1. What Is Autism?

Autism is a lifelong neurodevelopmental condition that affects how a person communicates, interacts, and experiences the world. It is described as a spectrum because each autistic person has their own unique strengths and challenges.

Recent research from Newcastle University and the University of Cambridge estimates that 1 in 57 children in the UK are on the autism spectrum, higher than the often-cited 1 in 100 figure. Many adults remain undiagnosed, especially women and people assigned female at birth, who often mask their traits.

2. Recognising Signs of Autism

Common traits in autistic people

• Feeling overwhelmed in busy or unfamiliar settings
• Needing clear routine and structure to feel safe
• Struggling with eye contact or small talk
• Deep focus on specific interests
• Sensory differences (sensitive to noise, light, or texture)
• Repetitive behaviours (like rocking or stimming)
• Finding social rules confusing or draining

People often discover they are autistic after years of anxiety, burnout, or feeling “out of step” with others.

 

3. Why Anxiety Is So Common in Autistic People

Studies show that around 40% of autistic people also experience clinical anxiety (van Steensel et al., 2011) — roughly four times the rate in the general population. Anxiety in autism may show up as:

• Avoidance (e.g. refusing school or work)
• Repetitive movements or routines to regain control
• Overthinking and fear of change
• Meltdowns or shutdowns when overwhelmed

Autistic people often experience anxiety differently to neurotypical people. The root causes may include sensory overload, difficulty identifying emotions (alexithymia), or a strong need for predictability in a world that feels uncertain.

This difference matters, because standard anxiety treatments are not always designed with autistic people in mind. Anxiety that stems from sensory overwhelm will not respond well to techniques aimed at challenging irrational thoughts — the thoughts are not irrational, the environment genuinely is overwhelming.

4. Ways to Manage Anxiety

• Self-soothing through routines, calming activities, or special interests
• Problem-solving skills to build confidence
• Environmental adaptations like noise-cancelling headphones or clear schedules
• Reasonable adjustments at work or school
• Professional support, such as modified CBT with an autism-aware therapist
• Speaking to a GP about therapy or medication if appropriate

Building routine is also key. Structure helps reduce anxiety and builds confidence in day-to-day life.

 

5. Why a Diagnosis Can Reduce Anxiety

For many people, anxiety is made worse by not understanding why they find things difficult that others seem to manage easily. Years of being told to try harder, or of assuming something is wrong with them, creates its own layer of distress. A formal diagnosis helps explain lifelong patterns and opens up support.

Diagnosis can:

• Help you understand your identity
• Provide access to workplace or school adjustments
• Reduce anxiety by validating your experiences
• Support referrals to therapy, coaching, or autism-informed services

NHS waiting times

Although NHS assessments are free, waiting lists are long. As of late 2024:

• 204,876 people were waiting for an autism assessment in England
• 89% had waited longer than the recommended 13 weeks
  (Source: National Autistic Society)

Many people face a wait of 12 months or more, with no clear timeline or support in the meantime. For someone whose anxiety is tied to uncertainty, an open-ended wait can itself become a source of distress.

 

6. Getting Assessed: What to Expect

Tailored for adults and children

• Adults: The assessment explores your history, social experience, masking traits, and challenges in daily life.
• Children: Input is gathered from parents and teachers, alongside observation of play, behaviour, and development.

A typical diagnostic process:

• Stage 1 – Pre-Assessment Interview
  Online or face-to-face interview (60–90 mins), including screening forms.
• Stage 2 – Full Diagnostic Assessment
  An in-depth session using standardised tools and professional interviews. Includes family input where helpful.

Assessment tools used:

• ADOS-2 (Autism Diagnostic Observation Schedule)
• ADI-R (Autism Diagnostic Interview)
• SRS-2, behavioural questionnaires, sensory profiles

What happens after?

• A multi-disciplinary panel reviews every case
• You receive a clear, easy-to-understand diagnostic report and outcome letter
• Guidance is offered on next steps, including therapy, coaching, or education support

 

7. FAQ: Anxiety as an Autistic Person

What causes anxiety in autistic people?

Anxiety can come from sensory overload, difficulty recognising emotions, or fear of unexpected change. Autistic people often rely on routine to reduce stress, so disruptions can feel overwhelming.

How does anxiety look in an autistic person?

You might notice:

• Increased repetition or insistence on routine
• Avoiding social situations or school
• Asking for lots of reassurance
• Meltdowns or running away from distress
• Hyperfocus or overthinking

These behaviours are ways of coping with uncertainty or sensory distress.

What helps?

• Regular rest and downtime
• Calming environments (low light, quiet spaces)
• Clear expectations and visual schedules
• Autistic-led therapy (like adapted CBT)
• Permission to stim or follow routines
• Supportive workplaces and schools

Is anxiety part of autism, or a separate condition?

Anxiety is not part of the diagnostic criteria for autism — it is a separate, co-occurring condition. However, the two are closely linked, and anxiety is one of the most common reasons autistic adults first seek help. A good assessment will consider both, because treating anxiety without recognising underlying autism often produces limited results.

 

8. Considering an Assessment?

If reading this has prompted questions about yourself or someone close to you, a formal assessment is the next step. You can read more about our private autism assessment service in London, or explore how autism assessment works more generally.