Transcript Bridging the Social Gap & Connecting Cultures: Asperger’s

Lisa Hoang, LMHC
Rose Augustine, MA
Pasadena Villa Network of Services
The “Stuff” People Say...

Right Click Here to Open the
Hyperlink to the Video:
Stupid SH*T that people say
to Aspies
Cultural Awareness
Preparing for Discovery
Cultural Awareness
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 Purpose
 Cultural Awareness is the foundation of
communication and it involves the ability of standing
back from ourselves and becoming aware of our
cultural values, beliefs and perceptions. Why do we
do things in that way? How do we see the world?
Why do we react in that particular way? (Stephanie
Quappe &Giovanne Cantatore, 2005)
 Cultural awareness becomes central when we have to
interact with people from other cultures.
Aspergers – Innate Culture
Multicultural Approach

 Culture: "any group of people who identify or
associate with one another on the basis of some
common purpose, need, or similarity of background"
(Axelson, 1999)
 Multiculture: Distinct group uniqueness and
concepts that facilitate attention to individual
differences (Gladding, 2009)
 Asperger's Syndrome is unique and diverse in
symptom presentations and prognosis. Each person
with AS has unique strengths, deficits, and needs.
Cultural Awareness

 Increasing cultural awareness means to see both the
positive and negative aspects of cultural differences
– celebrating discovery
 Degrees of Awareness
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My Way is the only way
I know their way, but my way is better
My way and Their way
Our Way (shared meaning – participatory)
“Labels are for soup cans”
Let’s Travel ….

Right Click Here to Open the
Hyperlink to the Video:
Asperger's High - Coming This
Fall on the CW!
Discover Differences

 Asperger Syndrome (AS) is considered a pervasive developmental
disorder at the higher functioning end of the autism spectrum.
 It is characterized by sustained impairment in:
 Social interaction and
 limited interests
 stereotyped and repetitive behavior (Stiefel, Shields, Swain, &
Innes , 2008)
 In contrast to autism, there are no obvious delays in language or
cognitive development, or in age appropriate self-help skills and
adaptive behaviors though there are subtle impairments.
 More common in males then females
 Officially recognized in 1994 in the DSM-IV (Elkis-Abuhoff, 2004)
Aspergers
Left Handed
Neurotypicals
Right Handed
Discover
Differences
Neurotypicals are Better
FALSE

Right Click Here to Open the
Hyperlink to the Video:
ADAM - Theatrical Trailer
Aspergers and Neurotypicals:
Social Differences
Men are from Mars Women are from Venus
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Cat People
41%
 Loner – More likely to be
solitary
 Affection typically
displayed on cats terms
 During stress/moments of
fear cats tend to hide/isolate
 Cats wont learn from
punishment – they will
avoid the source (discover
wants).
 Arduous to train
Dog people
74%
 Pack animal
 Look for and reciprocate
affection
 During stress/moments
of fear dogs protect &
approach
 Dogs can learn from
punishment
 Easy to train
Common Traits &
Characteristics

 socially awkward and clumsy
 physically awkward in sports
 naive and gullible
 very accurate memory for
details
 unaware of others' feelings
 unable to carry on
conversation
 trouble understanding things
they have heard or read
 easily upset by changes
 inappropriate body language &
expression
 literal in speech and
understanding
 repetitive and irrelevant
comments
 sensitive to loud sounds, lights,
odors
 unusually loud, high or
monotonous voice
 fixated on one subject or object
 rock, fidget or pace while
concentrating
Central Coherence

 Ability to focus on both details as well as wholes
 Challenges with Central Coherence suggests that a
person with Aspergers struggles with information
processing leading to limitations with understanding
the “big picture” and getting stuck on details.
 Weak central coherence leads to an inability to bring
together various details from perception to make a
meaningful whole AKA Gestalt
Central Coherence
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 Heightened focus on details rather than wholes
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Sensory struggles (hypersensitive sensory perception)
Reading comprehension
Theory of Mind
Executive Functioning
 The inability to hold information in mind in order to
use it later (poor working memory)
 Assess current skills &
needs in order to develop
intervention plan
 Keep structural timetable
 Consistent is key – limits
possible confusion or
distress
 Keep instructions simple
& clear (resume style)
 Be aware of possible
distractions
 Start simple/easy and
work up
Central
Coherence
Tips
Group I
Group II
Group I
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Group II
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Theory of Mind

 Challenges with Theory of Mind suggests that a
person with Aspergers has an arduous time gaining
insight to the thoughts, feelings, and beliefs that are
distinctive to others AKA perspective.
 An inability to recognize that other people have
thought's, feelings and intentions that are different to
one’s own and an inability to intuitively guess what
these might be
Theory of Mind

 Mind Blindness – difficulty conceptualizing and appreciating
the thoughts and feelings of others
 Being able to relate to and understand the behaviors of others
(distinguishing whether someone's actions are intentional or
accidental).
 Mind Blindness leads to Social Struggle
 Poor communication skills
 Difficulty with:
 Providing adequate information
 Commenting on conversation
 Organizing thoughts
 Inability to take another’s perspective, predict outcomes and
decipher intentions
 Difficulty generalizing tasks to everyday situations
 Teach using visuals
 Learn Check-ins
 Educate purpose of Small
talk & Practice (smart
talk)
 Role Playing
 Feedback from peers
 Repetition, Repetition,
Repetition
Theory of
Mind
Tips
Theory of Mind
Social Need Perspective
Executive Functioning

 Challenges in Executive Functioning suggests that the cognitive
process makes it difficult to execute some practical living
functions.
 Some examples:
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Organizing
Planning
Sequencing
Getting tasks and/or activities started (initiating)
Completing
Changes/Transitions
Focus
Emotional Control
Executive Functioning

 The way people monitor and control their thoughts
and actions (Carlson & Moses, 2001).
 Impairment or deficits in the higher-order processes
that enable us to plan, sequence, initiate and sustain
our Bx towards some goal, incorporating feedback
and making adjustments along the way.
 Involves working memory, planning, cognitive
flexibility and inhibitory control (language
development).
 Visuals (i.e. lists, charts)
 Memory Techniques
 Technology
 Clear, Short & Sweet
 Routine/Repetition
 Sleep
Executive
Functioning
Tips
Awarness

Perception
 He/She doesn’t care –
has No Empathy
 He/She doesn’t care –
they never listen or pay
attention
 He/She doesn’t care lazy, and careless
Perspective
 Theory of Mind –
Struggles with Mind
Blindness
 Weak Central Coherence
– Struggle with details vs
whole (lost/confused/left
behind)
 Executive Functioning –
Struggle with
organization, prioritizing
Awareness

Right Click Here to Open the
Hyperlink to the Video:
Neurotypical documentary
trailer
Social Integration Model

 Social Integration Model is rooted in the belief that it is the
responsibility of healthcare providers to prepare clients for life outside
of Tx - designed to assist individuals in reaching the highest level of
individual functioning possible.
 Emotional and psychological support are foundational. Focus on
facilities is less important than how individuals act, behave and
function outside of contained four walls. What really matters is how
individuals function in the real world – that is the premise of the
Social Integration Model.
 Social Integration Model immerses individuals into real life activities
within the community.
 Recreational, social, cultural and life skills activities within the
community with healthcare professionals form the core treatment
interventions in the Social Integration Model
Within the community, licensed
healthcare professionals observes clients
in real life situations, and intervene, as
appropriate, right there, on the spot and
in the moment. These observations are
then incorporated into the individuals
ongoing treatment plan.
Social Integration Model
How Does It Work
Benefits of Social Integration

 Reduces being marginalized – Exposure for
individuals exposure for the community (Demystify)
 Practicing coping skills in the moment with support
from healthcare providers with immediate feedback.
 Social involvement with therapeutic support
promotes effective participation in family,
occupational, community and societal life.
Real Life – Real Time – Relevant
Social Integration Model for Aspergers

 The adaptation of the social integration model is to
help normalize behaviors. The philosophical goal is
to assist individuals with Aspergers to achieve
maximum social functioning so that they integrate
into their families and society at large and can thus
enjoy those benefits of belonging and participating.
 Social and Life Skills development - through
modeling, active training, exposure, experience,
practice, repetition, etc.
 Kinesthetic
Social Integration Model

 Delivery of therapeutic
services in the natural
environment is embedded
in the DNA of the Social
Integration Model.
 Every activity must be
looked at as an
opportunity to provide
therapeutic services that
increase social
functioning.
 learning to eat with proper
manners at the table
 maintaining an organized
personal space
 developing habits that establish
proper ADLs
 learning to behave in proper
fashion in public places such as
stores & restaurants
 learning conflict resolution in
public settings
 establishing an ability to function
in high stimulus environments
(i.e. theme parks & other
recreational activities)
 developing healthy eating habits
 developing healthy exercise
regimens
Experience, Exposure,
Opportunity
Social Integration Model
Colors of Development
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 Hunter
 Sage
Felt different
Emotionally Reactive
Poor sense of self
Direct and Blunt
Loves animals
Unable to followthrough with goals
 Kicked out of multiple
schools
 Unable to complete
college
 Unable to go to a
restaurant with family
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Hunter– His Story
“The basement
couch is my future!”
Hunter
Colors of Development
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 Feels connected
 Lengthened the fuse
 Loves animals Career
 Follow through with
goals
 Can go out to eat
with family
 Poor perception of self
 Obsessive/Irrational thoughts
 Strong imagination
 High IQ
 Gifted in languages
 Unable to pass class
 Multiple medical leaves
 Struggled with making friends
Sage
Her Story
“I belong in a special
farm for special people
who get fake jobs to
help them feel that they
have purpose.”
Sage
Colors of Development
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 Acceptance (public
mistakes)
 Positive self-talk
 Strong imagination
 Tutoring – both ways
 In college (library)
 Friends – study dates
"Being happy doesn't
mean that everything is
perfect, it means that
you've decided to look
beyond the
imperfections"
Another View

 Cultural Awareness
 Social Differences
 DSM / Clinical Education
 Social Integration Model
 Examples of individual development
 Now …..
 Back to Purpose
A Different Perspective …
Celebrate Differences

 Qualitative advantage in social interaction, as manifested by a majority of the
following:
 peer relationships characterized by absolute loyalty and impeccable
dependability
 free of sexist, "age-ist", or culturalist biases; ability to regard others at "face
value“
 speaking one’s mind irrespective of social context or adherence to personal
beliefs
 ability to pursue personal theory or perspective despite conflicting
evidence
 seeking an audience or friends capable of: enthusiasm for unique interests
and topics;
 consideration of details; spending time discussing a topic that may not be
of primary interest
 listening without continual judgment or assumption
 interested primarily in significant contributions to conversation; preferring
to avoid ‘ritualistic small talk’ or socially trivial statements and superficial
conversation.
 seeking sincere, positive, genuine friends with an unassuming sense of
humor
A Different Perspective …
Celebrate Differences

 Cognitive skills characterized by at least four of the following:
 strong preference for detail over gestalt
 original, often unique perspective in problem solving
 exceptional memory and/or recall of details often forgotten or
disregarded by others, for example: names, dates, schedules,
routines
 avid perseverance in gathering and cataloguing information on a
topic of interest
 persistence of thought
 encyclopedic or ‘CD ROM’ knowledge of one or more topics
 knowledge of routines and a focused desire to maintain order and
accuracy
 clarity of values/decision making unaltered by political or
financial factors
A Different Perspective …
Celebrate Differences

 Additional possible features:
 acute sensitivity to specific sensory experiences and stimuli,
 for example: hearing, touch, vision, and/or smell
 strength in individual sports and games, particularly those
involving endurance or visual accuracy, including rowing,
swimming, bowling, chess
 “social unsung hero” with trusting optimism: frequent victim of
social weaknesses of others, while steadfast in the belief of the
possibility of genuine friendship
 increased probability over general population of attending
university after high school
 often take care of others outside the range of typical development
Enrich Yourself

Become Culturally Aware
Educate and Share with others (key
stakeholders)
Self Explore (who needs Tx – video
game ex)
Practice (Our Way)
Enrich Yourself
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The Ode to the Autistic Man by Scott Lentine
Try to understand the challenges that I face
I would like to be accepted as a human in all places
Where I will end up in life I don’t know
But I hope to be successful wherever I go
I would like to expand my social skills in life
Making new friends would be very nice
Stand proud for the autistic man
For he will find a new fan
I hope to overcome the odds I face today
Increased acceptance will lead me to a brighter day
By the age of 20, I will have made tremendous strides
I know in the future, life will continue to be an interesting ride
I have made new friends by the year
I will be given tremendous respect by my family and peers
I hope to get noted for bringing the issue of autism to the common man
So that autistic people can be accepted in this great land
Stand proud for the autistic man
For he will find a new fan
I hope to overcome the odds I face today
Increased acceptance will lead me to a brighter day
“Strangers in a new culture see only what they
know” – Unknown
Become Aware ….
Discover
Resources
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Organizations
 Advancing Futures for Adults with Autism
 Center for Autism and Related Disabilities
 Autism Speaks
 CARD
 AANE
Websites
 www.aane.org
 www.tonyattwood.com
 www.pasadenavilla.com
 www.autisminternetmodules.org
 www.autismvotes.org
 www.centerforautism.com
Books
 The Complete Guide to Asperger's Syndrome by Tony Attwood
 Asperger's Syndrome: A Guide for Parents and Professionals by Tony
Attwood
 A Self-Determined Future with Asperger's Syndrome: Solution Focused
Approaches by E. Veronica Bliss and Genevieve Edmonds
 Look Me in the Eye: My Life with Aspergers by John E. Robison
References

 American Psychiatric Association. (1994). Diagnostic and statistical
manual of mental disorders (4th ed.). Washington, DC.
 Attwood, Tony. "The Discovery of ." Morning News. 11.3 (1999): n.
page. Web.
 Garcia, Winner. "Three Core Deficits of Aspergers
Syndrome." www.sacramentooasis.com. Sacramento Aspergers
Syndrome Information and Support. Web
 Attwood, Tony. "What is Asperger's
Syndrome?."WWW.tonyattwood.com. Tony Attwood, n.d. Web.
 Pasadena, . "Social Integration Model."WWW.pasadenavilla.com.
Appleton Creative , n.d. Web.
 Quappe, Stephenie. "What is Cultural Awareness, anyway? How
do I build it?." Adler, Organizational Behavior. (1991): n. page. Web.
21 Mar. 2013. <www.culturosity.com>.