The experience of anxiety for autistic children and young people: A thematic synthesis review

Background: Anxiety is a commonly co-occurring mental health condition for autistic children and young people. Literature indicates a fractured conceptualisation of the construct of anxiety and measurement tools may be insensitive to unique autistic presentations. The neurodiversity paradigm calls for a shift towards qualitative research methodologies situated within everyday realities. The purpose of this review is to synthesise experiences of anxiety for autistic children and young people from their perspective and the viewpoint of parents.Method: Informed by PRISMA guidelines, this systematic review searched for empirical studies published between January 2012 and January 2022 reporting on the experience of anxiety for autistic children and young people aged between 3 and 18. Of the 473 studies screened for in-clusion, 10 studies fulfilled inclusion and quality appraisal criteria. Data were analysed using thematic synthesis.Findings: Findings highlighted differences in the ways children and young people and their parents conceptualise anxiety in autism. Parents tended to report behavioural presentations of children and young people's anxiety while young people provided insight into their cognitive processes and emotions. Lived experiences provided unique insights into the role of neurotypical envi-ronments in state anxiety and how differences in perception of time can also mediate young people's experiences of anxiety.Conclusions: Implications for policy and practice include the priority for authentically eliciting the views of cognitively-able and less-able autistic children and young people with cooccurring anxiety across contexts in assessment and research. This review highlights the need for significant investment in social environments that seek to minimise anxiety in neurodiverse children and young people.