Anxiety and Autism

Best Practice

The National Institute for Health and Care Excellence (NICE) is a UK government body which supports healthcare professionals and others to make sure that the care they provide is of the best possible quality and offers the best value for money.

NICE guidance on anxiety in adults on the autism spectrum

NICE makes the following recommendations re the treatment of anxiety and other mental health problems in adults on the autism spectrum.

"For adults with autism and coexisting mental disorders, offer psychosocial interventions informed by existing NICE guidance for the specific disorder" and "For adults with autism and coexisting mental disorders, offer pharmacological interventions informed by existing NICE guidance for the specific disorder."

In practice this means treating the person with autism in the same way as you would anybody else who suffers from anxiety i.e. using a combination of psychological techniques and/or medication.

NICE guidance on anxiety in children and young people on the autism spectrum

NICE makes the following recommendations re the treatment of anxiety in children and young people on the autism spectrum.

‘In the absence of evidence of how coexisting mental health disorders (including ADHD, OCD, PTSD, depression and conduct disorder) should be treated differently in autism, the GDG agreed that management should be in line with existing NICE guidance. There was, however, evidence for clinical efficacy of CBT programmes with autism – specific modifications on coexisting anxiety for children with autism. There was evidence for a positive treatment response to CBT in terms of no longer meeting diagnostic criteria for the anxiety disorder and/or showing global improvement in anxiety symptoms." (NICE, 2013)

In practice this means treating the child or young person with autism in the same way as you would any other child or young person who suffers from anxiety i.e. using a combination of psychological techniques and/or medication, especially cognitive behavioural therapy.

NICE goes on to state that cognitive behavioural therapy may be effective in reducing anxiety in some children and young people on the autism spectrum without learning disabilities, provided it has been adapted to meet their particular needs. According to NICE this could mean using ‘a more concrete and structured  approach with a greater use of written and visual information (which may include worksheets, thought bubbles, images and “tool boxes”)’ and ‘placing greater emphasis on changing behaviour, rather than [thoughts], and using the behaviour as the starting point for intervention”

NICE guidance on specific types of anxiety

NICE has published the following additional guidance on specific types of anxiety

• Generalised anxiety disorder and panic disorder (with or without agoraphobia) in adults. (2011). London: National Institute for Health and Clinical Excellence
• Social anxiety disorder. (2013). London:  National Institute for Health and Clinical Excellence
• Obsessive-compulsive disorder: Core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder.  (2005). London: National Institute for Health and Clinical Excellence

Updated

02 Nov 2017