AS Presentation Ahead07
- 1. Asperger Syndrome Unraveled: Applied Strategies for Successful Integration into Campus Life Presented by: Louise Bedrossian, Ed.S, LPC and Rodney Pennamon, M.Ed. Georgia State University © Louise E. Bedrossian and Rodney E. Pennamon, 2007. All rights reserved. May not be reproduced without permission.
- 2. What is Asperger Syndrome? Named for a Viennese psychiatrist, Hans Asperger Published a paper in 1944 describing a pattern of behaviors and abilities primarily in boys. Leo Kanner, an Austrian psychiatrist in his 1943 paper, also focusing on children noted the three basic characteristics that today are recognized as defining autism . These include social difficulties, communication problems and repetitive and restricted activities .
- 3. What is Asperger Syndrome? In 1981 Lorna Wing, a British autism expert , published a paper bringing to the forefront the work of Hans Asperger and Leo Kanner . In the work of Wing and Gould they refer to these characteristics described by Kanner as the” triad of impairments.” 1990’s diagnostic criteria for AS were included in the DSM-IV and the ICD10. The following impairments were listed: social interaction, social communication, social imagination and absence of general delay in language development
- 4. What is Asperger Syndrome? The DSM-IV-TR lists the following characteristics as indicative of impairment in social interaction for AS, specifying that at least two must be present: Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction Failure to develop peer relationships appropriate to developmental level A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people)
- 5. What is Asperger Syndrome? Lack of social or emotional reciprocity Other associated features may include motor clumsiness and awkward movements, as well as inattention BUT What do these students really look like when they are standing in front of us? Can we recognize the student who is likely to have such a disorder?
- 6. What is Asperger Syndrome? HAVE YOU MET THIS STUDENT? Often does not understand non-verbal/social cues Avoids eye contact Flat affect Poor reciprocal conversational skill Prosody is unusual Sensory sensitivity/sensory integration problems Unusual awkward gait …
- 7. What is Asperger Syndrome? People who are “loners” Concrete thinking Verbose on focused issues Central coherence difficulties
- 8. Inside the Asperger Mind People with AS perceive the world differently. Temple Grandin : “an anthropologist on Mars.” “…thinking in pictures;” “Words are like a second language to me.” “…sensory based language put into memory” Bob Morris :AS “…see things with six degrees of freedom;” “…getting into a machine and swimming in it.” Therese Joliffe : “…on a planet with alien creatures”
- 9. What it Looks Like from the Outside Theory of Mind: Inability to understand others’ plans, thoughts and points of view Communication: Problems with language pragmatics, voice inflection & modulation (receptive & expressive) Literal Thinking: Do not grasp abstract language or idiomatic expressions. Unexpected Change: difficulty making sense of changes & adjusting. Order and predictability highly preferred.
- 10. What it Looks Like from the Outside Sensory Sensitivity: Often respond with more slowly and with greater sensitivity to sensory stimuli; Difficult for the individual with AS to absorb and process these constant changes Preoccupation with a Subject: May focus on it to the exclusion of other activities; Often unaware of others losing interest in their discussion of this passion
- 11. Commonly Co-Morbid Disorders and Initial Diagnoses Depression -Affects about one in fifteen people with AS Anxiety -Affects 84.1 percent of children with PDD and continues into adulthood Obsessive-compulsive disorder- Third commonly occurring mental health problem among those with Asperger syndrome; 8% of children with AS, and continues to adulthood Eating disorders- Focus on rules and perfectionism with misunderstanding of usage may contribute to incidence
- 12. Accommodations and Strategies Common Functional Limitations Sensory sensitivity Difficulties in understanding social interactions Problems with both expressive and receptive communication Slower processing of auditory information Difficulties with comprehending cognitive information, including very literal interpretations, and difficulties with understanding main or overriding concepts. Tendency to become fixated on details Inflexible thinking tendencies and patterns Inefficient ability to regulate emotions Trouble with organizational tasks Poor motor coordination
- 13. Accommodations and Strategies Testing Accommodations: Extended testing time Testing in a distraction-reduced environment Use of a computer with word processing software, especially for essay tests and those that require extensive writing. Use of organizational software such as Inspiration for writing and organizing ideas Use of noise reducing devices such as white noise machines, head phones and earplugs
- 14. Accommodations and Strategies Classroom Accommodations: Use of audio recorders Use of a volunteer note-taker Access to PowerPoint presentations or instructors’ notes (preferably in advance, if available) Priority registration Behavioral contracts/guidance (not code of conduct issues) Priority seating (if needed)
- 15. Accommodations and Strategies Other Accommodations: Single/private dormitory room Assistance of dormitory personnel in case of an emergency situation, should a student become immobilized or unusually agitated and unable to respond, evacuate, etc.
- 16. Accommodations and Strategies Common Strategies : A list of activities and specific limited choices Clear instructions (i.e. routines, calming down) Behavioral rules Written guidelines Task checklists Task instruction cards (i.e. what you will need, don’ts, steps) Reminders Interpersonal communication advice (i.e. what to say, how to ask for help) Explanations and key elements of common social situations Organizational methods (i.e. schedules, wall calendars, notebooks)- A Resource notebook (i.e. financial, housing, leisure options, “who to call if…”) Advance training and job preparation (i.e. internships, part-time? employment)
- 17. Accommodations and Strategies Common Strategies (Continued): Explanations and key elements of common social situations Organizational methods (i.e. schedules, wall calendars, notebooks)- A Resource notebook (i.e. financial, housing, leisure options, “who to call if…”) Advance training and job preparation (i.e. internships, part-time? employment) Develop a Student Success Plan… (Sample template available in upcoming publication: College Students with Asperger Syndrome: Practical Strategies for Academic and Social Success , LRP Publications)
- 18. Successful Internships Previous general work experience helps prepare Explore the workplace environment beforehand for stimuli that are noxious to the student Clear job description, list of duties and expectations in advance is critical Determine needed modifications and accommodations Institution-sponsored worksites offer opportunity for educating employer about AS, and other interventions Student must be “otherwise qualified” and meet all technical standards
- 19. Coping with the Unexpected, Changes and the Adverse More disturbing for a longer period to those with AS Students need a plan for coping with unexpected changes such as: The test does not arrive at the alternate testing location The expected professor is not teaching the course The student’s car breaks down on the way to campus for class There is suddenly a new roommate Road construction closes the usual route to school or work There is a new disability service provider
- 20. Coping with the Unexpected, Changes and the Adverse Students need a plan for coping with noxious stimuli or sensory overload such as : Visual : Florescent lighting, crowds, heavy traffic, flashing lights/signs Auditory: Fast-paced speech, certain music, construction noise or emergency vehicle sirens Smells/Tastes: food odors, chemicals in labs, fragrances,, toothpaste, cleaning product or pesticide odors, smoke, city air pollution Tactile: Food textures, clothing, touching objects, solutions or other substances, being touched
- 21. Coping with the Unexpected, Changes and the Adverse Calming Routines Rocking, Spinning, Pacing Rubbing skin or clothing Sitting in a warm bath, or hot tub, especially one with circulating water Eating/chewing a favorite food, or just eating in general Watching something peaceful or monotonous (fireplace, fish tank, etc.) Listening to favorite music Students should be helped to develop a Disability Management Plan… (Detailed discussion in: College Students with Asperger Syndrome: Practical Strategies for Academic and Social Success , LRP Publications)
- 22. Coping with the Unexpected, Changes and the Adverse Finding Sanctuary in Times of Stress Ending a conversation that is unpleasant or beginning to escalate into aggression Learning and practicing deep breathing techniques Learning and practicing deep muscle relaxation Using mental imagery that is calming Repeating affirmations or a favorite line or phrase from music or literature Getting to a predetermined private place, such as the student’s room or disability services office, where other calming and satisfying behaviors can be performed Creating a calming daily routine on which to focus during unavoidable stressful situations that are routine
- 23. Communication and Social Interaction Problems with communication and social interaction Marked impairment in the use of multiple nonverbal behaviors Failure to develop appropriate peer relationships A lack of spontaneous seeking to share Lack of social or emotional reciprocity Difficulty with Theory of Mind YET… 75 to over 90 percent of communication is non-verbal Some say these skills can be taught
- 24. Communication and Social Interaction Building Social Skills and Connections Social Rules- concrete examples that demonstrate “rules Build a bank of rules and discuss transferability to other situations Social Stories -describe a social situation in a systematic fashion Descriptive - describe a situation or event Directive - describes how the reader should act in a situation Learning to read and non-verbal language though training programs such as those in books by Baron-Cohen (Mind Reading) & Ekman (Emotions Revealed)
- 25. Communication and Social Interaction Finding a Social Group Radio Film and video Robots Computer gaming Fantasy Pets and animals Computer generated or other music Trains or other mechanical interests Other computer applications Alternative for Social Interaction Practice: SecondLife.com
- 26. Organizational Skills and Asperger Syndrome Because of neurodevelopmental deficits, planning, organization, initiation and execution of goals are lacking for the student with Asperger syndrome. The student with AS might be clueless on how to begin a task, such as writing a paper, that requires multiple steps. Another common problem is committing to do too much, which can lead to unnecessary stress.
- 27. Organizational Skills and Asperger Syndrome Overall role for the provider and goal for the student should be development of self-management skills. Developing methods for the student to self-reinforce positive behavior, as well as to understand the purpose or reason for the behavior or task, increases probability of success for the student with AS.
- 28. Organizational Skills and Asperger Syndrome Identifying the problem is the first step, followed by implementing useful techniques that the student can utilize long after they have left the college campus. The disability service provider may wish to spend time exploring the problems the student is having and develop effective solutions.
- 29. Organizational Skills and Asperger Syndrome Schedules Calendars Action steps To Do/Task Lists Visual Reminders Setting manageable goals Time table Resources
- 30. Service Providers and Students with Asperger Syndrome Student needs are complex and multifaceted Preparing in advance will save time, effort and problems for service provider Student and support system personnel must take much responsibility Students’ use of a self-prepared Resource Book can be effective strategy Use of other campus resources is efficient and aids student success, retention, and graduation rates
- 31. Asperger Syndrome Unraveled: Applied Strategies for Successful Integration into Campus Life References Baron-Cohen, S., Mind Reading (2003), Jessica Kingsley Press, London and New York. Baron-Cohen, S., DVD-ROM, Mind Reading: An Interactive Guide to Emotions, (2003) Jessica Kingsley, Ltd., London Ekman, P., Emotions Revealed: Recognizing Faces and Feelings to Improve Communication and Emotions Life, (2003) Time Books, New York Grandin, T., Thinking in Pictures, Doubleday, New York, 1995 and, Vintage Books, New York, 2006
- 32. Asperger Syndrome Unraveled: Applied Strategies for Successful Integration into Campus Life References (Cont.) Gross, T., Temple Grandin: A Key to Animal Behavior, on Fresh Air , National Public Radio , on the web at http://wwwnpr.org/templates/story/story/php?storyId=4278538&sc=emaf , January 11, 2005 Joliffe, T., Lansdown, R. and Robinson T. (1992) Autism: A Personal Account. National autistic Society, London Sacks, O., Neurologist’s notebook: An anthropologist on Mars, New Yorker, and December 27, 1993
- 33. Asperger Syndrome Unraveled: Applied Strategies for Successful Integration into Campus Life General Resources The Complete Guide to Asperger’s Syndrome by Tony Attwood (2006) Succeeding in College with Asperger Syndrome by John Harpur, Maria Lawlor, and Michael Fitzgerald (2004) The Unwritten Rules of Social Relationships by Temple Grandin and Sean Barron (2005) Pretending to be Normal: Living with Asperger’s Syndrome by Liane Holliday Willey and Tony Attwood (1999)
- 34. Asperger Syndrome Unraveled: Applied Strategies for Successful Integration into Campus Life Websites Autism Society of America- www.autism-society.org Autism Speaks- www.autismspeaks.org HEATH Resource Center- www.heath.gwu.edu National Autism Association- www.nationalautismassociation.org National autism Society, (UK) Glossary of Terms-www.nas.org.uk/nas/jsp/polopoly.isp?d=666 OASIS (Online Asperger Syndrome Information and Support)- www.udel.edu/bkirby/asperger University Students with Autism and Asperger Syndrome- www.cns.dircon.co.uk/index.html