

Is it one thing (e.g. social interaction) or a complex combination?

To identify the specific anxiety triggers at school for your autistic child, you might like to use my abc anxiety worksheet or consider using mental health journalling.

Does your child’s teacher / teachers have any awareness of this anxiety or are they masking?

How aware is your child of the anxiety building?

Do they need adult help to spot it?

close up of a tween boy in school uniform

What Are The Signs of School Anxiety in Your Child?

you need to be clear so that your child can have full awareness and, most importantly, staff t school have full awareness.

It’s important to recognize that school anxiety can manifest in different ways for different children.

Some children may experience meltdowns or shutdowns, while others may exhibit physical symptoms like headaches or stomach aches.

By understanding your child’s unique presentation of anxiety, you can better support them in managing their emotions and developing coping strategies.

Anxiety in autistic children can manifest in many different ways, so it’s important to look for a range of symptoms of anxiety.

Repetitive behaviours, such as rocking or hand flapping, can be a sign of anxiety in autistic children.

These behaviours often increase during times of stress or anxiety.

As a parent, it can be challenging to spot school anxiety in your autistic child, as they may not always have the language to express how they are feeling.

However, there are some signs you can look out for.

For example, your child may become increasingly reluctant to go to school or start complaining of physical symptoms such as headaches or stomach aches.

They may also become more irritable or have difficulty sleeping, leading to fatigue during the day.

Additionally, watch out for changes in behaviour.

For example, if your child suddenly becomes more withdrawn, refuses to participate in activities they once enjoyed or has outbursts of anger or crying, this may be a sign of school anxiety.

You may also notice that they struggle to concentrate, leading to a decline in academic performance.

Another thing to look out for is avoidance behavior.

For instance, your child may try to avoid social situations or certain classes.

They may also ask to stay home from school or complain of feeling sick when it’s time to go to school. These behaviours can be an attempt to avoid the situations that trigger their anxiety.

This can lead to Emotionally Based School Refusal (EBSA), which is probably more widely known as “school refusal”.

a teen school girl at her desk, with a teacher standing nearby

School Refusal and Autism

School refusal is notably more prevalent among autistic children, with studies indicating that up to 43% of these students are persistently absent from school.

This high rate of absence is often due to the overwhelming demands and sensory inputs of the school environment, which can lead to significant anxiety and distress​ (UCL)​.

To effectively support autistic children experiencing school refusal, there must be a strong partnership between parents, teachers, and mental health professionals.

By working together, the team can identify all the barriers that make the school environment feel unsafe or uncomfortable, no matter how small they may seem.

These might include the noise during assemblies, the chaos of lunchtime, or the sensory overload during physical activities.

Once these are identified, tailored strategies such as providing a quiet room, allowing breaks as needed, and offering alternative activities during high-stress periods can be implemented.

This collaborative approach not only reduces anxiety but also helps create a nurturing and inclusive school environment where autistic students can thrive​ (National Autistic Society)​.

a tween school boy wearing a backpack

Autism and School Anxiety: The Most Common Factors

Sensory Overload

Sensory overload is one of the primary triggers of school anxiety, with loud noises, bright lights, and crowded hallways creating a sense of overwhelm.

Even everyday activities like walking to class or sitting in the lunchroom can be a challenge for those with sensory processing disorder.

a small crowd of tween school children

Social Interaction

Social situations and interactions with peers can also cause anxiety for autistic children at school.

The pressure to conform to neurotypical behaviors and expectations can contribute to anxiety levels, leading to feelings of social isolation and exclusion.

Academic Demands

In addition to sensory and social triggers, academic demands can also increase anxiety levels in autistic children.

Many autistic students struggle with executive functioning skills and transitions, making it harder for them to keep up with schoolwork and complete assignments on time, or even just to get started on a task.

Teachers who are not familiar with autism may misunderstand these difficulties as laziness or lack of effort, leading to frustration and anxiety for the student.

Transitions and Changes

Transitions are another common trigger for school anxiety.

For children on the autism spectrum, sudden changes in routine or schedule can be particularly challenging.

If you want to deepen your understanding about anxiety so you feel clear on exactly which steps will help for your child, consider our mini-course, Knowledge is Power!

Knowledge is Power: Understanding Anxiety in Children course

What Can Schools Do To Reduce Your Child’s Anxiety?

1. Staff Training / Understanding About Autism and Anxiety – Case Study: Jamie

In a small primary school, ten-year-old Jamie, who is autistic, experienced a remarkable change this year. His school had just conducted a comprehensive training session on autism and anxiety, focusing on recognizing subtle signs and the phenomenon of masking.

Jamie often hid his anxiety by keeping very quiet and self-contained at the back of the class, a behaviour that previously led his teachers to believe he was simply quiet.

After the training, Jamie’s teachers began to see this behaviour in a new light. They realized that his silence and preference for the background were his ways of coping with the sensory overload and social complexities of school life.

With this new understanding, they introduced small, but significant changes. They created a quieter corner of the room where Jamie could retreat when the typical school environment became too stimulating.

They also established a more predictable daily schedule to reduce unexpected stress.

These adaptations made a world of difference to Jamie. He felt truly supported and understood, reducing his need to mask and allowing him to participate more freely and confidently in class activities.

a smiling boy sitting on a beanbag

2. Nurture and Flexibility – Case Study: Erin

In a large secondary school that had a lot of neurodivergent students, the staff decided to embrace a nurturing approach tailored to the unique needs of each student.

This proved a lifesaver for 12-year-old autistic student Erin, who had experienced school-based anxiety at her previous school.

Erin had struggled with severe anxiety about attending school, often feeling overwhelmed by the fast-paced schedule and noisy classrooms.

Recognizing that one size doesn’t fit all, the school decided to assign a specific pastoral member of staff to be Erin’s mentor, providing her with a consistent and understanding point of contact.

Erin’s mentor worked closely with her to develop a flexible daily routine that allowed her to start her day in a quiet space, rather than the chaotic morning rush.

They also adjusted her schedule to include regular breaks in a designated calm area, which Erin could visit whenever she felt overwhelmed.

This flexibility in her school day significantly reduced her anxiety, making school a place where she could thrive rather than endure.

Over time, Erin began to show remarkable improvements, engaging more in class and even participating in group projects, which had previously been a major source of stress.

This nurturing approach not only supported Erin’s academic growth but also her social and emotional wellbeing.

a tween girl raising her hand in class

3. Predictability to Reduce School Anxiety – Case Study: Leo

Nine year-old Leo found daily transitions and unexpected changes at school particularly challenging and would regularly become dysregulated.

To help reduce his anxiety and provide a sense of security, the school introduced a set of visual supports, including a personalized visual schedule.

This schedule clearly depicted Leo’s daily activities with symbols and times, allowing him to anticipate and prepare for the day’s sequence of events.

The introduction of this visual schedule was transformative for Leo.

Each morning, he and his teacher would review the schedule together, discussing what to expect and when changes might occur.

This routine alleviated his feelings of being overwhelmed. It gave him a sense of control and predictability.

Over time, Leo became more confident and less anxious about school.

His teachers noted a significant improvement in his ability to engage with lessons and interact with his peers

nine year old boy chatting to teacher

4. Social Support at School – Case study: Mia

Six-year-old Mia often found break times overwhelming and socially confusing.

She tried to interact with others by tickling them, but many children didn’t like this, and they began to avoid her. She ended up alone, which made her anxious and sad about going to school.

Recognizing the need for structured social support, the school began a multi-faceted approach to help Mia figure out social interaction these less structured parts of her school day.

Firstly, Mia was introduced to social stories that illustrated various playground scenarios, such as how to join in a game or ask a peer for a toy. These stories helped Mia understand and predict the social cues and expected behaviours during breaks.

Next, the school assigned Mia a staff mentor, who specifically supported her during break times. This mentor organised semi-structured adult-led playground games where Mia could join in with her support. She also role-played successful social exchanges with Mia.

With these supports in place, Mia began to engage more successfully during break times.

She started using the strategies from her social stories to interact with her peers, with some success. Her confidence grew and her anxiety diminished as she made her first school friends.

Her teachers and parents noticed a remarkable improvement in her social skills and overall happiness at school, highlighting the effectiveness of targeted social support and adult guidance in helping autistic children thrive in social settings.

little girl alone in the school yard

5. Adapting the Environment at School – Case Study: Ethan

The staff at fifteen-year-old Ethan’s school took proactive steps to adapt the learning environment for him.

Ethan faced significant challenges with sensory overload and social gatherings.

Understanding Ethan’s needs, his teachers implemented several strategies to make his school experience more comfortable and conducive to learning.

To reduce sensory input in Ethan’s classrooms, his teachers paid attention to the class groupings Ethan was placed in, to ensure as far as possible that he wasn’t in noisy or disruptive classes. Staff attempted to avoid shouting and loud noises, and encouraged him to wear his noise-canceling headphones when loud noise couldn’t be avoided.

Recognizing Ethan’s difficulty with initiating tasks, they also assigned a teaching assistant to help him begin assignments and stay on track.

The pastoral team then considered what else would make Ethan feel safe and contained at school.

Acknowledging his anxiety and discomfort during large gatherings, Ethan was given permission to skip whole-school assemblies. Instead, during these times, he could spend time in a designated safe space.

These adjustments made a significant difference in Ethan’s school life. He felt more at ease and in control within the adapted environment, leading to noticeable improvements in his academic performance and engagement.

Ethan’s teachers and peers saw him become more involved in class discussions and more willing to collaborate on group projects. His parents felt thankful that his school had been so supportive.

a teen boy studying with the help of a teaching assistant

6. Reducing Unnecessary Demand at School – Case Study: Saira

Thirteen year-old Saira found assemblies, physical education (PE), and music classes overwhelmingly stressful due to the loud noises and large groups involved. She would often avoid school on days when these activities were scheduled.

After observing the negative impact these settings had on her, the school decided to reevaluate the necessity of her participation in these activities.

The decision was made to excuse Saira from attending the weekly assemblies and participating in PE and music classes.

Instead, during these times, she was provided with alternative activities that suited her interests and learning style, such as quiet reading or engaging in individual art projects.

This approach allowed Saira to remain productive and continue learning without the anxiety these larger group activities caused her.

This adjustment proved to be immensely beneficial for Saira. It not only reduced her daily stress but also improved her overall engagement with school.

Saira’s teachers and her parents noticed a significant increase in her happiness and academic performance as she could now focus on her strengths and interests without the added pressure of challenging situations.

7. Occupational Therapy Input at School – Case Study: Tom

Eleven-year-old Tom faced significant challenges with school anxiety, primarily due to his difficulty in regulating sensory input.

The school collaborated with an occupational therapist to develop a personalized sensory diet tailored to meet Tom’s specific needs.

The occupational therapist worked closely with Tom to identify the sensory activities that helped him feel more centered and less overwhelmed.

This sensory diet included activities such as using a weighted blanket during reading times, short breaks for tactile play with clay or a stress ball, and the use of headphones during noisy transitions.

These interventions were strategically scheduled throughout his school day to help maintain his sensory regulation and reduce feelings of anxiety.

Implementing this sensory diet significantly improved Tom’s ability to participate in classroom activities and interact with his peers. He was able to remain focused for longer periods and demonstrated a decrease in anxiety-related behaviours.

The targeted support from the occupational therapist enabled Tom to engage more fully with his learning environment.

three school boys standing in a row

8. Parent-Teacher Partnership to Help Autistic Children With Anxiety – Case Study: Jessica

A strong partnership between parents, teachers, and mental health professionals has been instrumental in supporting eight-year-old Jessica, an autistic girl with significant anxiety about school.

Jessica’s parents and her teacher, along with a school psychologist, formed a collaborative team to develop a support plan tailored to her needs.

This plan included regular meetings to discuss Jessica’s progress and any concerns, allowing for real-time adjustments to her learning environment and support strategies.

For instance, they introduced a visual schedule to help Jessica anticipate daily activities and transitions.

They designated a quiet space where she could retreat when feeling overwhelmed.

The team also implemented specific classroom strategies recommended by the psychologist, such as structured peer interactions to help Jessica develop social skills in a managed and supportive setting.

The outcomes of this partnership were profoundly positive.

Jessica began to show a significant reduction in anxiety. This was evident in her increased engagement in class activities and her growing ability to form friendships with classmates.

This collaborative approach not only supported Jessica’s academic and social development, but also ensured that she felt secure and understood within her school environment.

a parent-teacher consultation

Your Role as a Parent

Work with your child’s school to create a plan that meets your child’s needs and helps them feel safe and secure.

Consider asking about making accommodations such as a modified schedule or reduced workload if necessary.

Remain flexible and open to adjustments as your child’s needs may change over time.

Try to maintain a positive relationship with the school. As a parent, advocating for your child’s needs in school, whilst staying aware of the limitations in resources available, is crucial for your child’s success.

Start by gathering information about your child’s rights, such as special education services, accommodations, and modifications.

Meet with your child’s teacher, special educational needs coordinator, or head teacher to discuss your concerns and goals for your child’s education.

Consider bringing an advocate or professional to the meeting to support you.

Be specific about your child’s strengths and challenges, and provide examples of what has worked well for them in the past.

Together, develop an individualized plan, which outlines the accommodations and modifications that will support your child’s learning and wellbeing.

Be sure to review and update the plan regularly to ensure that it is meeting your child’s needs.

Building positive relationships with your child’s school is also important.

Communicate regularly with your child’s teacher and keep them updated on your child’s progress and any changes in their needs.

Attend parent-teacher conferences and school events, and consider volunteering in the classroom or school community.

School Anxiety in Autistic Children: Therapeutic Support

Supporting a child with school anxiety, especially when they are autistic, requires a thoughtful and coordinated approach.

Therapies like cognitive-behavioural therapy (CBT) can be a cornerstone of this strategy.

CBT helps children to understand and adapt unhelpful thought patterns while equipping them with practical skills to manage anxiety.

Graded exposure, where a child is gradually introduced to anxiety-provoking situations in a controlled manner, is a key part of CBT which can be highly beneficial.

However, it’s crucial that the school is fully on board and supportive of any therapeutic interventions. Communication and collaboration between parents, teachers, and healthcare providers are key.

Regular discussions ensure that everyone understands the child’s triggers, coping strategies, and overall treatment plan.

Together, we can create a consistent and nurturing environment that supports learning both at home and at school.

It’s also important to remain open to the possibility that a mainstream school may not be the right fit for every child. In some cases, a specialist school might be necessary to provide the tailored support your autistic child needs to thrive.

Related Articles

EBSA Resources For Parents: School Avoidance & Anxiety

Empowering Autistic Children: Top 10 Autism Classroom Ideas For Every Teacher and Parent to Know

The Parent Survival Guide to Back to School Anxiety

 School Stress: 5 Effective Ways to Support Your Child

Dr Lucy Russell is a UK clinical psychologist who works with children and families. Her work involves both therapeutic support and autism assessments. She is the Clinical Director of Everlief Child Psychology, and also worked in the National Health Service for many years. In 2019 Lucy launched They Are The Future, a support website for parents of school-aged children.

Through TATF Lucy is passionate about giving practical, manageable strategies to parents and children who may otherwise struggle to find the support they need.

Lucy is a mum to two teenage children. She lives in Buckinghamshire with her husband, children, rescue dog and three rescue cats. She enjoys caravanning and outdoor living, singing and musical theatre.

UK parents, looking for expert parenting advice?

Dr. Lucy Russell’s Everlief Parent Club offers a clear path towards a calmer, happier family life. This monthly membership includes exclusive workshops, direct support from child psychologists, and access to our private Facebook community.

Together, we can move towards a calm, happy family life and boost your child’s wellbeing. Become a member today!