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Asperger’s Disorder/Syndrome Melissa Peplinski ED 5570 Summer 2010 Dr. Marcel Lebrun Asperger’s syndrome (AS) is a neurobiological disorder that people have for life. AS is an autism spectrum disorder. Recent research has found that AS may be genetic. The essential features of Asperger's Disorder are severe and sustained impairment in social interaction and the development of restricted, repetitive patterns of behavior, interests, and activities. This disturbance must cause clinically significant impairment in social, occupational, or other important areas of functioning. In contrast to Autistic Disorder, there are no clinically significant delays or deviance in language acquisition. In 1944 an Austrian pediatrician named Dr. Hans Asperger observed children in his practice that had trouble integrating socially. Although their intelligence appeared normal, the children lacked nonverbal communication skills, failed to demonstrate empathy with their peers, and were physically clumsy. Their way of speaking was either disjointed or overly formal, and their all-absorbing interest in a single topic dominated their conversations. Dr. Asperger called the condition “autistic psychopathy” and described it as a personality disorder primarily marked by social isolation. Asperger’s observations, published in German, were not widely known until 1981, when an English doctor named Lorna Wing published a series of case studies of children showing similar symptoms, which she called “Asperger’s” syndrome. What are the characteristics that people might show with Asperger's syndrome? • Difficulty knowing what to say or how to behave in social situations. Many have a tendency to say the “wrong thing.” They may appear awkward or rude, and unintentionally upset others. • Trouble with “theory of mind,” that is, trouble perceiving the intentions or emotions of other people, due to a tendency to ignore or misinterpret such cues as facial expression, body language, and vocal intonation. • Slower than average auditory, visual, or intellectual processing, which can contribute to difficulties keeping up in a range of social settings—a class, a soccer game, a party. • Challenges with “executive functioning;” organizing, initiating, analyzing, prioritizing, and completing tasks. • A tendency to focus on the details of a given situation and miss the big picture. • Intense, narrow, time-consuming personal interest(s) — sometimes eccentric in nature — that may result in social isolation, or interfere with the completion of everyday tasks. (On the other hand, some interests can lead to social connection and even careers. For example, there are children and adults with an encyclopedic knowledge of vacuum cleaners.) • Inflexibility and resistance to change. Change may trigger anxiety, while familiar objects, settings, and routines offer reassurance. One result is difficulty transitioning from one activity to another: from one class to another, from work time to lunch, from talking to listening. Moving to a new school, new town, or new social role can be an enormous challenge. • Feeling somehow different and disconnected from the rest of the world and not “fitting in”—sometimes called “wrong planet” syndrome. • Extreme sensitivity—or relative insensitivity—to sights, sounds, smells, tastes, or textures. Many people outgrow these sensory issues at least to some extent as they mature. • Vulnerability to stress, sometimes escalating to psychological or emotional problems including low self-esteem, depression, anxiety, and obsessive-compulsive behaviors. According the the Asperger’s Association of New England as many as 1 in 250 people have Asperger’s. Boys are three to four more times as likely than girls to have AS How is AS diagnosed in children and adults? Some adults may hear about the symptoms of AS and self diagnose, mental health professionals can make an official diagnosis Parents may hear something about their children’s behavior from a teacher or school counselor and request a neurological evaluation With well chosen tests done by experienced professionals, parents and schools can better understand the child’s strengths and challenges. The suggestions and recommendations from these reports will guide the application of all interventions, strategies, accommodations and modifications of task requests. Most doctors rely on the presence of a core group of behaviors to alert them to the possibility of a diagnosis of AS. These are: abnormal eye contact, aloofness, the failure to turn when called by name, the failure to use gestures to point or show, a lack of interactive play, a lack of interest in peers There is strong evidence that Vincent Van Gogh, Emily Dickinson, and Albert Einstein all had Asperger’s Syndrome, could your student be the next famous poet, painter or mathematician? Teaching Best Practices Teach social skills - be patient. Behavior management may be necessary, remember this child is motivated to please you, teach him/her routines and make sure they understand your expectations. Use a buddy system, select a student or 2 to buddy with this student, they want and need friends but don't know how to be a friend. Establish daily routines and stick to them. Always provide lots of warning when your routine is going to change, class trips, supply teachers etc. Minimize transitions. Keep stimulus and distraction to a minimum. Chunk information presented. The child won't retain a lot of information at once. You may have to limit their 'special interest' time as they can become quite self absorbed with it. Instructional strategies should focus on teaching concretely and complex tasks should be broken down. Asperger’s in the classroom I know I have students with Asperger’s, now what do I do? (continued) • Try to stick to a structured routine • Use visual organizers for daily routine • Provide clear expectations and rules for behavior • Because many students with Asperger's have handwriting deficits, allow extra time for handwritten work and explore the use of word processors Routine Language • Use verbal cues that are short, direct, and concrete • Tell them in clear, short statements what they should do • When presenting multi-step directions, pause between instructions on multistep tasks and check for comprehension •If the student appears to be getting agitated or headed for a "meltdown," it may be due to stress from the particular situation or frustration. Avoid situations that might produce "sensory overload" for the student •Be particularly sensitive to peer rejection and bullying • A team of professional supporters may help; therapist, OT or sensory specialist, as well as an aide in an inclusive classroom Environment Are there treatments? Because AS can present patterns of behaviors and problems that differ widely from child to child, there isn't a "typical" or prescribed treatment regimen. However, your child may benefit from the following forms of treatment: • parent education and training • specialized educational interventions for the child • social skills therapy • language therapy • sensory integration training for younger kids, usually performed by an occupational therapist, in which they are desensitized to stimuli to which they're overly sensitive • psychotherapy or behavioral/cognitive therapy for older children •medications For more information on Asperger’s Syndrome and classroom strategies: The Asperger’s Association of New England www.aane.org Autism Society www.autism-society.org Teaching Strategies at New Horizons www.newhorizons.org Accommodating Students with Asperger’s http://www.tourettesyndrome.net/Files/tips_aspergers.pdf There are also many interesting fiction and nonfiction books about people with Asperger’s: Freaks, Geeks & Asperger Syndrome by, Luke Jackson Look me in the eye; my life with asperger’s by, John Elder Robison Bibliography Asperger’s Association of New England, “What is Asperger Syndrome?” 2008. Autism Society, “What’s Unique about Asperger’s Disorder?” January 23, 2008. May, Kelly. New Horizons for Learning, Teaching Strategies for Asperger’s Students. September, 2005. National Institute of Neurological Disorders and Stroke, Asperger Syndrome Fact Sheet. May 14, 2010. Nemours Foundation, Kids Health. Asperger Syndrome. 2010.