Transcript New Challenges in the Classroom: Asperger Syndrome and
New Challenges in the Classroom: Asperger and Tourette Syndromes
AASSA Conference Buenos Aires, 2007 Juani Pinzás, Ph.D.
Lucrecia Rodríguez, MA.
Colegio F. D. Roosevelt Lima, Peru
Why Asperger Syndrome?
Why Tourette Syndrome?
Increased cases in the classrooms Increased presence nationwide Recent research: Medical Psychological Educational Teachers’ concerns Parental expectations Counselors’ Role
Our task today:
Share updated information on theory about both syndromes Provide specific guidelines and tips for counselors and teachers Suggest ways of supporting parents
Outline of Presentation
Asperger Syndrome
Definition Diagnosis Characteristics Development Cognition Language Motor Social Treatment Recommendations for Counselors Recommendations for Teachers
Tourette Syndrome
Definition Diagnosis Facts Types of tics Motor Vocal Impact on School Performance Treatment Recommendations for Counselors Recommendations for Teachers
Asperger Syndrome (AS)
What is it?
“Asperger Syndrome (AS) is a neurobiological disorder named after a Viennese physician, Hans Asperger, who described a pattern of behaviors in
several young children, mainly boys , who had normal intelligence and language development , but who also exhibited autistic-like behaviors and marked deficiencies in social and communication skills
.” (Barbara L. Kirby, 2006)
Diagnosis of Asperger Syndrome
Asperger syndrome can be very difficult to diagnose. Children with Asperger syndrome function well in most aspects of life, so it may be easy to perceive them as just being "different.“ Researchers and mental health experts are still investigating the causes of autism and Asperger syndrome .
Asperger syndrome should be diagnosed by a clinical psychologist and/or child psychiatrist.
Diagnoses can be best done in Kindergarten or 1st grade.
Teachers cannot make a medical diagnoses like this one. The whole school should avoid labeling students with Asperger syndrome.
Comorbidity
Depression or Bipolar disorder Asperger Syndrome Asperger syndrome can be accompanied by depression or bi-polar disorder.
Identified Asperger Syndrome students may exhibit a variety of the following characteristics:
marked deficiencies in social skills preoccupation with a particular subject of interest obsessive routines difficulties with transitions or changes preference for sameness great difficulty reading nonverbal cues (body language) difficulty determining proper body space over sensitivity to sounds, tastes, smells, and sights
Cognitive Development
By definition, those with Asperger syndrome have a normal IQ and many individuals exhibit exceptional skill or talent in a specific area. Because of their high degree of functionality those with Asperger syndrome are often viewed as eccentric or odd and can easily become victims of teasing and bullying.
Asperger syndrome ranges from mild to severe.
Language Development
no significant delay in the development of language milestones despite normal language development, deficits in
pragmatics and prosody
extraordinarily rich vocabulary, sometimes sounding like "little professors" extremely literal, difficulty using language in a social
contexts
Language Development (Cont.)
high amount of verbal output, good verbal learning adequate to advanced level of word recognition,
Language Development (Cont.) **
speech tends to be formal, robotic or repetitive no figurative use of language, symbolic representation, nuances or double meanings linguistic sophistications such as jokes and idioms are hard to grasp.
language development is quite literal, therefore reading other people's intentions are areas where language problems occur.
Social Development
inadequate social
perception
no empathy problems reading nonverbal cues, such as facial expressions or
body language
inappropriate affect minimal social interactions weak social pragmatics
lack of "common sense"
obsessive routines
Motor Development and Other
motor delay motor dyspraxia (reflected in a tendency to be clumsy) problems in visual motor integration skills problems in visual
spacial orientation
problems in spatial
memory
usually have a deficit in nonverbal skills may have problems with
attention span
may have problems with
organization
As far as we know, there seems to be no cure for the disorder - children with Asperger syndrome will become adults with Asperger syndrome . But adults with Asperger's may lead full, happy, and productive lives.
The likelihood of achieving this is enhanced with appropriate education, support, and resources. Teachers, parents and counselors are key.
Outline - Tourette Syndrome
Definition Diagnosis Facts Types of tics Motor Vocal Impact on School Performance Treatment Recommendations for Counselors Recommendations for Teachers
Tourette Syndrome (TS)
What is it?
“Tourette Syndrome (TS) is a
neurological
disorder characterized by
repetitive, stereotyped
,
involuntary movements vocalizations
called
tics
and . The disorder is named for Dr. Georges Gilles de la Tourette, a French neurologist.” (National Institute of Neurological Disorders, 2006)
Diagnosis of Tourette Syndrome (TS)
Neurologists make the diagnosis after verifying that the patient has had both motor and vocal tics for at least 1 year.
Clinical psychologists or child psychiatrists should complement the diagnosis with a complete psycho-educational battery and a good family and child history. For families and physicians unfamiliar with Tourette syndrome, mild and even moderate tic symptoms may be considered part of a developmental phase or the result of another condition. (*) Many patients are self-diagnosed after they, their parents, other relatives, or friends read or hear about Tourette Syndrome from others.
Some Facts About Tourette Syndrome
The early symptoms of Tourette syndrome are almost always noticed first in childhood, with the average onset between the ages of 7 and 10 years. Tourette syndrome occurs in people from all ethnic groups. Males are affected about three to four times more often than females (3:1 or 4:1). Their cognitive development is normal. People with intelligence.
Comorbidity
Some individuals with Tourette syndrome experience additional neurobehavioral problems such as: Attention Deficit Hyperactivity Disorder (ADHD) or Obsessive-Compulsive Disorder (OCD) or Behavior Disorder
Comorbidity
Attention Deficit Hyperactivity Disorder Tourette Syndrome Obsessive Compulsive Disorder Behavior Disorder
Although the cause of Tourette syndrome is unknown, current research points to certain brain regions, the circuits that interconnect these regions, and the neurotransmitters (dopamine, serotonin, and norepinephrine) responsible for communication among nerve cells.
A significant percentage of all children will experience one, or even a few tics at some point in their development. For most children, a tic will emerge without any warning or explanation, remain a few weeks, and then disappear slowly. For some children the tic does not disappear, but continues its development as either a chronic tic or a Tourette condition. A tic is defined as a brief, repetitive, purposeless, involuntary movement or sound. Tics that produce movement are called "motor tics," while tics that produce sound are called "vocal tics" or "phonic tics."
Tics may often be characterized by whether they are "simple" or "complex." A simple tic involves one muscle group or one simple sound. A complex tic involves a coordinated movement produced by a number of muscle groups.
Motor tics generally precede the development of vocal tics and simple tics often precede complex tics.
Studies suggest that Tourette syndrome is an inherited disorder. Although there is no cure for Tourette syndrome , the condition in many individuals improves in the late teens and early 20s. As a result, some may actually become symptom-free or no longer need medication for tic suppression. Individuals with Tourette syndrome have a normal life expectancy. Tourette syndrome does not impair intelligence.
Examples of Simple Motor Tics
Eye Blinking Eye Rolling Nose Twitching Lip-licking Shoulder Shrugs Head Jerks Brushing or Tossing Hair Out of Eyes Mouth Opening Arm Extending
Examples of Complex Motor Tics
Pulling at Clothes Touching People Touching Objects Smelling Fingers Smelling Objects Jumping or Skipping Flapping Arms Tensing Muscle Groups Twirling Hair Sequences or patterns combining different simple and complex motor tics
Examples of Simple Vocal Tics
Throat Clearing Grunting Yelling or Screaming Sniffing Coughing Humming Whistling
Examples of Complex Vocal Tics
Unusual changes in volume of voice Coprolalia: obscenities or socially taboo phrases
Note: This list is not all-inclusive
** Tics often worsen with excitement or anxiety and lessen during calm, focused activities. Certain physical experiences can trigger or increase tics, for example tight collars may trigger neck tics, or hearing another person sniff or throat-clear may trigger similar sounds.
Tics come and go over time, varying in type, frequency, location, and severity. The first symptoms usually occur in the head and neck area and may progress to include muscles of the trunk and extremities.
** Although the symptoms of Tourette syndrome are involuntary, some people can sometimes suppress or manage their tics in an effort to minimize their impact on functioning. Tics vary in frequency. Decreased frequency occurs in the morning and it increases in the afternoon and Although Tourette syndrome can be a chronic condition with symptoms lasting a lifetime, most people with the condition experience their worst symptoms in their early teens, with improvement occurring in the late teens and continuing into adulthood.
Treatment
Because tic symptoms do not often cause impairment, the majority of people with Tourette syndrome require no medication for tic suppression. However, effective medications are available for those students whose symptoms interfere with functioning. Psychotherapy may also be helpful. Although such problems may result from Tourette syndrome . Psychotherapy can help the person with Tourette syndrome better cope with the disorder and deal with the secondary social and emotional problems that sometimes occur.
The Impact of Tics on School Performance
Tics can impact learning and performance in different ways.
The most commonly reported problems are that eye tics and head/neck tics directly interfere with reading and can be very frustrating for the student. Eye, head/neck, and arm tics also directly interfere with handwritten work for a number of students with tics.
Tics can distract students from concentrating as they become aware of the need to tic.
Severe or frequent tics can cause pain, frustration, and irritability.
Vocal tics can lead the student to withdraw from class discussions or make them embarrassed to read aloud. Tics can lead to peer teasing or fear of peer rejection.
General Tips for Teachers
Work around the tics. Keep the focus on learning. Be flexible. Keep a positive outlook as you remind yourself and the student that however bad a tic seems, this too shall pass.
Strategies for Teachers and Counselors Asperger Syndrome Tourette Syndrome
(see attached handout)
Sources
http://www.childdevelopmentinfo.com/disorders/asperger.shtml
http://www.udel.edu/bkirby/asperger/aswhatisit.html
http://www.hyperlexia.org/aha_winter9697.html
http://www.kidshealth.org/parent/medical/brain/asperger.html
http://www.ninds.nih.gov/disorders/tourette/detail_tourette.ht
m#56583231 http://www.tsa-usa.org/news/headlines.html
Books Used on Asperger Syndrome
Spectrum Disorders by Veronica Zysk
Preparing for Life: The Complete Guide for Transitioning to
Baker Autism? Asperger's? ADHD? ADD? by Diane Drake Burns Asperger's: What Does It Mean to Me? by Catherine Faherty
Understanding Asperger's Syndrome: Fast Facts--A Guide for
Emily L Burrows
Navigating the Social World: A Curriculum for Individuals with
Disorders by Jeanette McAfee Role Models by Norm Ledgin, Temple Grandin, and Marsha M. Ledgin
Books Used on Tourette Syndrome
(Patient-Centered Guides) by Mitzi Waltz Living with Tourette Syndrome by Elaine Fantle, Shimberg Tourette Syndrome: The Facts by Mary Robertson Search for the Tourette Syndrome and Human Behavior Genes by David E. Comings Coping With Tourette Syndrome and Tic Disorders (Coping) by Barbara Moe
A Mind of Its Own: Tourette's Syndrome: a Story and a
Guide by Ruth Dowling Bruun
Children With Tourette Syndrome: A Parent's Guide (Special
Needs Collection) by Tracy Haerle Hi, I'm Adam: A Child's Book About Tourette Syndrome by Adam Buehrens Tourette Syndrome by Donald J. Cohen
Contact Us
Juani Pinzás, Ph. D.
Educational Psychologist Counselor Early Childhood/Gr. 1 [email protected]
Lucrecia Rodríguez, MA
Educational Psychologist Counselor Gr. 2-5 [email protected]