Anxiety in high-functioning children with autism.

Cullinan et al. (2001) compared anxiety levels in high-functioning children with autism to two control groups. They used standard anxiety checklists to see which symptoms stood out most.

The kids were in late elementary school. The study asked parents and teachers to rate worry, fear, and ritual behaviors.

Children with autism scored much higher on every anxiety scale. Separation anxiety and obsessive-compulsive symptoms were the biggest differences.

Social worries were also elevated. The gap was large enough to suggest anxiety is a core part of the autism profile, not just a side note.

Adams et al. (2020) extends this by letting kids speak for themselves. Their survey of 6- to 14-year-olds found 96% self-report anxiety, yet only half feel adults notice it at school or in the community.

Ambrose et al. (2022) links the same high anxiety to real-life limits. They show higher parent-rated anxiety predicts fewer home and community activities, even after autism severity is held constant.

Capio et al. (2013) adds a twist: among school-age autistic students, those with milder autism traits and poorer social ties show the highest anxiety. IQ had no effect, confirming the 2001 pattern is about social connection, not smarts.

Screen every high-functioning autistic student for separation anxiety and obsessive rituals. These two areas pop up first and strongest. Use the data to write goals that target worry, not just social skills. When anxiety drops, kids join more activities and adults actually notice the change.