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: 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.

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, such as hunger, thirst, needing the washroom, pain or a racing heart. Feelings often show up first as body signals, like a tight tummy or fast breathing, so a child who doesn't notice these signals may miss a feeling until it is very big.
• Masking means hiding autistic differences to get through the day. In a 2026 survey of 136 autistic children aged 8 to 14, masking was common, many found it exhausting, and fewer felt positive about being autistic around peers or teachers than at home (Mullally et al. 2026). So feelings held in at school may come out at home.

Misunderstanding works both ways: the double empathy problem describes how autistic and non-autistic people can misread each other (Milton 2012). 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: speech, signing, pictures or AAC. These ideas come from children's hospital advice and emotion coaching research; they are not a tested program.

SickKids' AboutKidsHealth suggests a "feelings list" that includes body words such as "tight", "shaky", "heart" or "stomach", because younger children may find it easier to talk about a fast heartbeat or tight fists than about feelings (AboutKidsHealth, 2013).

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. If your child uses AAC, add feelings words and point to them as you talk.
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, daycare and school.

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 calm, so they are familiar before they are needed.

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), so there is no need to stop a stim that is not causing harm.

None of these tools has been shown to reduce anxiety in autistic children. They are low-risk to try, so notice what helps your child.

A calm space

A calm space is a small, quiet spot your child can go to when everything feels too much.

• Choose a corner or small tent with soft light and little to look at.
• Add what soothes your child, such as a blanket, cushions or headphones.
• Visit it together on good days, so it feels familiar.
• Stay nearby if your child wants you.

Calm choices

A choice board shows a few options as pictures, so your child can point instead of talking when upset. Our free calm choices board prints on letter-size paper. Start with 3 or 4 options your child already likes, such as jumping, slow breathing, headphones or a hug, plus a "break" picture, and practise using it when everyone is calm.

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).

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 and in their body. SickKids' AboutKidsHealth says many younger children "may not be able to communicate their anxiety verbally", and instead show it through behaviour and physical signs such as stomach aches, nausea, a faster heartbeat, muscle tension or trouble sleeping (AboutKidsHealth, 2021). The Canadian Paediatric Society notes that anxiety may contribute to aggression or self-injury in autistic children (CPS 2019). 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 same changes can mean pain or illness, so ask your family doctor or pediatrician to check. The CPS lists medical problems "which can cause pain or discomfort" among the things that make challenging behaviour more likely (CPS 2019).

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 First-Then board, a visual schedule or a calendar, and use a "change" picture when plans change. See our guides to First-Then boards and visual schedules.
• 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 echoes the program below but is not the program 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 programs: for children aged 4 to 7, the only anxiety trial found for this guide tested a program that works through parents. In the CUES-Junior trial in Western Australia, parents of 64 autistic children with worries about uncertainty joined an 8-week parent group or a waiting list. More children in the group improved in how they handled 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 with very uncertain results, compared only with a waiting list, and we could not confirm whether the program is offered in Canada.

Talk therapy: the Canadian Paediatric Society says autistic children who are verbal, with thinking skills at about an 8-year-old's level or above, "may benefit from group or individual cognitive behavioural therapy (CBT) sessions", and that modified CBT "may be appropriate for some younger children" (CPS 2019). Most evidence for CBT comes from older children who talk well (Sukhodolsky et al. 2013).

Where can I get help in Canada?

If worry is getting in the way of your child's daily life, such as sleep, eating, play, daycare or school, SickKids advises seeing your child's family doctor, pediatrician, a nurse practitioner or a psychologist (AboutKidsHealth, 2021). Other professionals can help too (AboutKidsHealth, 2025).

1. Take notes. Bring a diary: what the worry looks like, when it happens and what helps.
2. Ask what is available locally. Ask your doctor about children's mental health services near you and how long the wait is. 211 can find community services, such as parenting support.
3. Tell the daycare or school. Ask the teacher, educational assistant or resource teacher (in Ontario, the SERT) how worry shows there and what could help.
4. Get support for yourself. Autism Canada has a national support line, and the Hope for Wellness Help Line offers counselling and crisis support to Indigenous peoples at any time.