Tuesday, July 10, 2012

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!

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