Understanding hidden anxiety in neurodivergent children: Beyond traditional therapy

“My child's anxiety has got so much worse. They have daily meltdowns, they're avoiding everything now, and nothing we try helps. Can you help them with therapy?”

This is how most conversations with parents of anxious neurodivergent children begin. And I completely understand why - the anxiety and emotional dysregulation have become impossible to ignore. Your high-masking child is stuck in patterns of negative thinking, avoiding school or social situations they used to manage, constantly seeking reassurance or checking things over and over.

You can see they need help, and therapy feels like the obvious answer.

But here's what I've learned about neurodivergent children: that anxiety you can see? It's usually just the tip of the iceberg.

Underneath often lies huge amounts of unrecognised and unmet needs - all those "hidden" or "masked" differences that have been bubbling away unseen.

The traditional approach

Standard therapy focuses on that visible tip - the anxious thoughts, the avoidance, the safety behaviours. And yes, CBT or other therapies can help with these patterns. But if we only work on what's above the surface, we're missing the bigger picture.

What really works with anxious neurodivergent children

For therapy to truly help neurodivergent young people, we need to dive deeper. We need to understand and address what's hidden beneath the waterline.

This means taking a 'whole system' approach. Working not just with your child, but with you as parents, with school staff, with anyone who's part of their world. Because when everyone understands your child's hidden needs - their sensory differences, their processing style, their emotional patterns - everything changes.

When we can adapt environments to actually fit your child, when we can help others respond to their real needs rather than just their visible behaviours, something magical happens.

The anxiety often starts to naturally reduce. Not because we've taught your child to think differently, but because we've helped create a world that actually works for who they are.

The bottom line

Your child's anxiety isn't a character flaw to be fixed. It's often their nervous system's way of saying "this world doesn't quite fit me."

And when we help the world fit better? The anxiety often takes care of itself