Unusual fears in children with autism
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Many studies implicate excessive worry in autism regarding change, and excessive rigidity about things such as foods, rituals, and clothing.
“Many studies implicate excessive worry in autism regarding change, and excessive rigidity about things such as foods, rituals, and clothing [18, 19, 21-23].”
From Autistic Cognition: Charting Routes to Anxiety (2021) · cites this paper as [19]
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Traditional and atypical presentations of anxiety in youth with autism spectrum disorder
Kerns, C. M., Kendall, P. C., Berry, L., Souders, M. C., Franklin, M. E., Schultz, R. T., Miller, J., & Herrington, J. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-014-2141-7 · Cited by 405 · see citing works
“Frequent fears of loud sounds in addition to unusual phobias, such as fears of beards, toilet bowls, and mechanical objects, are described in numerous studies of youth with ASD, including Kanner’s seminal paper on the disorder, and may be related to atypical sensory experiences (Kanner 1943; Mayes et al. 2013; Muris e…”
BackgroundMaskey, M., Lowry, J., Rodgers, J., McConachie, H., & Parr, J. R. (2014) · PLoS ONE · doi:10.1371/journal.pone.0100374 · Cited by 215 · see citing works
“Mayes et al [11] in their study of phobia/fears in children with ASD also found recurring topics Reducing Specific Phobia in Young People with ASD”
BackgroundInfluentialWilliams, Z. J., He, J. L., Cascio, C. J., & Woynaroski, T. G. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.11.030 · Cited by 175 · see citing works
“Among these autism-specific fears, a number of studies have listed loud noises (either loud noises in general or specific noises such as toilets flushing) as the object of a child’s specific phobia (Gjevik et al., 2011; Kerns et al., 2014, 2016; B. Y. Lau et al., 2020; Leyfer et al., 2006; Mayes et al., 2013; Mukaddes…”
BackgroundKerns, C. M., Renno, P., Kendall, P. C., Wood, J. J., & Storch, E. A. (2017) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2016.1233501 · Cited by 170 · see citing works
“These symptoms have long been associated with a diagnosis of ASD (Gotham et al., 2013; Kanner, 1943; Lord et al., 1994; Mayes et al., 2013), but their correct classification as core or co-occurring features of the disorder has been debated (Kerns & Kendall, 2012).”
BackgroundKerns, C. M., Winder-Patel, B., Iosif, A. M., Nordahl, C. W., Heath, B., Solomon, M., & Amaral, D. G. (2021) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2019.1703712 · Cited by 156 · see citing works
“…uncommon focus (e.g., fears of specific songs, toilets, beards), and around the classification of excessive fears that are circumscribed around a specialized or perseverative interest (Gjevik, Eldevik, Fjæran-Granum, & Sponheim, 2011; Kerns et al., 2014; Leyfer et al., 2006; Mayes et al., 2013).”
BackgroundResultA Survey on Virtual Reality for Individuals with Autism Spectrum Disorder: Design Considerations
Bozgeyikli, L. “., Raij, A. B., Katkoori, S., & Alqasemi, R. M. (2017) · IEEE Transactions on Learning Technologies · doi:10.1109/tlt.2017.2739747 · Cited by 148 · see citing works
“However, some deficits are commonly observed in individuals with ASD [1], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21].”
Commonly studied comorbid psychopathologies among persons with autism spectrum disorder
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“visiting a particular location), of everyday objects (toilets, machines, foods), or of people with certain personal characteristics (Mayes et al. 2013).”
BackgroundRubenstein, E., Wiggins, L. D., & Lee, L.-C. (2015) · Journal of Developmental and Physical Disabilities · doi:10.1007/s10882-014-9397-x · Cited by 84 · see citing works
Lau, B. Y., Leong, R., Uljarevic, M., Lerh, J. W., Rodgers, J., Hollocks, M. J., South, M., McConachie, H., Ozsivadjian, A., Van Hecke, A., et al. (2020) · Autism · doi:10.1177/1362361319886246 · Cited by 81 · see citing works
“It has been suggested (Kerns et al., 2014; Mayes et al., 2013) that fears and anxieties often reported as “unusual” by caregivers of young people with ASD are due to the “intensity, obsessiveness, irrationality, or interference with functioning” rather than necessarily idiosyncratic or atypical (Mayes et al.”
BackgroundAutistic Cognition: Charting Routes to Anxiety
Stark, E., Stacey, J., Mandy, W., Kringelbach, M. L., & Happé, F. (2021) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2021.03.014 · Cited by 77 · see citing works
“Anxiety in autistic individuals does not always present as it does in non-autistic individuals [18], and may be related to fear of loud sounds, for example, or extreme anxiety responses to inanimate objects [19, 20], perhaps related to atypical sensory experiences in autistic individuals [18].”
BackgroundThe Differential Diagnosis of Anxiety Disorders in Cognitively-Able Youth With Autism
Kerns, C. M., Rump, K., Worley, J., Kratz, H., McVey, A., Herrington, J., & Miller, J. (2016) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2015.11.004 · Cited by 75 · see citing works
Children with Autism show Atypical Preference for Non-social Stimuli
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“Work investigating phobias in children with autism has also noted common themes such as a fear of buses, toilets, weather and social situations [76,77].”
BackgroundBrief measures of anxiety in non-treatment-seeking youth with autism spectrum disorder
Kerns, C. M., Maddox, B. B., Kendall, P. C., Rump, K. M., Berry, L. N., Schultz, R. T., Souders, M. C., Bennett, A. E., Herrington, J. D., & Miller, J. S. (2015) · Autism · doi:10.1177/1362361314558465 · Cited by 71 · see citing works
“In a sample of 1033 children with autism; Mayes et al. (2013) reported unusual fears, including fears of vacuum cleaners, elevators, mechanical toys, swings, and the wind in 41% of youth.”
BackgroundThe Relationship Between Sensory Reactivity Differences and Anxiety Subtypes in Autistic Children
MacLennan, K., Roach, L. E., & Tavassoli, T. (2020) · Autism Research · doi:10.1002/aur.2259 · Cited by 73 · see citing works
“Specific phobia is one of the most commonly diagnosed anxiety disorders for autistic people and is present in up to 40% of autistic children [Leyfer et al., 2006; Mayes et al., 2013; White et al., 2009].”
BackgroundMaskey, M., Rodgers, J., Ingham, B., Freeston, M., Evans, G., Labus, M., & Parr, J. R. (2019) · Autism in Adulthood · doi:10.1089/aut.2018.0019 · Cited by 62 · see citing works
Exploring the nature of anxiety in young adults on the autism spectrum: A qualitative study
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The Treatment of Anxiety in Autism Spectrum Disorder (TAASD) Study: Rationale, Design and Methods
Kerns, C. M., Wood, J. J., Kendall, P. C., Renno, P., Crawford, E. A., Mercado, R. J., Fujii, C., Collier, A. B., Hoff, A. L., Kagan, E. R., et al. (2016) · Journal of Child and Family Studies · doi:10.1007/s10826-016-0372-2 · Cited by 53 · see citing works
“, OCD, specific phobia, social, separation and generalized anxiety disorder) and yet are associated with significant distress and impairment (Kerns et al. 2014; Mayes et al. 2013).”
Kurzius‐Spencer, M., Pettygrove, S. D., Christensen, D., Pedersen, A. L., Cunniff, C. M., Meaney, F. J., Soke, G. N., Harrington, R. A., Durkin, M. S., & Rice, S. A. (2018) · Research in Autism · doi:10.1016/j.rasd.2018.09.002 · Cited by 53 · see citing works
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“2013) while up to 40 % of those with ASD present with fears, which can be described as unusual, atypical, or uncommon (Mayes et al. 2013; Mayes et al. 2012).”
BackgroundResultInfluentialAutism and Anxiety: Overlap, Similarities, and Differences
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Phenomenology and Presentation of Anxiety in Autism Spectrum Disorder
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“It could be that the types of stimuli or situations that cause anxiety in autism are unique, including atypical sensory stimuli or atypical threats (Kerns et al., 2014; Mayes et al., 2013).”
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Parent-Led Cognitive Behavioural Therapy for Children with Autism Spectrum Conditions. A Pilot Study
Byrne, G., Ghráda, Á. N., & O’Mahony, T. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05424-2 · Cited by 19 · see citing works
Knez, R., Stevanović, D., Fernell, E., & Gillberg, C. (2022) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s358373 · Cited by 16 · see citing works
“Recently, orexin/hypocretin system (Orx-S) dysfunction has been implicated in a variety of psychiatric and neurological disorders,12 including ADHD and ASD.13–18 Kohyama was likely the first to connect the Orx-S with both ASD and ADHD, suggesting that Orx-S hyperactivity might play a role in insomnia in these two clas…”
BackgroundInfluentialThe Stability of Self-Reported Anxiety in Youth with Autism Versus ADHD or Typical Development
Schiltz, H. K., McIntyre, N., Swain-Lerro, L., Zajic, M., & Mundy, P. (2017) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3184-3
Reinvall, O., Moisio, A., Lahti‐Nuuttila, P., Voutilainen, A., Laasonen, M. R., & Kujala, T. (2016) · Research in Autism · doi:10.1016/j.rasd.2016.01.009 · Cited by 14 · see citing works
Consoli, C., Turriziani, L., Antoci, M., Monaco, M. L., Ceraolo, G., Spoto, G., Nicotera, A. G., & Rosa, G. D. (2025) · Brain Sciences · doi:10.3390/brainsci16010053 · Cited by 13 · see citing works
“Additional alterations have also been observed in olfactory adaptation and habituation processes, leading to sensory and social processing difficulties, sometimes turning innocuous events, such as new olfactory experiences, into aversive ones [154–156].”
Dollion, N., Herbin, A., Champagne, N., Plusquellec, P., & Grandgeorge, M. (2022) · Anthrozoös · doi:10.1080/08927936.2022.2051932 · Cited by 14 · see citing works
Grandgeorge, M., Dubois, E., Alavi, Z., Bourreau, Y., & Hausberger, M. (2019) · Animals · doi:10.3390/ani9080522 · Cited by 12 · see citing works
“, when facing birds and squirrels [60]).”
A Pilot Study of One-Session Treatment for Specific Phobias in Children with ASD Traits
Muskett, A., Radtke, S., & Ollendick, T. (2019) · Journal of Child and Family Studies · doi:10.1007/s10826-019-01620-4 · Cited by 3 · see citing works
Keshavarz, S., & Esmaeilpour, K. (2025) · BMC Psychology · doi:10.1186/s40359-025-02369-w · Cited by 8 · see citing works
“In fact, it has been estimated that up to 46% of these children show anxiety symptoms that do not correspond to nomenclature systems such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) [17, 24].”
Miralles, A., Grandgeorge, M., & Michel Raymond, A. (2022) · Scientific Reports · doi:10.1038/s41598-022-10353-2 · Cited by 8 · see citing works
The BASIS Team, Milosavljevic, B., Shephard, E., Happe, F. G. E., Johnson, M. H., & Charman, T. (2017) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-016-3012-1 · Cited by 8 · see citing works
“Children with ASD often exhibit fears and phobias of unusual or commonplace objects (Mayes et al. 2013; Kerns et al. 2014).”
BackgroundRole of Odor Novelty on Olfactory Issues in Autism Spectrum Disorder
Scheier, Z. A., Sturm, K. L., Colavecchio, J. A., Pradhan, A., & Otazu, G. H. (2024) · Genes Brain & Behavior · doi:10.1111/gbb.70008 · Cited by 7 · see citing works
Fear: Autism Spectrum Disorder and/or Specific Phobia
Davis, T. E., & Ollendick, T. (2014) · Autism and child psychopathology series · doi:10.1007/978-3-319-06796-4_10 · Cited by 7 · see citing works
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Scope of Virtual Reality to Autism Intervention
Lahiri, U. (2020) · Springer eBooks · doi:10.1007/978-3-030-40237-2_4 · Cited by 6 · see citing works
Anxiety Disorders and Obsessive-Compulsive Disorders (OCD)
Maddox, B. B., Kerns, C. M., Franklin, M. E., & White, S. W. (2016) · Autism and child psychopathology series · doi:10.1007/978-3-319-27171-2_13 · Cited by 5 · see citing works
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“Further children with ASD have many common as well as unusual fears and phobias, supporting their mistrust (Dickerson Mayes et al., 2013).”
Bolton, M. J., Haynie, H. V., Ault, L. K., Hanes, S. H., & Watt, M. C. (2022) · doi:10.31234/osf.io/gbuz6 · Cited by 5 · see citing works
Marwati, A., Dewi, O. C., & Wiguna, T. (2021) · International Conference on Health and Medical Sciences (AHMS) · doi:10.2991/ahsr.k.210127.061 · Cited by 4 · see citing works
“Since the size of a room can cause fear in children with autism [25], the room size should not be oversized or undersized.”
BackgroundSpecific Phobia, Fear, and the Autism Spectrum in Children and Adolescents: Adapting OST for ASD
Davis, T. E., & Brennan, J. (2024) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-024-00475-6 · Cited by 4 · see citing works
“…objects, media/movies), activities/events (e.g., bowel movements, school trips), situations/places (e.g., a particular street, shops, heights, weather), people (e.g., men, small children), and irrational fears of dying or contamination (Evans et al., 2005; Lau et al., 2020; Mayes et al., 2013).”
Les apports de l’animal dans le développement des enfants aux troubles du spectre autistique
Grandgeorge, M. (2015) · Sens-Dessous · doi:10.3917/sdes.016.0017 · Cited by 4 · see citing works
Gut–Brain Inflammation and Disrupted Homeostasis Due to Activation of Mast Cells and Microglia
Katiraei, P., Frye, R. E., & Theoharides, T. C. (2026) · International Journal of Molecular Sciences · doi:10.3390/ijms27041768 · Cited by 3 · see citing works
Virtual Reality (VR) for School Children With Autism Spectrum Disorder (ASD)
Guazzaroni, G., & Pillai, A. S. (2018) · Advances in psychology, mental health, and behavioral studies (APMHBS) book series · doi:10.4018/978-1-5225-7168-1.ch009 · Cited by 3 · see citing works
From synaptic dysfunction to atypical emotional processing in autism
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Methods and Procedures for Measuring Comorbid Disorders: Psychological
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Kazzi, C., Campbell, L., & Porter, M. (2023) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-023-00371-9 · Cited by 1 · see citing works
“…to stimuli, which may explain anxieties like specific phobias of noise; (3) increased exposure to adverse psycho-social experiences (e.g., bullying, abuse, poor social support, underachievement); and (4) poor coping skills (Cooray and Bakala, 2005; Kerns et al., 2021; Mayes et al., 2013).”
Carlisle, G. K., Schuck, S. E. B., Fine, A. H., McKinlay, M. L., Zeiler, C., & Mejia, D. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-22346-4.00012-3 · Cited by 2 · see citing works
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“También existen descripciones de una serie de miedos y preocupaciones atípicas que, aunque son comunes y clínicamente impactantes en el autismo, no encajan en los marcos de diagnóstico convencionales (Kerns y Kendall, 2012; Kerns et al., 2014; Mayes et al., 2013).”
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Feasibility Study of a Novel App‐Based Anxiety Intervention for Autistic People
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“…delivery, including, for example, failure to differentiate negatively reinforced compulsions/ avoidance behaviors from autism-based repetitive behaviors or fixed interests (Landry et al., 2020 ), as well as difficulty distinguishing sensory sensitivities from phobias (Mayes et al., 2013 ).”
Anxiety disorders as comorbid conditions in neuropsychiatric diseases in children
Zavadenko, N. N., Nesterovskiy, Y. E., Николаевна, З. А., & Shypilova, E. M. (2024) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro202412407156 · Cited by 1 · see citing works
Review on Assessment of Anxiety Symptoms of Individuals With Autism Spectrum Disorder
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Shortcuts for fear in hierarchical visual systems
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Interdisciplinary Treatment for Pediatric Elimination Disorders
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Assistive Technologies and Design for People With Autism Spectrum Disorders
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A Review of Anxiety in Autism Spectrum Disorders
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Phobias, Fears and Anxiety in Adolescents with Autism Spectrum Disorder
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إدراك الأوجه وعلاقته بالعوامل النفسية والفسيولوجية لدى أطفال التوحد دراسة تشخيصية
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“One of the most common psychiatric comorbidities of ASD is anxiety disorder; one study has found that 40% of children with ASD also present with specific phobias (SP) (Mayes et al. 2013).”
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Using desensitize program to reduce phobias and specific fears in children with autism
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Anxiety Disorders as Comorbid States in Psychoneurological Disorders in Children
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“Of all types of AD, phobic fears are the most common, with estimates of prevalence ranging from 31% to 64%; prevalence in the pediatric population ranges from 5% to 18% [17].”
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“According to Mayes et al. (2013), the three most frequently reported uncommon fears in autistic youth were fear of toilets, fear of elevators, and fear of vacuum cleaners.”
An Investigation of Factors Affecting Bowel Movement Hygiene in Autistic Children
Stacey, N., Turtle, B., & Daly, J. (2026) · Occupational Therapy International · doi:10.1155/oti/5464138
Goryunov, А. V., Pavliv, N. I., Shushpanova, O. V., Блинова, Т. Е., & Голубева, Н. И. (2026) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro202612609251
- Authors
- Mayes, S. D., Calhoun, S. L., Aggarwal, R., Baker, C., Mathapati, S., Molitoris, S., & Mayes, R. D.
- Affiliations
- Pennsylvania State University (US)
- Corresponding author
- Mayes, Susan Dickerson
- Venue
- Research in Autism Spectrum Disorders
- Publisher
- Elsevier BV
- Published
- 2013-01
- Volume
- 7
- Issue
- 1
- Pages
- 151-158
- ISSN
- 1878-0237 (ISSN-L)
- 1750-9467
- OpenAlex
- W2052046114
- Cited by
- 92
- References
- 53
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 10 · 2023: 3 · 2022: 9 · 2021: 5 · 2020: 7 · 2019: 15 · 2018: 8 · 2017: 6 · 2016: 7 · 2015: 5 · 2014: 7
- FWCI
- 1.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Research in Autism (publishedVersion)
- Funders
- Autism Speaks
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- autism spectrum disorder, children's fears, fear of heights, sensory processing, parent report
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