Eastwood Psychologists

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Mental Health Services for Autism Spectrum Disorder (ASD)

Autism Spectrum Disorder (ASD) and Mental Health

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder characterized by challenges in social development, communication skills, and restricted interests. While ASD itself presents unique hurdles, individuals on the spectrum are often confronted with the added burden of co-occurring mental health problems.

Prevalence of Mental Health Conditions in ASD

The co-occurrence of mental health disorders in individuals with ASD is a growing concern. Recent studies suggest that nearly three out of every four individuals with ASD meet criteria for another mental health disorder. This high prevalence rate underscores the need for better understanding and management of the mental health needs of this population.
Individuals with ASD are at risk to experience all of the same mental health problems as do typically-developing people. One study of children aged 10 to 14 indicated that seventy percent of participants had at least one comorbid disorder, and 41% had two or more. The most common diagnoses in that study were social anxiety disorder, attention-deficit/hyperactivity disorder, and oppositional defiant disorder (Simonoff et al., 2008). These comorbidities can have a profound impact on an individual’s quality of life, family functioning, and access to appropriate treatment.

Factors That Increase the Risk for Mental Health Comorbidity

Numerous factors contribute to the increased risk of individuals with ASD developing comorbid mental health conditions:
  • Genetic Factors: Autism tends to cluster in families, along with mental health problems like mood and anxiety disorders.
  • Pre- and post-natal stressors: Problems like pre-term delivery and hypoxia at birth increase the likelihood of both Autism and mental health disorders.
  • Associated Medical Conditions and Syndromes: Individuals with both ASD and certain medical conditions, are at increased risk of having mental health problems.  For example, Fragile X syndrome is associated with hyperactivity and social anxiety, Prader-Willi syndrome is associated with compulsive behaviour, and seizure disorders can be associated with aggression and/or anxiety.
  • Psychosocial factors: Individuals with ASD often experience peer rejection, low levels of social support, and academic difficulties, all of which may contribute to the development of mental health problems. The impact of psychosocial stressors on mental health may be intensified when an individual with Autism becomes more aware that they are different from their peers (often during puberty).  People with ASD may also struggle to cope with, and solve social problems, because of limitations in communication skills and cognitive processing weaknesses.

Challenges in Diagnosis

Despite the importance of identifying and addressing mental health issues in individuals with ASD, there are several challenges that hinder timely diagnosis and intervention:

Diagnostic Overshadowing:

This occurs when new problems or behaviours are attributed solely to ASD, and the presence of another disorder is not recognized. All concerning behaviours are attributed to the known ASD diagnosis, potentially leading to missed diagnoses.

Baseline Exaggeration:

Behaviours signaling the development of a mental health condition may be perceived as an exacerbation of long-standing behavioural difficulties, rather than a new, separate issue. This can lead to a delay in identifying and addressing mental health concerns.

Current Diagnostic Criteria do not easily apply to ASD:

Many mental health diagnoses rely on a person’s ability to describe internal feeling states. Because individuals with ASD often struggle to describe their feelings, it can be harder to diagnose their mental health problems.

Despite these challenges, healthcare professionals and caregivers must remain vigilant and open to the possibility of comorbid conditions. Early diagnosis and appropriate treatment can significantly improve the quality of life and long-term outcomes for individuals with ASD. By acknowledging the prevalence of mental health conditions, understanding the contributing factors, recognizing potential indicators, and addressing diagnostic challenges, we can better support the mental well-being of individuals on the autism spectrum.

Does a person with ASD have another neurodevelopmental or mental health disorder? What to look for:

ADHD (Attention-Deficit/Hyperactivity Disorder):

Symptoms of ADHD include hyperactivity, impulsivity, distractibility, forgetfulness, difficulty focusing, organizational problems, and careless errors. Many of these symptoms are also associated with ASD. An additional diagnosis of ADHD should be considered when ADHD symptoms are more frequent, intensive or disruptive than expected for the person’s age (chronological and mental/developmental age).

Anxiety Disorders:

Individuals with ASD may struggle to verbally express feelings of anxiety, worry or fear. However, anxious people may avoid specific situations, or become very distressed when they are required to face specific situations. Signs of anxious distress in ASD can include crying, tantrums, refusal to cooperate, repetitive questions, reassurance seeking, increasing reliance on rules or scripts, and heightened focus on special interests. These signs may indicate the need for additional support or treatment to cope with anxiety.

Depression:

Depression in individuals with ASD may manifest as changes in activity levels (e.g., either increased agitation or reduced activity), self-injury, temper outbursts, loss of interest in previously enjoyed activities, and changes in sleeping or eating patterns.

In summary, any notable change in a person’s behaviour or reactions could signal the presence of a mental health disorder. It can be challenging to assess and diagnose comorbid mental health disorders in individuals with ASD, so it is best to consult with professionals who are experienced in the assessment, diagnosis, and treatment of both ASD and mental health disorders.

Mental Health Services for Autism

At Eastwood Psychologists, our Mental Health Services for Autism include both Counselling and Psychotherapy. Counselling and Psychotherapy are “talk therapies”, which means that the client’s mental health is supported by talking with their therapist. Therapists and clients talk about the client’s inner experience (thoughts and feelings) and also talk about the client’s actions, including how they currently behave in different situations, and how they might experiment with behaving differently in an effort to improve their social-emotional well-being.

Psychotherapy

In Psychotherapy, the therapeutic relationship between the therapist and the client forms the basis for emotional development. The goal of Psychotherapy is to help the client understand and change their own thoughts, feelings and behaviours. Psychotherapy is particularly helpful for clients who are experiencing significant difficulties with mood or anxiety. To benefit from psychotherapy, clients need to be able to engage in conversation with their therapist, although they might have a limited ability to talk about feelings/emotions due to ASD. For more information about Psychotherapy, please see our psychotherapy page. There are many different types of techniques that psychotherapists use to help their clients.

Counselling

Counselling is another type of “talk therapy” that is often used to help promote the mental health of people with Autism. In Counselling sessions, the therapist helps a client think through their situation and options in order to solve or cope with their problems. Counselling is especially helpful when a client needs support with solving a problem in their life.

Contact us for assessment and treatment of mental health problems

Mental health problems in Autism, despite being common, are often overlooked or undertreated. There are many reasons why people with Autism don’t access mental health treatment, but one of the reasons is that therapists are not always confident about how to adapt their therapies to meet the needs of people with Autism. At Eastwood Psychologists, our experienced, regulated psychologists and psychotherapists are knowledgeable about accommodations that help children and adults with Autism access, and benefit from, psychotherapy and counselling. Please reach out to us for more information!

References

Center for Autism and Related Disabilities at the University of South Florida.  Autism and Mental Health Issues: A Guidebook on mental health issues affecting individuals with Autism Spectrum Disorder. 

http://card-usf.fmhi.usf.edu/docs/resources/CARD_ASDMH_Brochure092109.pdf

Khachadourian V, Mahjani B, Sandin S, Kolevzon A, Buxbaum JD, Reichenberg A, Janecka M. Comorbidities in autism spectrum disorder and their etiologies. Transl Psychiatry. 2023 Feb 25;13(1):71. doi: 10.1038/s41398-023-02374-w. PMID: 36841830; PMCID: PMC9958310.

Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G. Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry. 2008 Aug;47(8):921-9. doi: 10.1097/CHI.0b013e318179964f. PMID: 18645422.