Autism and Emotions

Why do children with autism struggle emotionally?

Children with autism often have cognitive deficits that include decreased concentration, impaired social communication, and poor emotion regulation—all of which can cause them to struggle emotionally. Emotion regulation is a complex cognitive process that entails recognizing and modifying emotional responses in a goal-directed manner. This instinctive action regulates the type, intensity, and duration of an emotional response.

Research that involves the comparison of children who have autism to those who do not shows that autistic children:

• Display more emotion regulation difficulties
• Are less efficient at using emotion regulation coping techniques
• Demonstrate irregular patterns of emotion regulation strategy use

For some children with autism, emotion regulation problems may make it difficult for them to recognize their emotions, while others may feel certain emotions more intensely (e.g., irritability, nervousness). Sensory sensitivities, social challenges, and difficulty coping with changes can further increase stress and frustration levels. These factors may contribute to repetitive actions, maladaptive behaviors, and meltdowns that are often observed, as well as more pronounced emotion dysregulation.

What Is Emotion Dysregulation?

Emotion dysregulation is defined as the inappropriate or ineffective regulation of emotions that leads to negative feelings, thoughts, judgments, and behaviors. The first step of healthy emotion regulation involves being able to identify an emotion that needs to be regulated. Recognition then triggers the use of regulation strategies that aim at either increasing or decreasing the emotion. The entire emotion regulation process entails the following five steps:

1. Situation selection or identification – this involves recognizing an emotion-evoking situation and deciding whether to avoid or approach the situation
2. Situation modification – this is the problem-solving step when a mental plan of action begins
3. Attentional deployment – this step involves either paying more attention to the situation or actively engaging in deflection
4. Cognitive change – this involves cognitive processes that help interpret the situation (e.g., perception, memory/recall)
5. Response modulation – this step refers to the type, intensity, and duration of the emotion that is expressed in response to the situation

In general, positive emotions are typically welcomed and encouraged, while negative emotions often trigger more specific strategies that help resolve issues and improve feelings. Although this process occurs naturally for most people, those with autism may struggle to:

• Identify certain emotions
• Understand why they are feeling certain emotions
• Activate emotion regulation strategies
• Use regulation strategies effectively or in an appropriate manner
• Recognize changes in their internal or external environment that trigger emotions 

This form of emotion dysregulation is sometimes described as one of the primary underlying causes of all core autistic symptoms.

Furthermore, mental health issues such as depression and anxiety are among the most common emotional disorders associated with autism. The reported incidence of depression is between 17% and 70%, while the incidence of anxiety is between 14% and 84%. These incidence rates also appear to be related to emotion dysregulation in autism.

These well-documented findings regarding emotional struggles children with autism typically face suggest that teaching them effective ways to recognize and manage their emotions can help improve emotion dysregulation.

Approaches To Improving Emotion Dysregulation 

Incorporating emotion regulation activities into daily interactions, particularly play-based tasks, can help children with autism learn recognition, management, and coping skills. The following examples may be useful:

1. Use play to encourage a child to explore his or her emotions – Play-based activities such as painting, puppet or action-figure play, messy play, drawing, music play, or dancing games can help develop preschool and school-age emotions.
2. Encourage a child to participate in play-based applied behavioral analysis (ABA) therapy – this is a beneficial intervention for autistic children who struggle emotionally. Sessions may involve teaching and modeling emotions through specialized games, toys, tools, or interactive videos.
3. Label emotions as they are encountered throughout the day – A parent or caregiver can point out emotions while playing, watching television (TV), reading, or interacting with others. For example, while watching TV, if a child’s favorite character (e.g., bunny) is smiling, a parent can point to the character and say “the bunny is happy.”
4. Model appropriate responses to different emotions – A parent can use emotion cards that have pictures of faces or actions to teach appropriate responses to emotions. For example, after showing a picture of a child with a frown, a parent could say “She is sad, when you feel sad, you can ask for a hug” and then model the behavior by hugging a teddy bear.

Helping a child with autism learn how to manage emotions appropriately takes time and practice, but it is an important tool that has a lasting impact.