Adolescents and Young Adults with Aspergers and High Functioning Autism

Treatment for adolescents (teens) and young adults with Asperger's Disorder or High Functioning Autism are few and far between. One of the reasons is that many of these individuals are fairly high functioning and reluctant to join in groups, so, we have a really hard time outside of major/major metropolitan areas forming groups. What we often rely upon is individual therapy and coaching for these individuals. What does individual therapy consist of? Well, it usually starts with psycho-education. That is, learning the ins and outs of the disorder. Often this means learning it from the perspective of others, because one of the major difficulties people have is getting and understanding the perspective of others. While there are a lot of materials and training programs out there for younger teens and children with Asperger's Disorder there really aren't many for older teens and young adults. Still, we are able to make use of some of the materials from Michelle Garcia Winner which can easily apply to and be adapted for young adults and the work place. One set of materials we often use is her "social Behavior Mapping" method, which refocuses their attention on how they are perceived by others. This lack of "reciprocity" or use and understanding of "pragmatic language" is a common source of difficulty. An example of this is the individual who, while at work, is asked to sign a get well card for the office manager's daughter, who he has never met. While everyone else in the office signs the card as it is passed around, this individual, let's call him Tom, instead of signing says, "Well, I don't really know her." While this is true, and often family, friends and even therapists spend a lot of time arguing about the "truthfulness" of such statements, it becomes a work issue because such a reaction and comment is simply unexpected in the workplace, where social rules instruct you to sign the card, and if you can't think of anything just....sign your name and write "get well." How many arguments about this I've had with clients with Asperger's I can't tell you. Like Tom they know the social norm, they could recite it to you, but don't implement it because they need to stick to the facts of the situation. The big leap for them is to understand 1 How other's see their actions; and 2) Learn how to use the reaction of others to monitor and adjust their own behaviour. Something that just doesn't go on often enough. Michelle's work addresses these issues, not by going right to a problem area and ...well "sticking a finger in someone's eye while pointing out their problem." Instead we address the learning and thinking process as a who, and give students simple techniques to support their use of appropriate social interactions. Therapy for adolescents, teens, and young adults with Asperger's Disorder also often focuses on some of the same themes you would expect anyone their age to be dealing with. Individuals with Asperger's and high functioning Autism almost always tell me they want to develop relationships, make friends and become close to others. But because of these social cognitive deficits, like the one described above, this can be difficult task. This isolation can lead to anxiety, stress and depression just as it could with anyone else. So often these individuals with Asperger's Disorder and high functioning autism are often seen for the same reasons anyone else is seen. Therapies that are effective with others, such as Cognitive Behavioural Therapy 9CBT) is often just as effective, and can be easily adapted to make use of external and visual support systems. Finally there is the use of self-help books. Often individuals with Aspegers Disorder or high functioning autism can't afford the services of a psychologist or other licensed health professional. For those individuals a coaching mode using self help / self directed materials may be a good place to start. One book I often recommend, especially for young adults entering college or the workplace, is "Social 'Thinking at Work," again, by Michelle Garcia Winner. This is an excellent book, written especially for those with Aspeger's or high functioning autism. I would suggest this is one of the best books around for young adults, and recommend it highly. You can call around and find it at several bookstores, find it through the "suggested readings" link on my web page (at www.relatedminds.com) or borrow it through your local library. Checking out Mitchelle's web page at www.socialthinking.com may also reveal some more recent books and materials. I'd give a look there. I hope this has been helpful. All i can do is recommend you find a clinician, therapist, counsellor or registered psychologist, who has expertise in this field. And that would mean working for several years with all age groups, children, adolescents and dults, in order to understand the complexity of this developmental disorder. The good news is that overall research has shown we are highly successful at helping higher functioning children, adolescents and adults than we could have hoped. 'Good luck in your reading!

Teaching Autistic Teens To Make Friends

Teaching Autistic Teens To Make Friends

Can the skills of making friends really be taught? The answer seems to be yes. In a study appearing in the April edition of the Journal of Autism and Developmental Disorders, UCLA clinical instructor of psychiatry Elizabeth Laugeson and colleagues report that in comparison with a control group, the treatment group taking the class significantly improved their overall social skills and interactions with their peers. "Although, typically, developing teens often learn basic social rules through observation of peer behavior and specific instruction from parents," Laugeson said, "adolescents with autism spectrum disorders often require further instruction. You can read more about this study by clicking above.

"It's hard enough to be a teenager," she said, "but it's harder still for adolescents with autism because they typically lack the ability to pick up on all the social cues most of us take for granted — things like body language, hand gestures and facial expressions, along with speech inflections like warmth, sarcasm or hostility. "Lack of these basic social skills may lead to rejection, isolation or bullying from their peers. And sadly, that isolation can carry into their adult life."

Many of these skills need to be directly taught. Preferably in a group context where teens with autism spectrum disorder / Aspergers can practice and observe others practicing these skills (and do it in a protected environment) or individually. If the teen needs to work on these skills one-to-one because there are no groups or they have difficulty working in a group, there is still that option. If, however, individual training is used it is critical that parents become involved in knowing what skills are being taught, how they are cued, and how they can help with homework...using these new skills in a wide variety of environments. That's how they become part of your child's daily lives.

In this group study Laugeson and her colleagues developed a social skills class called PEERS (Program for the Education and Enrichment of Relational Skills), to give high-functioning teens with ASD a set of specific social skills. In it they worked on issues such as: "How do you have a successful get-together with someone? How do you go up to a group of teens and join their conversation? What do you say as a comeback when someone teases you? Without these core social skills, it becomes very difficult for teenagers to make and keep friends."

In the study, 33 teens with ASD — 28 males and five females — attended the PEERS classes. All the participants had a previous diagnosis of high-functioning autism, Asperger's Disorder or Pervasive Developmental Disorder–Not Otherwise Specified (PDD-NOS). The teens met once a week for 12 weeks; each session lasted 90 minutes. Instruction was conducted in a small-group format, with seven to 10 teens, using established strategies for teaching social skills to adolescents with ASD. How could you get a class like this going in your school? First, contact the school's support teacher. If that doesn't work, go to the principal. Failing there many lower mainland districts have ASD or "Autism Teams." Ultimately, if your school doesn't have the skills or ability to put together such a program you should ask for a consultation with the "POPARD Partner," this is the individual who works with the Provincial Outreach Program for Autism and Related Disorders (POPARD). They often provide training, support and consultation to schools and individual teachers in developing these "social learning" groups. Here in BC we are more likely to call such a group a "social learning" group as the issue at hand isn't simply not knowing a specific social skill (although our student most likely doesn't), instead it's a matter of understanding the nature of social reciprocity. The give and take of language and communication involving emotion and meaning. (See books by Michelle Winner on "Social Learning" through my website at http://www.relatedminds.com/autism or directly through Amazon.ca

As part of the study this article is about parents were required to attend separate, concurrent sessions where they were provided direct instruction and guidance to support their child's development. Honestly, if someone is treating your child for deficits in social awareness and not seeing you on a regular basis to review and teach skills...something is missing in the program.

"Parental involvement was mandatory and important," said Laugeson, associate director of the UCLA Parenting and Children's Friendship Program and director of the Help Group–UCLA Autism Research Alliance. "Other research has shown us that parent involvement can have significant positive effects upon children's friendships, both in terms of direct instruction and supervision, as well as supporting a child's development of an appropriate peer network."

Please, take a moment to read the article. One of the problems in the field of autism/ASD/Aspergers is that we really don't have solid research proving that what we do brings about change. Often it is obvious to those doing the work, but it's good to see some basic science going on to back up our day to day practice in the field.