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Effective Strategies for Working with

Students with Asperger’s Syndrome

Presented by

Beth Beenken and Lee Oldenburg

February 20th, 2004

Or…

WHATEVERWORKS

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Asperger's Syndrome….a history

• A neurobiological disorder named for a Viennese physician, Hans Asperger in 1944. Hans Asperger wrote a paper in which he described a pattern of behaviors in children of normal intelligence and language development, but who exhibited autistic like behaviors and marked deficiencies in social and communication skills.

• Asperger Syndrome was added to the DSM IV in 1994

• Only in recent years has it been recognized by professionals and parents

Asperger SyndromeIs it?

PDD-NOS

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Spectrum Overview…a theory

AutismAsperger’s/High Functioning Autism

PDD/NOSLearning Disabilities ?

“Normal”

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Refer for Assessment and Diagnose

• Help families, teachers, etc… understand the student better.

• Enable the student to obtain services (special ed, SSI, Voc rehab).

• Rule out other problems• Help families start to grieve appropriately• Help parents take blame off themselves• Identify student’s strengths• Help parents find appropriate team members for

child, and more importantly a parent support group

Psychological Assessment Tools

• Parent interviews and rating scales (CBCL and AS scale)

• Teacher information (interviews and writing scales)

• Intelligence testing (WISC III)• Achievement Testing• Informal observation of student

The student may also need speech and language assessment, OT assessment and additional neuropsych testing.

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Diagnostic Criteria For 299.80 Asperger's DisorderA. Qualitative impairment in social interaction, as manifested by at least two of the following: marked impairments 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 B. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by

at least one of the following: encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is

abnormal either in intensity or focus apparently inflexible adherence to specific, nonfunctional routines or rituals

stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)

persistent preoccupation with parts of objects C. The disturbance causes clinically significant impairment in social, occupational, or other important

areas of functioning D. There is no clinically significant general delay in language (e.g., single words used by age 2 years,

communicative phrases used by age 3 years) E. There is no clinically significant delay in cognitive development or in the development of age-

appropriate self-help skills, adaptive behavior (other than social interaction), and curiosity about the environment in childhood

F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia

What does Asperger Syndrome look like?

Positive Traits of Aspergers Syndrome• Determination• Reliability• Dedication• Honesty• Will not understand why people lie• Will be a loyal friend• Creative…Is often musical, artistic or

dramatic• Approaches problems from a completely

different angle• Strong moral code and sense of justice

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Possible signs a child with AS might display:Fascinations (obsessions)

• Have excellent rote memory and often become obsessed with complex topics such as weather (tornados!), patterns, music, etc…often to the exclusion of anything else

• May add new special interests from time to time• Can become incredibly knowledgeable about

topics of special interest in order to help facilitate conversation and indicate intelligence to others.

• Special interests can be a “safe zone”

ROUTINE• MUST HAVE ROUTINE• Likes to know what to expect in a

day• Creates own routines to put order in

life• Dislikes deviation from routine, may

become upset by last minute changes of lesson, teacher, fire drills, etc…

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Theory of Mind• Thinks that EVERYONE thinks and feels the same

as he does about everything!• Will often believe that she is 100 percent right• Not realize that he is hurting someone’s feelings• Has a hard time understanding others motivation

Theory of Mind refers to the notion that many individuals with Autistic Spectrum Disorders do not understand that other people have thoughts, ideas, and ways of thinking that are different from theirs. They therefore also have difficulty understanding the attitudes, actions and emotions of others.

(Edelson 1995)

Social and Emotional Interactions

• Often runs on a high stress level, frequently in addition to sensory difficulties

• Can have a quick temper

• Impulsive thoughts or actions

• May laugh inappropriately when he doesn’t understand situation

• Will not pick up on verbal or non verbal cues that a person has had enough conversation

• Socially clumsy and “wears friends out”

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• Has difficulty taking turns• When stressed, frequently repeats things over

and over• Inappropriate reciprocal interaction• Difficulty determining proper body space• Poor Social Skills (cannot read social cues,

therefore do not give the right social and emotional responses)

• Naive (find the world a confusing place)• Needs to be in control• Perfectionism!• Noncompetitive games work the best!

Academics• IQ’s are within the full spectrum, but many above normal

range in verbal ability• Concrete thinking (versus abstract)• Grammar and vocabulary are usually good• Speech sometimes stilted and repetitive• VERY Literal! Does not understand idioms!

Visual:• Thinks in pictures or scenes• Recall happens more easily when things are shown rather

than said• Finds it hard to remember the sequence of spoken words

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Memory and Thinking• May have exceptionally large vocabulary and accurate

understanding of words• Recall over a long period of time is usually good• If often able to list large amounts of factual information• Difficulty making choices and predicting outcomes• Everything needs to be black or white• Just say no to ambiguity!• High achiever in topics that have structure

Generalizing is difficult: The transfer of knowledge from one subject area to another is not easily done

Physical• Messy handwriting• Often have fine motor deficit, making it

difficult to take notes and draw pictures• Ball sports and balancing activities difficult• Clumsy• Tends to dislike competitive and team

sports• May have an odd gait

• Consider an alternative PE program

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SENSORYThe emotional response to the stimuli may be heightened

Visual:• Bright or flickering lights can be unbearable• Can find it difficult to look at someone when talking

because there is too much visual and aural info to process at once

Auditory• May hear things that others don’t (like the sound of an

electric light or a high pitched whine)• Fire Drills are overwhelming• May find it difficult to interpret words as meaningful

language• May have difficulty sorting out background noise

Olfactory• Strong odors can overwhelm• May have STRONG reaction to certain smells

Tactile• May dislike labels in clothes• May feel unpleasant to be touched• May be sensitive to certain fabrics or clothes

All of these can cause tantrums, behavior problems or meltdowns. Awareness is the key to a positive classroom experience!

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The key to CLASSROOM

SUCCESS!

ORGANIZATION• Create a visual organizer• A series of pictures or words that show the sequence of

events or tasks to be done.• Break down the tasks into small pieces• Post it notes!• Make sure the student has made the link between the

picture and the activity• Create a desk map• Use expandable labeled for desk and homework folders• For older students, use assignment notebooks…check daily• Lists and Schedules: create lists of tasks, assign times that

work is to be done• POSITIVE, POSITIVE, POSITIVE reinforcement for even the

smallest organizational success!

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Trouble Shooting• Prearranged signal• Create a “code” for help• Choose seating carefully• Early arrival• Use timers• Speaking ball• Teacher selected (cooperative learning) groups • Be directive (don’t give too many choices)• Encourage mistakes• Designate a “safe place”, create some rules• Provide a stress ball and other “fiddle” toys• Teach anger management• Encourage a small comfort item• Pick your battles

Behavior Management• Analyze what led to behavior problem

Examples:-unclear about assignment-Found assignment to unstructured-overwhelmed by sensory input-found assignment to difficult-interrupted by routine

• Realize your normal “problem solving” solutions may not work with Asperger’s children

• Plan and modify for future success• Don’t be afraid to ask for help! Parents and other

teachers are your greatest resource!

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Class work• Make everything visual• Be an active teacher (think multiple intelligences!) doing

things as you talk will keep the visual learner interested.• Tie in the Asperger student’s special interest. (Math: If a

tornado was going 10 miles and hour… etc)• Give him special jobs that relate to his special interest

(computer, library, etc)• Be prepared to do some things “unconventionally”• Cooperative learning works well with AS students in well

thought out groups!• Remember that the AS world is pretty black and white. Yes

and No answers work well. Maybe does not.

Communication

Monitor your speech: • Don’t give out too much information at once• Avoid sarcasm• Explain idioms, metaphors and figures of speech• Only say “will you…and can you”… if there is

actually a choice• Repeat instructions, check for understanding• Communicate between home and school with a

communication notebook

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Teaching SOCIAL SKILLS through social stories

What are social skills?Social skills are the competencies that one

uses to “read” other people and manage emotional interactions. People with high levels of social competencies have the ability to handle relationships well and are able to adapt to a variety of social situations.

Differentiated Instructional Strategies (page 8)

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Why do we teach social skills?Children on the Autism spectrum, those with emotional and behavioral disorders (EBD), ADD and ADHD often have the most problems with social skillsAs our special needs children spend more time in the regular classroom, behavior problems occur due to breakdowns in communication.Even in classrooms structured to aid inclusion,

inappropriate behaviors interrupted social and academic learning. Typical behaviors include climbing on desktops, screaming, tantruming, and running away at breaks in routine.

Social Problems are usually classified into three categories:Socially Awkward: Individuals who try very hard to have friends, but cannot keep them. This is usually because of lack of reciprocity in their interactions.

Socially Avoidant: Individuals who avoid all social interactions. Examples would include: tantrumming, running away or if an infant, arching their back.

Socially Indifferent: Individuals who do not seek interaction with others. They do not seem to mind

being by themselves.

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What are social stories?Social stories describe social situations to teach children with autism as well as typically developing children.

Typically have pictures as well as words.

Provide both guidance and self direction to promote self-awareness, self-calming and self-management in responding to social situations.

Social stories contain four sentence types:

1. Descriptive: information about the setting, subjects and actions (who is involved, what he or she is doing and where he or she is)2. Directive: statements about the appropriate behavioral response (tells the child what he or she needs to do or say)3. Perspective: sentences describing the feelings and reactions of others (explains the reactions)4. Control: analogies of similar actions and responses using nonhuman subjects (gives the child a way of remembering what to do or say)

(Gray, 1995)

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Example: I Don’t UnderstandSometimes at school I don’t understand what to do.

It is okay. I will try not to be upset.

I can ask _________________ to help me.

I can say, “I don’t understand what to do.”

_____________ will tell me. I will try to listen,

I will try to ask for help when I don’t understand what to do.

Body OdorMy underarms smell bad when I sweat.

People at school don’t like to smell body odor.

I can wash under my arms every day.

Deodorant stops the bad smell.

I can put deodorant under my arms.

I will try to wash and use deodorant every day.

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How do we get started?• Initial Behavior AnalysisName_________________ Date________________Setting_________________ Activity______________What happened just before the behavior occurred?________________Describe the behavior.__________________________________What was the consequence of the behavior?____________________

ConsequencesLocationDate/Time

Record of ProgressName________________ Date___________________Behavior_____________________________________Social Skills Lesson______________________________

Intervention Chart

Lesson Read? How often does the behavior occur?

Day 7

Day 6

Day5

Day 4

Day 3

Day 2

NoYesDay 1

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JUST REMEMBER...you are AWESOME!

Our goal is not to change the Asperger child…but to provide support, structure and understanding! Your flexibility and creativity as a teacher will enable this child to grow and ultimately blossom as a student! Enjoy these special children…you are a gift to them!

Books

Asperger’s Huh? A Child’s Perspective by Rosina G. SchnurrThis is Asperger Syndrome by Elisa Gognon and Brenda MylesAsperger Syndrome What Teachers Need to Know by Matt WinterComic Strip Conversations by Carol GrayThe New Social Story Book by Carol GrayAsperger’s What Does It Mean To Me? By Catherine FahertyAsperger Syndrome and Your Child by Michael PowersActivity Schedules for Children with Autism by Lynn McClannahanHitchhiking through Asperger’s Syndrome by Lise PylesMaking Visual Supports Work by Jennifer SavnerPower Cards by Elisa GagnonSomebody Somewhere by Donna WilliamsAutism an Introduction to Psychology Theory by Francesca HappeThinking in Pictures by Temple GrandinUnderstanding AS and HFA by Gary Mesibov and Victoria Shea

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Resources

Websites on Asperger’s Syndrome

• http://www.udel.edu/bkirby/asperger• http://www.spacehost.us/~aliki/autism/links.html• http://www.thegraycenter.org/• http://www.autism.org//temple/inside.html• http://www.autism.org//temple/faq.html• http://www.autism.org//temple/genius.html• http://www.autism.org//mind.html

There are so many great websites on Asperger Syndrome.Go to your favorite search engine and search!