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 .


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.

1990s 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


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)


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?


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


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


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


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)


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.


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, donts, 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)


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 students 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


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


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)


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 students 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


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)


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.


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.


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.


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


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., Neurologists notebook: An anthropologist on Mars, New Yorker, and December 27, 1993


General Resources

The Complete Guide to Aspergers 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 Aspergers Syndrome by Liane Holliday Willey and Tony Attwood (1999)


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

Health & Medicine

AS Presentation Ahead07