Case study on Anxiety

B. is a fourteen year old girl and attends an autism unit within a mainstream school. She is very anxious and can be negative about her achievements and talents.


B. is a fourteen year old girl and attends an autism unit within a mainstream school. Her strengths lie in her care for others and in her many talents, such as drawing. K.L frequently reflects negatively on herself, which can result in her viewing herself as a ‘bad person.’ She also has a tendency to focus on negative things that have happened in the past and finds it difficult to reflect positively on events. She finds it difficult to acknowledge and speak about her achievements and talents. When experiencing high levels of anxiety, B. will attempt to exit the room or will reflect negatively on herself and believes that she deserves to suffer. In the past she has engaged in self-injurious behaviour in response to anxiety.

Stress Response

In consultation with teachers and parents the following challenges were identified

  • Being in noisy environments
  • An adult raising their voice
  • Changes in routine, such as a substitute teacher
  • Negative experiences in previous placement settings, particularly bullying
  • Watching a film or advertisement with upsetting content
  • B. enjoys spending time with soft toys, however, she believes that these are not age appropriate and is very anxious about her peers finding out about these interests

Maintaining Factors

  • B. was unaware of strategies she could use to lower her anxiety level
  • She did not want to worry those around her, so she would keep negative thoughts to herself


  • B. and her class were encouraged to complete “positive books” each day to help them to reflect positively on past experiences
  • She was given worry dolls to tell her worries to. These were used at night and then placed in a box
  • Use of strategies to support B. with labelling her emotions e.g. The 5 Point Scale, Emotional Toolbox, and she used emotional regulation loom bands. Three colours were used; red, orange and green. She wore the band which represented how she felt
  • Cognitive based strategies to help her identify her ‘poison’ thoughts, and choose and appropriate ‘antidote thought’
  • Using a visual representation B. was encouraged to decide if worries were within her control or outside her control
  • Take Ten visual breathing programme was used to teach deep breathing as a method of relaxation during times of anxiety
  • Delivering messages throughout the day to promote movement and sensory regulation
  • Access to a safe space for time out. Use of fidget toys, and relaxing activities in this space
  • In collaboration with school, B. was taught about autism and famous women with autism