Understanding Neurodivergence, Anxiety, and Accommodations
By: Dr. Dawn Ilardi
For many parents, one of the hardest parts of raising a neurodivergent child is figuring out what belongs to the child’s unique way of thinking and what comes from anxiety layered on top of it. The two can be very difficult to tease apart.
Because anxiety can be common among neurodivergent children, it can influence how they experience school, friendships, and daily life. Recognizing the different ways anxiety shows up is the first step in helping kids build resilience.
How Anxiety Can Show Up
Clinging to parents during drop-off or in new settings.
Inflexibility, getting stuck, or rigidity— during play time, with routines, when following rules, organizing belongings, and more.
Perfectionism—with drawing, schoolwork, or even play.
Irritable or frustrated when plans or schedules change unexpectedly.
Refusal to participate in group activities, like sports or birthday parties, or even going to school.
Teens might mask anxiety, and it can show up as withdrawal, irritability, or arguments instead.
Excessive worry about school performance, social situations, or the future; or worry about getting sick or the safety of others.
Black and white thinking—something feels just right or completely wrong.
Parent Accommodations
When we see our children struggling, it’s natural to step in and try to make things easier. This is instinctual and it’s important when advocating for a child. But not all accommodations are equally helpful.
When Accommodations are Helpful
Accommodations can be powerful tools when they support a child’s growing independence, confidence, and self-regulation, such as with:
Visual schedules: Adding structure with visual schedules can make steps predictable and ease transitions (bath, teeth care, book, lights out).
Cues: Using lists or verbal redirection can help a child stay on task (e.g., during homework).
Sensory supports: Offering headphones in a crowded environment, encouraging movement during homework, or providing leg massage at bedtime can help with regulation.
These kinds of accommodations don’t “feed” anxiety—they provide scaffolding and supports so a child can grow skills related to cognitive and emotional regulation, but also independence and confidence.
When Accommodations are Not Helpful
Sometimes, without realizing it, parents may accommodate in ways that can reinforce anxiety. Most commonly, a child is seeking accommodating responses from a parent so it’s a natural response. This happens when the focus of the parent accommodation is on reducing or removing distress in the moment, such as with:
Providing frequent reassurance: Answering the same worry-driven question again and again (e.g., “Are you sure they’re not mad at me?”; “Did you make sure the door is locked”; “Can you promise me I’m not sick”).
Allowing avoidance: Letting a child skip school, social, or extracurricular activities because it makes them uncomfortable or nervous.
Constantly adjusting to avoid distress: Walking on eggshells so you won’t upset your child, such as avoiding talking about certain topics.
While these strategies bring short-term relief, research shows us that they can strengthen the cycle of anxiety in the long-run and make it harder for children to cope with their big feelings. In other words, their anxiety can get stronger and last longer.
Finding the Balance
The goal isn’t to eliminate anxiety—it’s to support children in managing it while still moving forward and doing the things that are appropriate for their abilities.
A helpful question to ask yourself: Is this accommodation helping my child build independence and coping skills, or is it shielding them from discomfort in a way that could keep anxiety in charge?
When accommodations empower kids to gradually stretch their comfort zones, they’re helpful. This is how they develop resilience and grit!
Show Acceptance and Build Confidence
One of the most powerful ways to support your child is through validation and encouragement. This means acknowledging their feelings while also reminding them of their strength and bravery to handle those feelings.
For example, you might say: “I know you’re feeling really scared and it’s okay to feel scared. I also know how brave you are and that you can do this.”
As parents, we want to resist the urge to “fix” the problem or protect our child from their own feelings. Instead, help them understand that they can handle those anxieties and fears, and you’ll be right next to them, always believing they can do it. For some kids (and teens), even your calm, supportive presence is enough – no words are needed!
If you want to learn more, check out Supportive Parenting for Anxious Childhood Emotions (SPACE) treatment, an intervention developed by Eli Lebowitz, PhD of Yale University: www.spacetreatment.net
Dr. Dawn Ilardi at the Pediatric Neurodevelopmental Center in Atlanta, Georgia is working one-to-one (virtually or office) with parents to empower them to use SPACE strategies. Reach out with any questions: dawn.ilardi@pedneurocenter.com