Case Study BC: Emotional Wellbeing and Anxiety

BC is a nineteen-year-old autistic man who has recently transitioned from Post Primary School to a work placement.


BC is a nineteen-year-old autistic man who has recently transitioned from Post Primary School to a work placement.

It has been noted that BC has a very good memory, a robust sense of humour and a keen interest in movies , with an extensive collection of DVD’s, Blu-rays and Video Cassettes. He has excellent computer skills and also enjoys art and drawing.

Factors Impacting Emotional Well-being:

In line with his diagnosis, BC presents with difficulties in social communication skills, sensory processing and significant challenges around flexibility and rigid thought patterns. Direct observations of BC, at home and in school, and from discussions with his parents, staff and BC, himself,  led to the identification of the main factors contributing to stress and anxiety.

Social Communication Difficulties:

  • Conversations where others have a different opinion from him on an area of focused interest, proves difficult for BC. He finds it difficult to cope and tolerate differing perspectives, often culminating in elevated levels of stress and anxiety.
  • Knowing what to do during unstructured times; these times are difficult and often lead to BC perseverating on negative thoughts and past events.
  • Awareness of social difficulties; request to try to work on making “real friends” as opposed to acquaintances from online fora.
  • Literal interpretation of language; frustration when others dismiss or do not understand his interpretation.

Sensory Processing:

  • Finding it difficult to work in cluttered spaces.
  • Being highly distractible, particularly if expected to listen to a lot of verbal direction.
  • Sensitivity to certain noises, smells, and textures.
  • Needing movement throughout the day

Rigidity of Thought:

  • Worrying about changes to his current routine. The transition from education to work caused him increasing levels of anxiety. BC often became quite distressed, saying, “I don’t want my life to turn into a mess,” and desperately trying to find ways of maintaining contact with his school.
  • Coping with deviations from his understanding of social rules – For example, not understanding why his parents would not consent to him watching particular 18+ rated movies, even though he is 19 years.
  • Tendency to focus on events from the past, which he perceives to be negative and he now regrets. He speaks frequently about “alternative histories,” and his wish to change things that happened some years ago.

Emotional Regulation:

  • BC did not have any awareness of his increasing level of stress when he encountered difficult situations or the skills to cope when faced with stressful events. Often, such events would result in an “emotional stress response,” where BC would engage in behaviours of concern, such as shouting, using bad language, slamming doors, or hitting out at others.


The following strategies were used to reduce stress and anxiety.

BC transitioned successfully to two different work placements and continues to progress at each placement. The visual strategies introduced to support BC to manage stress and anxiety were very effective. BC is able to identify that his energy ‘is running low’ and opts to engage in calming activities to replenish his energy account.