The Autism-Trauma Connection

Neurological disorders such as ASD have been on the rise for decades, and as an educators, we have seen a huge increase in students on the spectrum in our classrooms. According to the CDC, 1 in every 31 children in the United States is diagnosed with Autism Spectrum Disorder, while 5-8% of children and adolescents will be diagnosed with PTSD, or Post Traumatic Stress Disorder. Understanding that symptoms of autism can look almost identical to trauma response or survival mode, or that a student may present with symptoms of both ASD and PTSD interchangeably helps us to support them fully as they navigate the social-emotional obstacles and academic rigor of public or private school. In fact, over 90% of adults on the spectrum have also reported traumatic or adverse experiences. Adults with ASD are more than four times more likely to be diagnosed with PTSD later in life. Diagnosis is difficult, however, due to the similarity of symptoms between trauma and ASD and the additional challenge of diverse communication needs and styles. These overlapping symptoms can include emotional dysregulation, difficulty in communication, or sensitivity to sensory input or output. Physical or emotional shutting down and meltdowns can be linked to both trauma and ASD, especially if the particular trigger was a form of stress or unexpected change (Chalmers, 2025). Behaviors are especially difficult to differentiate when children are young as elementary aged children and below are still adapting their social interactions, learning emotional regulation strategies, and building methods to respond appropriately to change or sensory overload. Children or adolescents who have experienced trauma typically live their day to day lives in survival mode, marked by hypervigilance and dysregulation. This can look superficially similar to a child or adolescent with ASD who is experiencing the world in a diverse neurological landscape, but the method of emotional expression can be very different. Children with ASD tend to struggle with showing or identifying emotions in others, while children suffering from traumatic stress experience intense and often overwhelming emotions that can be unpredictable due to triggering events or implicit memories. In both scenarios, emotions are difficult to manage, and behaviors stemming from emotional triggers may be interpreted negatively when the child may simply need regulation strategies or support.

The intensity of ASD symptoms may increase as trauma impacts the neurodevelopment of the brain. When trauma occurs, cortisol surges, and chronic high levels of stress can greatly impact brain development in the areas of social communication, emotional regulation and the processing of sensory information, the typical areas of challenge for children with ASD. Trauma can also impact emotional processing and regulation due to changes in the structure and effective connectivity of the brain. Other key brain structures that are effected by trauma and ASD include the amygdala, the right putamen and frontal regions; these regions are responsible for working memory, focus and attention, concentration, impulse control, and identifying and expressing emotions (Stanborough, 2024). Common symptoms of trauma in children with ASD include hypervigilance, sensitivity to sensory input, avoidance of physical or relational triggers, difficulty regulating or self-soothing, challenges in communicating with peers or adults, regression of previous skills and social withdrawal. Trauma can impact a child's ability to focus and concentrate, retain information, or regulate emotions and think clearly; all of these abilities are required to develop a new skill, whether it is academic or social-emotional in nature. Some children, with the appropriate support and resources are able to build the resilience necessary to recover and the impact on development may be minimal, however, the long lasting effects of adverse experiences can exacerbate peripheral symptoms of ASD in adults (Okumura et al, 2024). Exposure to childhood adverse experiences impacts children and adults with ASD by increasing PTSD and hypersensitivity symptoms, begging the question, does trauma increase ASD symptoms, or are children with ASD more at risk for trauma and how do we provide appropriate and effective interventions?

Diagnosis

It is possible for children to be misdiagnosed with either ASD or PTSD depending on their specific symptoms and needs, or even diagnosed with both conditions. One major risk factor for misdiagnosis is the timing of trauma and corresponding PTSD symptoms during the typical intervention period for ASD screening. In the United States, we do not have a routine screening in medical offices to determine if a child has been exposed to adverse experiences such as abuse or maltreatment. Research and intervention strategies for ASD are growing in quality, quantity and popularity, while trauma informed practice and research is still lacking when we consider that almost 1 in 4 adolescents will report abuse or maltreatment before age 18. If a child is misdiagnoses, the interventions offered my not benefit them as intended due to the root cause of their distress (PTSD UK, 2026). For example, if a child is diagnosed with ASD and placed on medication targeted at irritability, aggression and self injury, but the root cause of their symptoms may be based on traumatic experience, meaning that the child or adolescent would benefit more from an SSRI. Finding the root cause and screening for both PTSD and ASD is pivotal in recovery and intervention for children. Interventions for ASD include Applied Behavioral Analysis (ABA) or Pivotal Response Training (PRT), while interventions for PTSD focus on Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR) or Prolonged Exposure (PE). These interventions are vastly different in their approaches, and some individuals with PTSD may benefit from talk therapy while children with ASD present with communication challenges that make talk therapy inappropriate and ineffective.

The Connection

The connection between PTSD and ASD has been largely unexplored until recently. For many years, scientists have known that almost 70% of those diagnosed with ASD suffer from a comorbid psychiatric disorder and that anxiety, depression, or obsessive compulsive disorder (OCD) are more common among those with ASD than the general population (Gravitz, 2018). Rates of PTSD in children or adolescents with ASD tends to lie within the same average as the general public, at 3%, however, many scientists are beginning to suspect that this is an underestimation based on the diverse expression of PTSD symptoms for those on the spectrum. PTSD is known to cause panic, extreme startle responses, sleep disruption, hypervigilance, and anger, all of which can also be attributed to the diagnosis of ASD. In addition, what makes an event traumatic may depend on the individual, especially if they are on the spectrum. While the majority of those who suffer with PTSD have experienced abuse, maltreatment, violence, natural disasters or assault, children on the spectrum may develop PTSD symptoms after more subtle events such as fire drills or sensory overload, the loss of a pet or transition of important person out of their routine (like a teacher), or even the behavior of others towards them in a general setting. Children on the spectrum are more vulnerable to bullying, teasing, and isolation, which can be a traumatizing event for them as well. Researchers who are focused on the connection between autism and PTSD find that the more autistic traits an individual possesses, the more signs they display for PTSD. In fact, they found that the connection between PTSD and ASD is stronger in men than in women, although women in the general population have an increased risk of developing PTSD (Gravitz, 2018).

In the Classroom

Educators and those who work in organizations with children and adolescents must remember that there is no typical display of ASD or PTSD. One of the most traumatic experiences for children with ASD is the social isolation and social deficit experienced as they are separated in special education settings, or the overwhelming sensory information that must be processed. The manner in which PTSD manifests itself in the general population versus those on the spectrum is diverse and we must be careful not to make assumptions when we approach working with students or children. The traits of both ASD and trauma can present in similar ways such as repetitive movements (stimming for children with ASD), symptoms of depression or anxiety, or emotional regulation. You may also observe avoidant behaviors, sleep disturbances and a lack of interest in play or exploring. In 2023, a study showed that children who experienced abuse or maltreatment between the ages of eighteen months and 6 years were more likely to have disrupted development of social cognitive skills that may mirror those typical in children with ASD (Stanborough, 2024). In one study, Swedish mothers suffering from postpartum depression had a direct impact on the ability of their infants to develop gaze-folllowing, a typical social skill found in infancy. This same developmental disruption is found in infants with ASD, making diagnosis difficult for children before they can speak. Another skill that is found disrupted in both infants with ASD or suffering from adverse experiences is joint attention, or the ability for two people to pay attention to the same thing, which usually develops around 18 months and is connected to development in the pre-frontal cortex.

For both ASD and PTSD, educators should be aware of effective interventions and helpful coping mechanisms such as yoga, fidget toys, putty, weighted materials such as blankets or stuffed items (Delisio et al, 2023). Each classroom should also include a calm corner or sensory space, even if the space is more subtly designed. For example, I have an area in my classroom that we call the "cozy corner" that includes cushioned chairs, floor poufs, blankets and furry pillows. The corner itself is near the back of the room, near a window that overlooks trees and nature, with an orchid plant perched on the windowsill. Often, students have told me they wish they could stay in that corner for the remainder of the school day. I also have an area near my desk with comfortable chairs I call my bestie chairs, where students can come and talk to me while cuddling pillows in a more private area with aromatherapy, artificial plants and natural lights and warm bulbs in the table lamps. All over the room are rugs where students are allowed to sit or lounge, and a few other comfy chairs and floor poufs are spread across the classroom. Art supplies and sensory items are available to all students in the form of paint, markers, colored pencils, large fuzzy pipe cleaners, buttons, and fabrics.

Other helpful strategies include creating a daily routine and sense of structure, as well as teaching strategies for calming the nervous system such as deep breathing or grounding. In addition, providing soothing music or low stimulation spaces can provide a sense of calm when a child is overwhelmed. For the past two years, I have had a student in my classroom on the spectrum who enjoys music to relax or take a break, but this music looks nothing like your typical meditation melodies. He prefers electronic dance music, and depending on the pace of the beats, may prefer to listen to it in two times speed. The first time he requested EDM, he sat in a comfy chair, put his head back and fell asleep!

More than any other intervention or strategy, a mindset of inclusion can both prevent trauma and positively impact those in the classroom with PTSD, ASD, or a combination of both conditions. Inclusive involves actively infusing your classroom with opportunities for students on the spectrum to socialize with, be mentored by, and share their interests with their peers. Encourage students to make space for others who are different than them, and teach the necessary skills to communicate the diverse individuals, including those with special needs. Bridge the gap in social skills between students by actively promoting conversations and activities that engage all learners.

References:

Chalmers, Brandy. (2025, June 9). When Trauma and Autism Look Alike- and How to Tell Them Apart. Rula. https://www.rula.com/blog/autism-trauma

Delisio, L., Casale-Giannola, D., Bukaty, C. (2023). Supporting Emotional Regulation in Individuals with ASD, ADHD and Bipolar Disorder Through Trauma-Informed Instruction and Self-Regulation Strategies. Journal of Research in Special Education Needs, V. 23(2), 136-146. doi.org/10.1111/1471-3802.12586

Gravitz, Lauren. (2018, September 26). At the Intersection of Autism and Trauma. The Transmitter. https://www.thetransmitter.org/spectrum/intersection-autism-trauma

Okumura, K., Takeda, T., Komori, T., Toritsuka, M., Yamamuro, K., Takada, R., Ikehara, M., Kamikawa, K., Noriyama, Y., Nishi, Y., Ishida, R., Kayashima, Y., Yamauchi, T., Iwata, N., Makinodam, M. (2024). Adverse Childhood Experiences Exacerbate Peripheral Symptoms of Austism Spectrum Disorder in Adults. Psychiatry and Clinical Neurosciences. John Wiley and Sons Australia, LLC.

PTSD UK. (2026). Can Childhood PTSD be Mistaken for Autism? PTSD UK. https://www.ptsduk.org/can-childhood-ptsd-be-mistaken-for-autism/

Stanborough, Rebecca. (2024). Is it Autism, Trauma or Both? Part One- Understanding the Overlap. WPS Publishing. https://wpspublish.com/blog/is-it-autism-trauma-or-both-understanding-the-overlap