Helping your child understand feelings and find calm

What is co-regulation, and why does it come first?

Co-regulation is when a calm adult helps a child's body and feelings settle. Children borrow that calm, again and again, and slowly build self-regulation: the ability to calm themselves. For young children, co-regulation is the main tool, and it stays important for years.

A 2026 review describes parent-child co-regulation as "a key mechanism" in how children learn to manage emotions, working both "moment-by-moment" and over the long term (Northrup et al. 2026). The authors say autism can make this harder, because of "pervasive and idiosyncratic triggers, reduced emotional awareness, and ambiguous emotional communication". In plain words: triggers can be everywhere and hard to predict, your child may not notice their feelings building, and their signals can be hard to read. They also note that research in young autistic children "remains limited".

Co-regulation in practice:

• Calm yourself first. Slow your breathing, lower your voice and relax your face.
• Get close and on your child's level, if they want you near.
• Use very few words, and name what you see: "Big feelings. I'm here."
• Rock, hum or breathe slowly alongside your child, if they like that.
• Offer a calm tool you have practised together, without insisting.

Your own stress matters too, because it is hard to lend calm you don't have. See looking after yourself.

Why can feelings be hard for autistic children to notice and name?

Many autistic children find it hard to notice, understand and name their own feelings. This is a real difference, not stubbornness or rudeness.

• Alexithymia means difficulty identifying and describing your own emotions. A review of 15 studies, mostly in adults, found it in about half of autistic people (49.93%), compared with about 5% (4.89%) of non-autistic people, and concluded it is "common, rather than universal" (Kinnaird et al. 2019). The first study in children found it "substantially elevated" in autistic children, though children's and parents' answers did not agree with each other (Griffin et al. 2016).
• Interoception is the sense of what is happening inside your body. The National Autistic Society (NAS) describes it as "knowing whether you are hungry, thirsty, hot or cold, need the toilet, are ill or injured" (NAS). Feelings show up as body signals, such as a tight tummy or a racing heart, so a child who struggles to read these signals may miss the start of a feeling. The NHS lists difficulty describing feelings, hunger or pain among the signs of autism in children (NHS).
• Masking: some children hide their difficulties to cope at school, and their feelings may come out later, at home (NAS).

Misunderstanding works both ways. The double empathy problem describes how autistic and non-autistic people can misread each other (Milton 2012), so your child may show feelings in ways other people miss. Learning your child's own signals matters as much as teaching them yours.

How can I teach my child about feelings?

Teach feelings in small, everyday moments, using your child's way of communicating, whether that is speech, signing, pictures or a communication device. These steps are practical ideas drawn from UK guidance and research on emotion coaching, not a tested programme.

1. Name feelings in the moment. Keep it short: "Your body looks tight. I think you feel worried."
2. Link feelings to body clues. "Your heart is fast. Your hands are squeezing." Point to where on the body.
3. Use pictures. Photos of real faces, simple drawings or other visual supports give your child something to point to.
4. Use a simple feelings scale. Three levels are usually enough for younger children, and older children may manage up to five. Always include "I don't know", and body energy choices such as "my body feels fast" or "slow".
5. Show you understand. "It's hard when plans change."
6. Talk it over later. When everyone is calm, look back at what your child felt and what helped.
7. Use the same words and pictures at home, nursery and school.

Talking about feelings like this is called emotion coaching. In a trial with 128 parents of 4 and 5 year olds in the general population, parents who learned it coached their children more and reported bigger falls in behaviour problems (Wilson et al. 2012). The research reviewed for this guide found no trial in autistic children.

Which calm tools can we try?

Different tools suit different moments, and your child's choices matter most. Practise tools when your child is already calm, so they are familiar before they are needed. The NAS suggests having "a plan beforehand", such as "a calming playlist to listen to at the shops or a stress ball in their pocket" (NAS).

On breathing, a one-minute animated video guiding four slow breaths raised heart-rate variability and lowered heart rate, which are body signs of calming, in a general sample of 342 children with an average age of 7.5 (Obradović et al. 2021). No similar study has been found in autistic children. Exercise and movement is one of the practices a large US review rated as evidence-based for autistic children, with studies from age 3 (NCAEP 2020). Autistic adults describe stimming as a way to self-regulate and object to efforts to remove it (Kapp et al. 2019), and the NAS says "if stimming is harmless, there is no reason to prevent an autistic person from doing it" (NAS).

None of these tools has been shown to reduce anxiety in autistic children. They are low-risk things to try, so notice what actually helps your child. A calm choices board lets your child point to what they want.

How common is anxiety in autistic children?

Anxiety is common in autistic children, although estimates vary. A 2011 review of 31 studies, covering 2,121 autistic children and teenagers, found that 39.6% had at least one anxiety disorder (van Steensel et al. 2011). A 2019 review covering all ages found a lower figure, 20%, and higher estimates in clinic samples than in whole-population samples (Lai et al. 2019).

Anxiety can start young. In a study of 82 autistic children aged 3 to 6 in Spain, 30.48% had significant anxiety on a parent questionnaire, and worry about uncertainty was the most common kind (Durán-Bouza et al. 2025).

Uncertainty seems to play an important part. Intolerance of uncertainty is "a tendency to react negatively on an emotional, cognitive, and behavioural level to uncertain situations and events" (Rodgers et al. 2019). In one study, it appeared to link autism and anxiety in children and teenagers, although that kind of study cannot prove cause (Boulter et al. 2014). The NAS lists other causes, including unexpected change, social and sensory environments, "difficulty identifying, understanding and managing emotions" and masking (NAS).

What does anxiety look like in a child who can't tell me?

In a child who speaks little, anxiety often shows in what they do. Guidance for schools in England notes that children who find talking hard "may express their needs, discomfort or confusion through actions" (Department for Education). A NICE guideline notes that self-injury "may indicate pain or distress", and that repetitive movements can "indicate distress or discomfort" (NICE NG11). In the preschool study above, more repetitive behaviour went with higher anxiety.

Changes worth noting, from practice rather than a tested checklist:

• more stimming, or the same question asked again and again
• changes in sleep or eating
• clinginess, or avoiding places and people
• going very still or quiet
• more meltdowns, or new hitting or self-injury

The NAS lists body signs too, including restlessness, a churning stomach, a fast heartbeat, faster breathing, sweating, feeling sick and "problems sleeping" (NAS). The same changes can mean pain or illness, so ask your GP to check. NICE lists pain among the things to check when behaviour changes (NICE CG170).

What helps an anxious autistic child?

Two practical approaches fit what is known about uncertainty: making the unknown smaller and easier to see, and gently practising small changes when your child is calm.

• Make it visible. Show what is happening with a Now and Next board, a picture timetable or a calendar, and use a "change" picture when plans change. See transitions and change.
• Practise small surprises. When your child is calm, plan tiny changes, starting with good ones (a new snack), then neutral ones, then harder ones. Praise coping, not just calm. This fits the aim of the CUES programmes below, but it is not the programme itself.
• Don't avoid everything. The 2026 review warned that avoidance used as a "quick fix" may hinder how children learn to manage feelings over time (Northrup et al. 2026).

Parent-led programmes: for anxiety in children aged 4 to 7, the only trial found for this guide tested a programme that works through parents. In the CUES-Junior trial, parents of 64 autistic children aged 4 to 7 with worries about uncertainty joined an 8-week parent group or a waiting list. More children in the group improved in how they responded to uncertainty, family life was less affected, and the gains were still there 2 months later (Ong et al. 2026). But it was one small trial, the results were very uncertain (wide confidence intervals), and the comparison was a waiting list rather than other support. It is not clear yet whether the programme is offered on the NHS.

Talking therapy: NICE recommends considering cognitive behavioural therapy (CBT) for anxious autistic children "who have the verbal and cognitive ability to engage" in it, adapted with "greater use of written and visual information", "involving a parent or carer" and other changes (NICE CG170). Most evidence for it comes from older children who talk well (Sukhodolsky et al. 2013).

How do I get help for anxiety in the UK?

Start with your GP if worry is affecting sleep, eating, play, nursery or school, or family life. The NAS says "if anxiety is affecting your life... speak to your GP", who may suggest "counselling, therapy, or medication" (NAS). The NHS suggests asking "your GP or local autism team" about mental health support (NHS).

1. Take notes. Bring your diary: what the worry looks like, when it happens and what helps.
2. Ask about CAMHS. Your GP can refer your child to CAMHS, the NHS children's mental health service. Ask what it offers autistic children and parents.
3. Expect a wait, and start at home. In England, children still waiting for support at the end of 2023-24 "waited on average nearly six months for treatment to begin, with almost a third of these children waiting over a year" (Children's Commissioner). These figures cover all children.
4. Tell the nursery or school. Ask the SENCO how anxiety shows there and what adjustments could help.
5. Get support for you. The YoungMinds Parents Helpline is for parents worried about a child's mental health, and the NAS offers information and parent support.

Families of neurodivergent children have described barriers at every stage of CAMHS, including "misunderstandings of neurodevelopmental differences vs. mental health conditions" (Williams et al. 2026). If so, ask for the referral to explain how anxiety, not only autism, affects your child.