Does anyone have any experience with children with autism who have panic attacks? I have a high
functioning 3rd grader struggling in the general ed class and I'm running out
of ideas. She often complains of nausea, overheating, and more recently, trouble
breathing. Although it was originally thought the nausea was due to
hypersensitivity to sight/sound/smells, we've noticed that it often comes when
something is difficult or confusing. I'm wondering if it could be a panic attack. It's starting to affect her ability to
function in the classroom on a day-to-day basis. Any feedback would be much

Tags: autism, inclusion, specialneeds

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I teach 4th grade and have had several students with autism and anxiety. I don't know your student's strengths and challenges, I'm not sure what you've tried, or what type of support this student receives, but I recommend you try to be proactive and prevent the anxiety before it occurs. Once the panic attack starts, it's very difficult to redirect the student.

Here are some things that have worked for me with anxious students (with and without autism): Knowing the daily schedule may help make the day predictable and less stressful for this student (visual on desk has helped some students). Sometimes it's comforting for students with anxiety or other disorders to work at the teacher's table/desk (or in close proximity). Checking in at the beginning of the task and clarifying or supporting this student may help. Another strategy you might try is to pre-teach some of the difficult or challenging material, so this student already has some idea what an upcoming task entails. This can be challenging in some subject areas (math for me), but is quite doable in other subject areas (reading). I've had success pre-teach reading strategies in guided reading to struggling or anxious children before whole class instruction. Oral rehearsal can be very helpful for alleviating anxiety with classroom routines or sharing. For example, one student with autism was able to share during morning meeting once we had an instructional aide discuss and rehearse her sharing topic before morning meeting. You might also try acknowledging the problem frankly with the student. I once told a very anxious student that it was normal to get nervous when they were trying something new. I explained that feeling sick to your stomach is a normal feeling when you're nervous and that I was there to help him get through it. Sometimes this reassurance is all it takes for a student to take a risk and try. Rely on your knowledge of this student and the relationship you have with her. I hope this helps.
Thank you for your reply! Until recently, we weren't positive her stomachaches were connected to stress. She had very little difficulty functioning in the classroom from September through December. However, they are coming more frequently and with more symptoms. Now we are working to determine the cause - it's not consistent and can occur at anytime. I have also found that redirection is nearly impossible, so our main goal is to try find and remove the source of anxiety. I like the idea of oral rehearsal. We do literature circles in reading, and have the students read and discuss the reading at home. Reviewing her notes prior to the group meeting could work. Do you preteach in the general ed classroom? Pre-teaching reading is easier for me too, because I work with her during independent reading time.
Dear Melissa,

I was a practicing Registered Pharmacist for 25 years. I have had the opportunity to counsel and observe many patients/customers over those years. I don't mean to be pretentious.

You mention "Autism" in your title. This diagnosis has become inclusive of all learning disabilties. Since Autism covers most diseases and conditions that adversely affect learning, we do not know what "condition" this child is affected with.

Her symptoms may not be psycological (panic attacks). There may be underlying physiological problems. If a customer came to me with this discussion, I would recommend that they visit a physcian, to rule out any organic problem. I would not recommend a psycological consult.
I share your concern for this child. Our first response is to help in someway, to find a solution, but this is beyond our ability.
I am not suggesting a diagnosis, but here are a few of my experiences.
I have had a few patients that bought in prescriptions for "anxiety" or panic attacks. I recommend to each person, after an extensive discusion of their symptoms, to be examined by a cardiologist before filling their prescriptions. Each of these patients were diagnosed with relatively minor heart aliments, prolapsed valves or heart murmurs. They were treated accordingly and never needed their "psyc meds". Their panic attacks were a symptom of an underlying heart problem.
Once again, I am not suggesting that these experiences apply to your student, but these symptoms should be communicated to the parents.
I am not an educator, I do not know what you are allowed to do as a teacher. BUT, try to document the symptoms and occurrences, and provide this information to the parents. They may be unaware.

I hope that I have helped, JJC
An Autism student with panic attack most of the time can be redirected. Get them to think about someting else. We had a student that was afraid of an elevator. The first time went bad but the second time went ok. We had the student to count to ten. Each time it went a little smoother. Now he is the first one to push the elevator button. He does not forget to count.

In general ed have a one-on-one person to go with them . Some one they are familiar with. I have found that when an Autism student go out to general ed for the first couples of times they need that one-on-one for support. It's like being surrounder with familiar things. For some to let that one on-one go is hard. Some Autism want let them go where others will. Then always remind the student that they will be gone to general ed class tomorrow or today. After a while they will remind you.

A daily schedule with words and visuals and a warning before transition can help ease anxiety. As far as panicking when there is a difficult task, it may help to provide her with sensory objects at her desk. For example a squeeze ball, cushion on her chair, stretchy band, just something that will help her with her tension and anxiety. Another idea might be to provide her with a safe spot to go to when shes becoming upset. Allow her to go there at any appropriate time and give her 3-5 minutes before approaching her. Working in a 1:1 setting on difficult assignments is going to be key for her,(token economies are great too) she needs to learn coping strategies for her anxiety. Hope this helps, good luck!



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