SOCIAL SKILLS SUPPORT FOR ADOLESCENTS WITH ASPERGER’S SYNDROME A Project Presented to the faculty of the Graduate and Professional Studies in Education California State University, Sacramento Submitted in partial satisfaction of the requirements for the degree of SPECIALIST IN EDUCATION in School Psychology by Gabriela Mariz Quoc Le SPRING 2013 SOCIAL SKILLS SUPPORT FOR ADOLESCENTS WITH ASPERGER’S SYNDROME A Project by Gabriela Mariz Quoc Le Approved by: ______________________________________, Committee Chair Catherine Christo, Ph.D. _______________________ Date ii Students: Gabriela Mariz Quoc Le I certify that these students have met the requirements for format contained in the University format manual, and that this project is suitable for shelving in the Library and credit is to be awarded for the project. ____________________________________, Department Chair ______________ Susan Heredia, Ph.D. Date Graduate and Professional Studies in Education iii Abstract of SOCIAL SKILLS SUPPORT FOR ADOLESCENTS WITH ASPERGER’S SYNDROME by Gabriela Mariz Quoc Le Adolescents with Asperger’s Syndrome (AS) face unique challenges in the educational setting. Specifically, adolescents with AS have difficulties with social skills and social communications. These students typically perform within the average to above average range in the classroom, however they may struggle to initiate and maintain appropriate relationships with peers. School administrators, teachers, and other school personnel may not fully understand AS and how to best support adolescents with AS. The purpose of this project is to provide educators with information and resources to help support the social needs of adolescents with AS. Participants with be presented with background information of AS and strategies to support students with AS. ________________________________, Committee Chair Catherine Christo, Ph.D. _____________________________ Date iv ACKNOWLEDGEMENTS We would like to thank our supervisor, Catherine Christo, for her support and guidance throughout the development of this project. We would also like to thank the professors of the School Psychology Program: Stephen E. Brock, Leslie A. Cooley, and Melissa A. Holland, for their level of commitment and passion to teaching and instilling confidence in their students. Next, we would like to thank the members of our cohort for their friendships and continued support. Lastly, we would like to thank our families and friends for all the support and encouragement throughout this journey. v TABLE OF CONTENTS Page Acknowledgements ……………………………………………………………………… v Chapter 1. INTRODUCTION …………………………………………………………………… 1 Background of the Problem ……………………………………………………... 1 Purpose of the Project …………………………………………………………… 2 Definition of Terms ……………………………………………………………… 3 Limitations ………………………………………………………………………. 4 Statement of Collaboration ……………………………………………………… 4 2. LITERATURE REVIEW ……………………………………………………………. 5 Social Skills Deficits and Adulthood ……………………………………………. 9 Social Skills Strategies for Students with ASD and Asperger’s ……………….. 10 Conclusion ……………………………………………………………………... 18 3. METHODOLOGY …………………………………………………………………. 20 Research ………………………………………………………………………... 20 Development of the Presentation ………………………………………………. 20 4. FINDINGS ………………………………………………………………………….. 22 Discussion ……………………………………………………………………… 22 Recommendations ……………………………………………………………… 23 Appendix A. Presentation Slides ………………………………………………………. 24 vi Appendix B. Presenter’s Manual ………………………………………………………. 71 Appendix C. Presentation Handouts …………………………………………………… 75 References ……………………………………………………………………………… 85 vii 1 Chapter 1 INTRODUCTION Background of the Problem Hans Asperger, a Viennese physician, was the first to discuss and describe individuals who exhibited social deficits but whom also presented with average cognitive ability and language development (Myles and Simpson, 2002). Originally naming the disorder, Autistic Psychopathy (AP), Asperger described individuals with AP as having average or high intelligence but also possessing learning difficulties and attention problems. The social deficits Asperger observed were described as odd social interactions, behaviors, and communication. He also described individuals with AP as displaying problematic behavior in social situations and having impairments in emotions and instincts. Lorna Wing brought the disorder to the attention of the scientific community in her 1981 English-language journal article. Wing described AP as an Autistic Spectrum Disorder, calling it Asperger’s syndrome (AS), and expanded the description of its characteristics and development (Hippler and Klicpera, 2003). In 1994, the American Psychiatric Association added AS as a pervasive developmental disorder in the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) (Myles and Simpson, 2002). More recently, the diagnostic criteria for Asperger’s Disorder as described by the DSM –IV-IR suggests individuals with AS have no clinically significant delays in cognitive development, language, adaptive behavior, or curiosity about the environment. They do however, display qualitative impairments in social interactions and perform 2 restricted repetitive and stereotypical behaviors, interests and activities. These deficits cause clinically significant impairment in important areas of functioning like social and occupational situations (American Psychiatric Association, 2004). In 2012, the Center for Disease Control and Prevention (CDC) estimated that 1 in 88 children have been identified as having Autistic Spectrum Disorder (ASD) in the United States (Center for Disease Control and Prevention, 2012). With the growing number of children identified with ASD, research and curriculum support has also grown. However, few have focused their research specifically on the adolescent with the disorder (Webb, Miller, Pierce, Strawser, & Jones 2004). Few have also focused on interventions for the social deficits affecting those who are functioning on the higher end of the spectrum, such as those with AS or High Functioning Autism (HFA) (Rao, Beidel, and Murray, 2007). Purpose of the Project All students face various challenges throughout their academic careers. However, students with Asperger’s Syndrome (AS) face their own unique challenges; specifically, students with AS have difficulty with social skills and social communication (APA, 2004). Those with AS have deficits in social skills that typically include problems initiating social interactions, inappropriate emotional responses, and lack of empathy to others’ distress (Weiss and Harris, 2001). Those with AS also have difficulty with pragmatics and semantics, and tend to interpret utterances literally. This makes understanding idioms, irony, metaphors, and humor very difficult (Happe 1993, 1995; Kerbel & Grunwell, 1998; Ozonoff & Miller, 1996; Rapid & Dunn, 2003). Nonverbal social cues are also difficult for those with AS to perform and understand. Myles and 3 Southwick (1999), indicate students with AS often display inappropriate eye contact, proximity, posture, and even gestures. Students with AS typically perform within the average to above average range in the classroom, however they may struggle outside the classroom. These students may find it difficult to initiate and maintain peer relationships (Church, Alisanki, & Amanullah, 2000). Thus it is important for teachers, administrators, aides, and all other school staff members to have a better understanding of AS and the challenges these students face. Also it is imperative to identify age appropriate curriculum and strategies to support these students, as well as to assist in their development. Definition of Terms Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR): The standard diagnostic tool used by mental health professionals worldwide to promote reliable research, accurate diagnosis, and thus appropriate treatment and patient care. Qualitative impairment in social interactions: Marked impairment in the use of nonverbal behaviors such as eye contact, facial expression and body posture; failure to develop peer relationships and a lack of social and emotional reciprocity. Social skills: Set of skills that allow individuals to communicate, relate, and socialize with others. Restrictive, repetitive and stereotyped patterns of behavior, interests, and activities: Preoccupation of interests that is abnormal in intensity or focus; repetitive use of objects 4 or phrases; excessive attachment to routines, objects and interests; repetitive motor mannerisms; and inflexible adherence to routines or rituals. Limitations This project has been designed to give teachers and administrators a better understanding of Asperger’s Syndrome and the challenges that students with AS face. This project is an informational guide and a tool that provides school staff with strategies to help support students with AS socially and to help develop social skills. It may not be time effective to provide social skills training for these students in place of academic instruction; therefore strategies that can be implemented alongside academic curriculum and throughout students’ daily schedules may be more plausible. Statement of Collaboration The authors of this project collaborated on all aspects. Each author contributed equally in researching the literature and the compilation of this project. 5 Chapter 2 LITERATURE REVIEW There is a significant amount of research focused on social skill development for children diagnosed with Autism Spectrum Disorder (ASD). However, research is limited when looking specifically at adolescents diagnosed with Asperger’s syndrome (AS) and/or High Functioning Autism (HFA) (Webb, Miller, Pierce, Strawser, & Jones 2004). The lack of substantial research is surprising when considering the evidence that suggests AS/HFA may be the fastest growing disorder under the autism spectrum (Sansosti & Powell-Smith, 2006). Like other disorders under the autism spectrum, those diagnosed with AS/HFA also present with social skill deficits. However, those with AS/HFA do not have clinically significant impairment in language or cognitive development (American Psychiatric Association, 2004). This implies that the social support established for those with ASD may not be appropriate for the specific needs of those diagnosed with AS/HFA. Because of their specific needs and the growing number of those identified with AS/HFA, it is imperative that more research be conducted to assist the AS/HFA adolescent student in social skill development. Cognitive Functioning and Academic Performance The American Psychiatric Association (2004), identifies children with AS/HFA as having average overall intelligence and language skills. Studies looking more specifically at the cognitive functioning of students with AS/HFA found these students have relative strengths in non-verbal reasoning, concept formation, and spatial visualization and integration (Barnhill, Hagiwara, Myles, & Simpson 2000; Ehlers, Nyden, Gillberg, 6 Sandberg, Dahlgren, Hjelmquist, & Oden 1997). Studies have also suggested, however, that students with AS/HFA have specific relative weaknesses in their cognitive ability. More specifically, studies have found that students with this diagnosis have weaknesses in their ability to comprehend abstract material and make inferences (Church, Alisanki, & Amanullah, 2000). These skills are critical to adequately maintaining mature social relationships. Central auditory processing impairments were also found (JanssonVerkasalo, Čeponiene, Kielinen, Suominen, Jäntti, Linna, Moilanen, & Näätäanen 2003; Lepisto, Silokallio, Nieminen-von Wendt, Alku, Näätäanen, & Kujala 2006), with processing auditory information becoming increasingly difficult for these individuals when paired with background noise (Alcantara, Weisblatt, Moore, & Bolton, 2004). Students with AS/HFA have also been found to have impairments in executive functioning and visual motor coordination (Barnhill, et al. 2000; Landa & Goldburg, 2005). Due to their generally average level of functioning in intellectual and language abilities, students with AS/HFA are commonly included in general education classrooms (Myles & Simpson, 2001). Academically speaking, students with AS/HFA have been found to have strengths in comprehension of factual material, oral expression, and reading recognition (Church, et al., 2000). However, intellectual strengths, advanced vocabularies, and “parrot-like-responses” may inaccurately provide teachers the perception that these students understand more than they actually do (Ghaziuddin & Gerstein, 1996). 7 Cognitive deficits typical in those with AS/HFA can negatively affect academic performance (Myles and Southwick, 1999), though the research varies greatly in this population. Griswold, Barnhill, Myles, Hagiwara, and Simpson (2002), for example, found mean academic achievement scores ranged from significantly below to significantly above average for AS/HFA students. Although oral expression and reading recognition were found to be relative strengths, comprehending verbally presented information, language based-critical thinking, and written language were found to be deficits. Students with AS/HFA also had low mathematics scores, having most difficulty solving equations and answering mathematical calculation problems. Social Skills and Communication Although many individuals with AS/HFA don’t have delays in language ability, difficulty with social skills and social communication are commonly found (APA 2004). Those with AS/HFA have deficits in social skills that typically include problems initiating social interactions, inappropriate emotional responses, and lack of empathy to others’ distress (Weiss and Harris, 2001). Additionally, these individuals may present with social challenges such as difficulty inferring the intentions or perspective of others, understanding of how their actions affect others, and turn-taking (Ozoneffe, Rogers, & Pennigton, 1999). Because individuals with AS/HFA tend to engage or perseverate on behaviors and topics of interest, conversations with others tend to be one -sided and focused on their topic of interest (South, Ozonoff, & McMahon, 2005). Those with AS/HFA also have difficulty with pragmatics, semantics, and tend to interpret utterances literally. This makes understanding idioms, irony, metaphors, and 8 humor very difficult (Happe 1993,1995; Kerbel & Grunwell 1998; Ozonoff & Miller 1996; Rapin and Dunn 2003). Those with AS/HFA can also have difficulty speaking at an appropriate rate, rhythm, and volume level (Woodbury-Smith & Volkmar, 2009). Nonverbal social cues are also difficult for those with ASD to perform and understand. Myles and Southwick (1999), indicate students with ASD often display inappropriate eye contact, proximity, posture, and even gestures. Due to their generally average functionality and cognitive ability, students with AS/HFA are often very aware of their social skill deficits. Participating in general education classrooms exposes students with AS/HFA to higher levels of social demands and pressures than compared to lower functioning students on the spectrum (Rao, Beidel, & Murray, 2007). In the elementary school years, deficits in social skills can result in difficulties initiating and maintaining peer relationships. In adolescence, these deficits not only result in difficulty initiating and maintaining relationships but have resulted in ridicule and rejection (Church et al., 2000). When looking at how adolescents perceive themselves, it was discovered that students with AS/HFA rate themselves more than one standard deviation below the mean in social skills and social competency when compared to typically developing children. The parents of these participants rated their children nearly two standard deviations below the mean (Knot, Dunlop, &Mackay, 2006). In addition, social deficits cause hardship for individuals with AS/HFA outside of the school setting, complicating further their relational lives. 9 Social Skills Deficits and Adulthood Romantic Relationships These deficits in social skills and communication also complicate adolescents and young adults’ romantic lives. Because of their lack of social knowledge and skill, adolescents and adults with AS/HFA are often unaware that their social cues and actions may actually be causing distress or discomfort toward their person of interest. Their lack of awareness can also lead to their inability to understand rejection and, as a result, may lead to longer periods of persistence. Inappropriate or dangerous behaviors, such as obsession, stalking, aggressiveness, inappropriate touch, and threats to the person of interest or themselves, can be an ultimate result of their failure to understand rejection. Unfortunately, individuals with AS/HFA may not understand that their behaviors are considered extreme or unwanted. Understandably, these extreme behaviors can lead to legal repercussions (Stokes & Kaur 2005; Stokes, Newton, & Kaur 2007). Employment Due to current economic hardship, gaining employment in today’s society can be incredibly challenging. This is especially true for students with AS/FHA. Although they do not present with deficits in overall cognitive and language ability, deficits in social interactions and communication have been found to greatly impede their job accessibility and performance. Effectively communicating and interacting with supervisors and coworkers has been found to be the primary obstacle in successful job performance. Social deficits have been found to lead to both unsuccessful job interviews and to job termination (Hurblbutt & Chalmers, 2004; McCraken, McGough, & Shah, 2002). 10 Transitions Due to the social and even fiscal impact of these deficits, it is imperative to provide social education and intervention to youth with AS/HFA. Hendricks and Wehman (2009), suggest adolescents on the autism spectrum need to prepare themselves for life after school. They suggest building skills and conducting transition plans such as setting goals, selecting courses of study, and indentifying services and support. Studies also suggest that goals must be individualized, functional, and based on skills needed in the student’s current and future environment (Iovannone, Dunlap, Huber, & Kincaid, 2003). Wehman (2006), suggests including adolescents in their transition planning to be a fundamental part of the process. It allows them to learn about themselves and plan for their future. Wehnman also suggests, in addition to transition planning, effective social skill training is beneficial for AS/HFA adolescents in that it provides valuable life skills that can transition into higher education, careers, and even adult relationships and romances. Social Skills Strategies for Students with ASD and Asperger's Adolescents face many social challenges and situations upon entering secondary settings, middle school and high school. Those with AS/HFA are particularly challenged. However, when looking at interventions for these students, there is a general lack of agreement. Richard Simpson (2005) states there are no single, best suited, and universally effective method for helping these youth socially. However, applied behavior analysis appears to be one such method that is effective for students with ASD (p. 146). 11 Applied Behavior Analysis Applied Behavior Analysis (ABA) has been effective in decreasing problem behaviors and increasing appropriate behaviors. ABA is the process of studying and modifying behavior (Morris, 2012). According to Morris (2012), ABA is the design, implementation, and evaluation of environmental modifications to produce socially significant improvement in human behavior. Applied Behavior Analysis includes the use of direct observation, measurement, and functional analysis of the relations between environment and behavior. The first step in ABA is analyzing the behavior using the ABC model; Antecedent, Behavior, and Consequence. ABA implements a number of techniques, including, (a) task analysis; (b) chaining; (c) prompting; (d) fading; (e) shaping; and (f) differential reinforcement (Morris, 2012). Task analysis is the process wherein in which a task is analyzed into its component parts so that those parts can be taught. Chaining consists of breaking down the target skill into the smallest units to ease learning. Prompting is providing assistance to encourage the desired response from the student; prompts can be verbal or visual cues, physical guidance, or demonstration. Fading is gradually fading prompts until prompts are no longer required. Shaping involves gradually modifying existing behavior into the desired behavior. Differential reinforcement is providing reinforcement to behavior that will likely increase that behavior. Generalization, or having the student display target behaviors in natural settings, is the goal of ABA (Morris, 2012). 12 Hagopian, Crockett, Van Stone, DeLeon and Bowman (2000) looked at the effect of noncontingent reinforcement on problem behavior and stimulus engagement. Stimulus engagement was found to remain high throughout the study, while problem behavior decreased. Participants responded well to available stimuli provided by researchers, which was determined by the level of engagement towards the stimuli. Hagopian et al., suggests that providing meaningful reinforcements can decrease problem behaviors. Reinforcements that are meaningful, and remain meaningful, can increase effectiveness. In this study, aggression was a target problem behavior; when participants responded appropriately they were reinforced with preferential incentives such as toys, a cassette player, and food. Parents also play a role in the efficacy of social skills acquisition. Hupp and Reitman (2000) suggest parents are integral members in providing treatment for their children. Parents are able to reinforce behaviors across settings, which may increase the likelihood that social skills are generalized outside of the treatment setting. Hidden Curriculum The "hidden curriculum" is a social skills training method for students with Asperger's Syndrome. This curriculum includes the skills that are not taught directly, such as making eye contact when in conversation or not interrupting peers’ conversation (Myles & Simpson, 2001). According to Myles and Simpson, the hidden curriculum needs to be approached systematically through a process of instruction and interpretation. Instruction includes providing direct assistance in skill acquisition. Instruction components include (a) scope and sequence, (b) direct instruction, (c) social stories, (d) 13 acting lessons, and (e) self-esteem building. Interpretation includes understanding situations through strategies such as visual images. Scope and Sequence is identifying skill areas that may be deficient, as well as ensuring that prerequisite skills have been developed, such as understanding that voice tone communicates different messages. Direct Instruction provides an effective instructional sequence that facilitates skill acquisition. Direct Instruction includes (a) rationale, understanding why information being taught is relevant; (b) presentation, telling and showing the student what needs to be learned; (c) modeling, showing the student what they are supposed to do; (d) verification, monitoring the student’s emotional state in order to ensure comprehension; (e) evaluation, assess student's understanding and use of skill; and (f) generalization, providing opportunities for students to use newly acquired skills in a variety of settings. Social Stories describe social situations specific to students and circumstances; social stories will be discussed further later in this review. Acting Lessons consists of students learning to express emotions verbally and nonverbally in specific situations, as well as learn to interpret others’ emotions and feelings. A benefit of Acting Lessons provides students with the opportunity to engage in simulations and receive feedback from an instructor and peers. Self-Esteem Building is vital, as it helps students develop a positive self-image. Some strategies to build selfesteem include: letting the individual be a helper or tutor, praising and giving compliments to the individual when they are doing well, as well as encouraging the individual to compliment themselves (Myles & Simpson, 2001). 14 Interpretation helps turn learned actions into meaningful interactions. Interpretation strategies include: cartooning; social autopsies; and the Situation, Options, Consequences, Choices, Strategies, Simulation (SOCCSS) strategy (Myles & Simpson, 2001). Cartooning consists of illustrating social situations to enhance understanding; visual symbols have been found to increase processing abilities. Social Autopsies helps students interpret social situations, identify and understand social mistakes and develop a plan to ensure the error does not occur again. The SOCCSS strategy was developed to help students put social and behavioral issues into a sequential form (Roosa, 1995). According to Roosa, SOCCSS strategy is broken down into (a) situation, (b) options, (c) consequences, (d) choices, (e) strategies, and (f) simulation. Situation is described as the teacher working with an individual to define that problem and state a goal to repair the problem when a social problem arises. Options are brainstorming options for behavior. Consequences looks at what the consequences would be for each option generated by the individual and teacher. Choices asks the student to prioritize the options and consequences and select a solution. Strategies is developing a plan of action around the selected choice. Lastly, Simulation gives the student an opportunity to turn the abstract strategy into something more concrete through role-playing, imagery, or talking to peers about the plan. Students with HFA/HS are at a disadvantage socially because they may not understand the hidden curriculum. They may unintentionally break the rules and get in trouble. Instruction and interpretation of the hidden curriculum should be an integral portion of the education of students with HFA/AS (Myles and Simpson, 2001). 15 Social Stories Social stories were developed in the 1990s in responses to evidence that students with ASD struggled to interpret social cues, had trouble recognizing someone else's perspective, and had deficits in their ability to identify appropriate responses to social stimuli (Boutot, 2009). A social story is a strategy used to assist students with understanding and reacting to social situations through a pictured or written story about that situation. Over the years, social stories have been successful in teaching a variety of skills and improvement of behaviors associated with ASD. The goal of a social story is to help students identify and respond in a specific, socially appropriate manner (Callahan, 2011). To increase the effectiveness of a social story, the problem behavior or social situation must be identified and then a story is developed targeting that behavior. The Social Story Program uses specific guidelines to increase success for the student (Callahan, 2011). It is imperative that the student has a full comprehension of the terms and examples used in the social story. When developing a social story, the Social Story Program recommends using specific types of sentences. The first type of sentence is descriptive. The descriptive sentence helps the student identify contextual variables of the social story. The second type of sentence is directive. The directive sentence identifies the behavior as being in response to a specific cue. The third type of sentence is perspective. The perspective sentence identifies reactions and emotions that come from the situation described within the story. The fourth type of sentence is affirmative. The affirmative sentence signifies the cultural influences of the social situation. Sansosti, 16 Powell-Smith, and Kincaid (2004) have added two more types of sentences that help in the aid of writing and comprehension of the social story. Their sentences include control sentences that help the student comprehend analogies, allowing them to generalize the social story to real life, and cooperative sentences that help them to identify and label the aid given in the situation. Boutot (2009) suggests the use of the "I Will" card strategy that incorporates elements of social stories. I Will cards are a strategy to teach social skills to students, capitalizing on their strengths, such as memory. I Will cards display both the situation and the student's self-talk statement pertaining to that situation. This strategy helps students monitor their own behavior through the use of self-talk and understanding the situations on the I Will cards. Boutot, states that "self-talk provides empowerment over one's behavior and teaches lifelong skills in the context of everyday social situations" (p. 280). Social Skills Training Programs The effectiveness of structured group social skills training (SST) programs for youth with High Functioning Autism has been researched, but is limited. White, Koenig and Scahill (2010) state that few structured intervention approaches that target social skill development in young adolescents with ASD have been developed. Little research has been conducted regarding the efficacy of group-based SST, however it is appealing because it provides an opportunity for students to practice skills with peers in a semistructured format with adult assistance (White et al., 2010). The study conducted by White et al. incorporated the Social Development Program, which included a high degree 17 of structure and predictability, explicit teaching, use of verbal and visual teaching aides, frequent repetition of the skills taught, and parental involvement. Each session was broken down into a brief introductory time, homework review, skills teaching, skills practice, group snack, and free time for socializing with peers. Some topics that were taught were: giving a compliment, beginning conversations and making appropriate responses, working with others, and giving feedback. Results were positive, as some participants demonstrated improvement in social skills. However, gains were not uniform across settings, and gains were not consistently maintained following treatment (White et al.). Despite the widespread clinical use of social skills training programs for children with Asperger's Syndrome/High Functioning Autism, empirical support is in its infancy. Autism researchers are implementing varied SST programs from diverse theoretical foundations, with differing levels of intensity and variable duration of treatment (Rao, Beidel, and Murray, 2007). Rao et al. recommend that researchers must provide further documentation of the specific social skills deficits in youth with Asperger's Syndrome and High Functioning Autism. These social skills deficits may be different from those identified for children with other disorders inside and outside of the autism spectrum. The efficacy of SST interventions for youth with Asperger's Syndrome and High Functioning Autism must be established. SST programs need to be designed to facilitate the generalization of skills outside of the treatment setting, as the ultimate goal is for the students to interact appropriately in their natural social contexts (Rao et al.). Lastly, it is recommended that SST programs be manualized so that they can be implemented easily 18 in natural settings such as schools and community centers. According to Krasny, Williams, Provencal, and Ozonoff (2003) there are few programs that meet the criteria of SST programs conducted by qualified professionals who have received rigorous training in both program delivery and behavioral therapy. In sum, adolescents with AS/HFA, should be provided with a curriculum that will allow skills to translate into naturally occurring settings outside of the classroom. Conclusion Students on the autism spectrum, including students with Asperger’s syndrome/high-functioning autism face many challenges. Although not presenting significant deficits in cognitive and language ability, those diagnosed with AS/HFA have deficits in social skills and communication. Due to their intellectual ability, many students with AS/HFA are mainstreamed into general education classrooms. However, their social deficits often cause difficulties in peer interactions. Difficulties interacting with peers do not limit themselves to the educational setting. Social deficits are found to greatly impact adults with AS/FHA, especially when considering employment and romantic relationships. Because the social skill deficits are found to have a profound effect on the lives of those with AS/HFA, it is crucial that adolescent students are provided the necessary social skill support. Although, there are evidence-based practices that have been found to be effective in the improvement of social skills such as Applied Behavior Analysis, there continues to be a lack of manualized strategies, programs, or curriculums for the educational setting. It is important that the interventions be both effective and generalize outside of the classroom. Although the relevancy of social skills 19 curriculums for adolescents with AS/HFA has increased, research available on social skills support for students with AS/HFA is still in its infancy. Therefore, more research is needed in order to establish effective strategies that would assist AS/HFA adolescent students with social skills deficits. Due to the lack of information addressing effective social skill strategies of adolescent students with AS/HFA, this project is intended to educate general education teachers, by creating a workshop, with information to increase the understanding of AS/HFA and provide strategies to best support students with AS/HFA socially. 20 Chapter 3 METHODOLOGY Research In completing this project, the authors conducted a review of literature. Data was collected through journal articles, electronic resources, and scholarly publications. Authors searched for journal articles through the Academic Search Premier (EBSCO) database, as well as through Google Scholar. The key word Asperger’s Syndrome was used in combination with terms such as: adolescent, support, social skills, and general education. Within these journal articles, the authors obtained additional articles and other resources from reference lists. Publications and books used in professional practice were also included in the research. The authors gathered information from all acquired literature and categorized data into groups that pertained to the same topic. Each author focused on specific topics when reviewing and developing the literature review. Development of the Presentation A presentation was developed in order to provide educators with a more complete understanding of Asperger’s Syndrome. The information shared with participants include characteristics, academic strengths and weaknesses, social skills strengths and weakness, and effective strategies to best meet the needs of students with AS, among other topics. The main findings from the literature review were shared in the presentation, and handouts were developed to provide supplemental information. 21 The in-service training is presented through a Powerpoint presentation and is designed to be administered in three hours. The intended audience for the presentation is administrators, general education and special education teachers, school counselors, and school psychologists. The Powerpoint presentation can be located in the appendix of this project. 22 Chapter 4 RESULTS The workshop presentation was developed using information obtained from the literature review. The workshop is intended to be administered in approximately three hours. The workshop’s intent is to develop a better understanding of Asperger’s Syndrome (AS) and High-Functioning Autism (HFA), as well as how to support individuals with AS/HFA in the both the special education and general education setting. The PowerPoint slides with notes and activities, and instructions for presenters are included in the appendices. The workshop is to be presented to administrators, teachers, school psychologists, and instructional assistants. Discussion Individuals with AS/HFA often times receive a majority of instruction in the general education setting with minimal supports. However, they are likely to face adversity in the everyday social aspects of being a student. Therefore, as educators, it is important that we have an understanding of characteristics of AS/HFA, strengths and weaknesses, and support strategies. Support for individuals with AS/HFA outside the special education setting may be limited due to the individual’s class schedule. However, supporting the social development of individuals with AS/HFA is important so that they are set up for success in the present and future. General education teachers, administrators, and instructional assistants can be helpful in helping individuals with AS/HFA identify social mistakes and appropriate solutions. There is still much research that needs to take place in order to 23 identify and develop strategies to meet the social needs of individuals with AS/HFA. These individuals demonstrate many strengths, and with appropriate supports can excel at any endeavor they choose. Recommendations It is recommended that presenters familiarize themselves with the contents of the workshop. Also with the upcoming release of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and possible changes in Asperger’s Syndrome, presenters may need to make requisite changes to portions of the PowerPoint presentation. 24 Appendix A Presentation Slides 25 Slide 1 Assisting Your Students with Asperger’s/High Functioning Autism STRATEGIES TO BEST SUPPORT THE SOCIAL SKILLS OF ADOLESCENT STUDENTS WITH ASPERGER’S/HIGH FUNCTIONING AUTISM Note to presenters: Utilize this time to introduce yourselves to the audience and have the audience introduces themselves to you. Presenters may also introduce the topic of the presentation. 26 Slide 2 Presentation Goals To increase the understanding of Asperger’s/High Functioning Autism Identify strategies and curriculum that may assist you in supporting your student’s social needs. Ask: At this moment, what do you already know about AS/HFA? What experience have you had working with this population of students? What was successful? What was challenging? Note to presenters: Give the audience 5 minutes to discuss present knowledge of AS/HFA in small groups. Share responses with the whole group. 27 Slide 3 Prevalence In 2012, the Center for Disease Control and Prevention (CDC) estimated that 1 in 88 children have been identified as having Autistic Spectrum Disorder (ASD) in the United States. Research suggests AS/HFA may be the fastest growing disorder under the autism spectrum. Sample Language: Because there is a growing amount of individuals diagnosed with an autistic spectrum disorder, especially those with Asperger’s or High Functioning Autism, it is important for teachers to be educated on this disorder and to have tools and resources to best support these students. 28 Slide 4 Definition of Key Terms Diagnostic and Statistical Manuel of Mental Disorders, Fourth Edition, Text Revision (DSM-IVTR) – The standardized diagnostic tool used by mental health professionals worldwide. Qualitative impairment in social interactions – Marked impairment in the use of nonverbal behaviors such as eye contact, facial expression and body posture. Failure to develop peer relationships and a lack of social and emotional reciprocity. Sample Language: Refer to the Defining Key Terms handout now and throughout the presentation. Note to presenters: Providing definition of terms will provide the audience needed information without taking up large amounts of time or departing from topics later discussed in the presentation. 29 Slide 5 Definition of Key Terms Restrictive, repetitive, and stereotyped behavior, interests, and activities – Preoccupation of interests that is abnormal in intensity or focus; repetitive use of objects or phrases; excessive attachment to routines, objects and interests; repetitive motor mannerism; and inflexible adherence to routines or rituals. Social Skills - Set of skills that allow individuals to communicate, relate, and socialize with others. Adaptive Behavior – age-appropriate behaviors that are necessary for independent living and functioning safely and appropriately in daily life. Ask: How would restrictive or repetitive behaviors interfere with learning or academic performance? How would deficits in social skills or adaptive behaviors interfere with learning or academic performance? Note to Presenters: Pause for questions and clarification if needed. Provide 5 minutes for discussion. 30 Slide 6 Diagnostic Criteria for 299.80 Asperger’s Disorder Qualitative impairment in social interactions. Restrictive repetitive and stereotypical patters of behavior, interests and activities. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning. There is no clinically significant general delay in language. There is no clinically significant delay in cognitive development or in the development age-appropriate selfhelp skills, adaptive behavior, and curiosity about the environment in childhood. Sample Language: What exactly does it mean to have Asperser’s Disorder? According to the DSM-IV-TR, there are certain criteria that must be present in order to make a diagnosis. Refer back to your key terms for clarification while we go through the criteria. Ask: What would be an example of the different criteria? Note to Presenter: Allow for 5 minutes for the audience to share their examples. Provide examples for each criterion. 31 Slide 7 How is AS/HFA different from Autistic Disorder? Diagnostic Criteria for Asperger’s Disorder Qualitative impairment in social interactions. Restrictive repetitive and stereotypical patters of behavior, interests and activities. The disturbance causes clinically significant impairment in social, occupational, or other areas. There is no clinically significant general delay in language. There is no clinically significant delay in cognitive development or in the development ageappropriate self-help skills, adaptive behavior, and curiosity about the environment. Diagnostic Criteria for Autistic Disorder Qualitative impairment in social interactions. Restricted repetitive and stereotyped patterns of behavior, interests, and activities. Qualitative impairments in communication. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play. Sample Language: Let’s look at how AS differs from ASD. These students are often performing typically when compared to other students when we think about cognitive and language ability. However, they do struggle significantly with peer interactions and often have or perform repetitive behaviors or narrow interests. All of which cause significant difficulty in their lives. Note to Presenter: Highlight and emphasize how AS/HFA is different from other forms of spectrum disorders. 32 Slide 8 Cognitive Functioning No clinically significant delay in cognitive development (average overall intelligence). Students with AS/HFA have been found to have strengths in: Non-Verbal Reasoning- analyze information , solve problems, and find relationships within visual information. Spatial Visualization and Integration - ability to mentally manipulate or mentally rotate visual information. Sample Language: Look at your Key Terms handout once again. The main discriminating characteristic is that students with AS/HFA have intellectual abilities that are similar to their peers. Ask: Let’s think about and write down examples of subjects/task/assignments that involve these cognitive functions on the Cognition and Academics handout. Note to Presenters: Give the audience 5 minutes to discuss in small groups. Share responses with the whole group. Examples may include mathematics and science, etc. . 33 Slide 9 Cognitive Functioning Although students with AS/HFA have average intelligence and specific strengths, research suggests that cognitive deficits may also be present. Deficits may include: Comprehending abstract material and inferences. Apply already obtained skills to solve new problems. Processing auditory information (especially when there is background noise). Ask: Let’s think about and write down subjects/task/assignments that involve these cognitive functions. How would these deficits make learning difficult? Note to Presenters: Give the audience 5 minutes to discuss in small groups. Share responses with the whole group. Examples may include, comprehending poetry/literature, processing/comprehending information that is presented through lecture without visuals, and difficulty maintaining focus when there is background noise. 34 Slide 10 Cognitive Functioning Other deficits include: Executive Functioning-planning, impulse control, organization, flexibility of thought and actions. Visual-Motor Coordination-hand-eye coordination. Self-Reflection and Self-Monitoring. Ask: Let’s think about and write down subjects/task/assignments that involve these cognitive functions. How would these deficits make learning difficult? Note to Presenters: Give the audience 5 minutes to discuss in small groups. Share responses with the whole group. Examples may include, difficulty starting or finishing large papers/projects, writing or taking notes from the board. 35 Slide 11 Academic Performance Strengths Weaknesses Oral Expression Language Based- Reading Recognition Critical Thinking Written Language Abstract Thinking Advanced Vocabularies Comprehension of factual material Sample Language: Research suggests students with AS/HFA have relative strengths and weaknesses in the following academic areas. Although having intellectual strengths, and advanced vocabularies; these students often respond with parrot-like-responses. This may leave educators with the impression that these students understand more than they actually do. Ask: Please add this information to the Cognition and Academics handout as well. 36 Slide 12 Communication No clinically significant general delay in language. Although there is not a delay in language ability, difficulty with social communication are commonly found. Deficits in communication may include: Difficulty with pragmatics, semantics, and interpret utterances literally. Difficulty understanding idioms, irony, metaphors, and humor. Difficulty speaking at an appropriate rate, rhythm, and volume level Sample Language: Here is another criterion for AS according to DSM-IV-TR. Ask: How would these delays in social communication affect academic performance? Note to presenters: Give the audience 5 minutes to discuss in small groups. Share responses with the whole group. 37 Slide 13 Communication Social communication relates to social skill deficits which may include: Difficulty initiating social interactions Conversational turn-taking Difficulty inferring the intention or perspective of others Inappropriate emotional responses Difficulty understanding how their actions affect others Lack of empathy toward other’s distress Nonverbal social communication is also an area of deficiency. Difficulties include: Inappropriate eye contact, proximity, posture, and gestures Sample Language: As you can imagine, delays in social communication have an effect on social skills as well. Ask: What kind of affect would a deficit in social communication have on a student’s ability to relate to peers? How would this influence their attitude toward school? How would this influence their academic performance? Note to presenters: Give the audience 5 minutes to discuss in small groups. Share responses with the whole group. 38 Slide 14 Communication and Behavior Restrictive, repetitive and stereotypical patters of behavior, interests and activities. Individual with AS/HFA tend to engage or perseverate on behaviors and/or topics of interest. This tends to cause conversations to be one-sided and focused only on their topic of interest. This may also prevent involvement in social interactions due to their desire to participate in restrictive or repetitive behaviors. Sample Language: Here is another criterion for AS according to DSM-IV-TR. Ask: What subjects/topics/activities would be difficult for students with AS/HFA based on what was discussed in the last three slides? Note to Presenter: Give the audience 5 minutes to discuss in small groups. Share responses with the whole group. Examples may include: understanding poetry or literature, working with partners or within a group, behavioral difficulties due to inappropriate responses or restrictive behaviors. 39 Slide 15 The Implications of Social Skill Deficits Because students with AS/HFA do not have deficits in cognitive and language ability, they are often placed in general education classrooms. This means they are exposed to higher levels of social demands and pressures than lower functioning students on the spectrum. In the elementary school years, social skill deficits can result in difficulties initiating and maintaining peer relationships. In adolescence, deficits not only cause difficulty initiating/maintaining relationships, deficits can also lead to ridicule and rejection. Sample Language: Now that you have a better understanding of AS/HFA, let’s consider the implications of their difficulties. 40 Slide 16 Social Skill Deficits in Adulthood Romantic Relationships Deficits in social skills and communication cause difficulty understanding social or non verbal cues such as rejection. This may lead to a longer period of persistence when they are not able to understand or “read” disinterest from the person of interest. Deficits can also cause these individuals to be unaware of how their unwanted and sometimes extreme behaviors may cause distress or discomfort. This has been found to sometimes lead to behaviors such as inappropriate touch, aggression, stalking, or threats. Sample Language: Social communication/skill deficits not only affect AS/HFA student’s academic performance; deficits that are not addressed will most likely expand into adulthood and affect different aspects of their lives. 41 Slide 17 Social Skill Deficits in Adulthood Employment Although individuals with AS/HFA may have the cognitive ability to gain and maintain employment, deficits in social interactions and communication have been found to greatly impede job accessibility and performance. Effective communication and interaction with supervisors and coworkers has been found to be a primary obstacle in job performance. Social deficits have also been found to lead to both unsuccessful job interviews and job termination. Sample Language: Because students with AS/HFA are performing typically in cognition and language they may not be receiving the social skills training that is commonly taught to students on the lower end of the spectrum. When these deficits are not addressed, it causes difficulty and distress into adulthood. Thus, it is very important for teachers to have skills to address some of the deficits they see in the classroom. It is hoped that the skills learned may generalize outside of the classroom. 42 Slide 18 Social Skill Strategies The Hidden Curriculum Applied Behavior Analysis Social Stories Sample Language: We will be discussing some strategies that can strengthen social skill deficits for individuals with AS/HFA 43 Slide 19 The Hidden Curriculum SOCIAL SKILLS Sample language: One aspect that is often overlooked for individuals with Asperger’s Syndrome is the Hidden Curriculum. Ask: At this moment, what do you all know regarding the hidden curriculum? Note to presenters: Give the audience 5 minutes to discuss present knowledge of the hidden curriculum in small groups. 44 Slide 20 Hidden Curriculum The hidden curriculum consists of social skills that we assume all individuals have, but are not taught directly Examples: Appropriate greetings Eye contact during conversation Not interrupting peers’ conversations Sample Language: It is assumed that all individuals know social norms, appropriate social skills, etc. However, for individuals with Asperger’s Syndrome/High-Functioning Autism, this knowledge may not be as second nature as one would expect. Also, individuals with AS/HFA may not understand how to generalize these social skills across different settings and situations. Ask: What are some things you’ve all seen from your experiences with students with AS/HFA? Note to presenters: Allow for 5 minutes for the audience to share their examples 45 Slide 21 Hidden Curriculum What can we do to help these individuals better understand and generalize social skills? Myles and Simpson (2001) suggests approaching the hidden curriculum through a process of instruction and interpretation. Instruction includes providing assistance in skill acuqisition Interpretation includes understanding situations through strategies such as visual images Note to presenters: Pause for questions before moving on to the next slide. 46 Slide 22 Instruction include components such as: scope and sequence, direct instruction, and acting lessons Scope and sequence: identifying skill areas that may be deficient Note to presenters: Give an example of a skill area that may be deficient Sample Language: Some skills areas that students with AS may have deficiencies in are initiating a conversation, giving appropriate compliments, and accurate responses to nonverbal cues. Note to presenters: Ask the audience for other examples. Pause for questions before moving on to the next slide. 47 Slide 23 Direct Instruction provides an instructional sequence that facilitates skill acquisition Includes: Rationale: understanding why information being taught is relevant Presentation: telling and showing the student what needs to be learned Modeling: showing the student what they are supposed to do Verification: monitoring for comprehension Evaluation: assess student’s understanding and use of skill Generalization: providing opportunities for students to use newly acquired skills in a variety of settings Note to presenters: Pause for questions, clarifications 48 Slide 24 Acting Lessons consists of students learning to express emotions verbally and nonverbally in specific situations, as well as learn to interpret others’ emotions and feelings A benefit of Acting Lessons is it provides students with the opportunity to engage in simulations and receive feedback from instructor and peers. Ask: When would be a good time during the school day to provide students with opportunities to act? Note to presenters: It is important to identify opportunities to provide social supports that do not interfere with academics. 49 Slide 25 Interpretation helps turn learned actions into meaningful interactions. Some interpretation strategies are Cartooning and Social Autopsies Sample Language: Interpretation allows students to act out and hopefully generalize learned skills across natural settings. 50 Slide 26 Cartooning: consists of illustrating social situations to enhance understanding: visual symbols have been found to increase processing abilities Social Autopsies: helps students interpret social situations, identify and understand social mistakes, and develop a plan to ensure the error does not occur again Note to presenters: Pause for questions and clarifications if needed. 51 Slide 27 Activity Example: A 14-year old boy named John is new to his high school. He has had a difficult time establishing friendships with his peers. His peers interpret his behavior as hyperactive and “scatter brained.” Scope and Sequence: the identified social skill deficit is tone of voice; John’s tone of voice in different situations has caused misunderstandings How would you go about conducting a social autopsy with the student? Sample Language: We are going to perform an example of a social autopsy. Ask: With the information provided, how would you go about performing a social autopsy with John? Allow 10 minutes for participants to work in small groups. Share with the whole group Listen for: identify specific situations, tones of voice in different situations, consequences, appropriate tone of voice in specific situations 52 Slide 28 Questions? Ask: Are there any questions regarding what we’ve covered pertaining to the hidden curriculum? 53 Slide 29 Applied Behavior Analysis (ABA) Ask: Does anyone have experience with ABA? Sample Language: It isn’t practical to implement ABA during the school day, however we can incorporate aspects of ABA in order to support our students with AS/HFA socially. 54 Slide 30 ABA ABA implements a number of techniques, including: task analysis, chaining, prompting, fading, shaping and differential reinforcement. Task analysis is the process wherein a task is analyzed into components so that those components can be taught Chaining consists of breaking down the target skill into the smallest units to ease learning Sample Language: ABA has been shown to be effective in decreasing problem behaviors and increasing appropriate behaviors. 55 Slide 31 Prompting is providing assistance to encourage the desired response from the student Fading is gradually fading prompts until prompts are no longer required Shaping involves gradually modifying behavior into the desired behavior Differential reinforcement is providing reinforcement to behavior that will likely increase that behavior. 56 Slide 32 Activity Example: Diana is a 14-year old, 9th grade student. She has great interest in marine animals, however her peers do not share the same interest. Diana has had a difficult time maintaining friendships due to deficits in her conversational skills. Identify the target skill, prompts, how to fade prompts and types of reinforcements that may increase target behavior. Note to presenters: Begin the task as a whole group Sample Language: What is the target skill? (carrying on conversations with peers) Allow 5-10 minutes for participants to discuss in small groups. Share with the whole group. Note to presenters: Listen for “conversation,” “back and forth dialogue,” “listening to others.” 57 Slide 33 Social Stories A social story is a strategy used to assist students with understanding and reacting to social situations through a pictured of written story. The goal of a social story is to help students identify and respond in a specific, socially appropriate manner. To increase the effectiveness of a social story, the problem behavior or social situation must be identified and then a story developed targeting that behavior. Note to presenters: Pause for questions. 58 Slide 34 Social Stories The Social Story Program uses specific guidelines to increase success for the student. When developing a social story, it is recommended that specific types of sentences are used. Descriptive sentence: helps student identify contextual variables Directive sentence: identifies the behavior as being in response to a specific cue Perspective sentence: identifies reactions and emotions that come from the situation described in the story Affirmative sentence signifies the cultural influences of the social situation 59 Slide 35 Sample social story for sharing: When a classmate needs a pencil, I will try to help (descriptive sentence). I will share one of my pencils so that they can complete their class work (directive sentence). My classmate will be thankful that I helped and he may realize that I am nice (perspective sentence). Sharing is important, because if we can help one another, we should (affirmative sentence). Sample Language: There are a number of social situations that students encounter daily. Here is a generic example of a social story pertaining to sharing. 60 Slide 36 Activity Example: Brian likes to play basketball during lunch. However, Brian has a difficult time playing with other students because he gets upset when other students have the basketball. Create a social story to help Brian better understanding playing basketball with others appropriately. Note to presenters: Allow 10-15 minutes for participants to work in small groups. Share each story with the whole group. 61 Slide 37 Questions? Sample Language: Teachers and school staff can play vital roles in supporting students with AS. Teachers can provide learning opportunities during regular instruction time. Ask: What strategies do you feel are practical for you? Also, when can strategies be used? Note to Presenters: Allow time for discussion. 62 Slide 38 Handouts Self Evaluation for Group Assignments Sample Language: At this time we would like to present a few ways in which you as educators can assist your students in self monitoring appropriate social behaviors. The first handout is a self evaluation form for students to fill out after participating in group activities and assignments. This allows students to monitor their social behavior and to think about how they can become better group members in the future. Note to presenters: Allow time for the audience to look over the handout. 63 Slide 39 Handouts Teacher Checklist Sample Language: Now let’s take a look at the Teacher Checklist. This handout may be a helpful tool when monitoring the frequency of appropriate classroom behavior. Note to presenters: Allow time for the audience to look over the handout. 64 Slide 40 Handouts Student Checklist Sample Language: Now let’s take a look at the Student Checklist. This handout encourages students to self monitor the frequency of their own classroom behavior. It also encourages students to ask for help if they need it. Note to presenters: Allow time for the audience to look over the handout. 65 Slide 41 Handouts Resources for Educators Sample Language: The last handout is a list of resources designed for educators in assisting students with AS/HFA. Note to presenters: Allow time for the audience to look over the handout. 66 Slide 42 Thank You Any Questions? Sample Language: This concludes our presentation. We hope you found this helpful and informative. Are there any further questions? Note to presenters: Allow time for questions from the audience. 67 Slide 43 References Alca´ntara, J. I., Weisblatt, E. J. L., Moore, B. C. J., & Bolton, P. F. (2004). Speech-innoiseperception in high-functioning students with autism or Asperger’s syndrome Journal of Child Psychology and Psychiatry, 45(6), 1107–1114. American Psychiatric Association (2004). Diagnostic and statistical manual of mental disorders, text revision (DSM-IV-TR). Washington, DC: Author. Callahan, K. M. (2011). Applied behavior analysis in populations with autism: A Look at social interactions. Honors Theses, 71. Center for Disease Control and Prevention. (2012). Autism Spectrum Disorders: Data and Statistics. Retrieved from http://www.cdc.gov/ncbddd/autism/data.html. Barnhill, G., Hagiwara, R., Myles, B. S., & Simpson, R. L. (2000). Asperger syndrome: A study of the cognitive profiles of 37 children and adolescents. Focus on Autism and Other Developmental Disabilities, 15, 146–153. Ehlers, S., Nyden, A., Gillberg, C., Sandberg, A. D., Dahlgren, S., Hjelmquist, E., & Oden, A. (1997). Asperger syndrome, autism and attention deficit disorders: A comparative study of cognitive profiles of 120 children. Journal of Child Psychology and Psychiatry and Allied Disciplines, 38, 207–217. Ghaziuddin M., Gerstein, L., (1996). Pedantic speaking style differentiates Asperger syndrome from high-functioning autism. Journal of Autism and Developmental Disorder, 26(6), 585-595). 68 Slide 44 69 Slide 45 References McCraken, J., McGough, J., & Shah, B. (2002). Risperdone in children with autism and serious behavioral problems. New England Journal Medicine, 347, 314–321. Morris, B. K. (2012). Introduction to applied behavior analysis. Retrieved from http://www.autism-help.org/intervention-applied-behavioral-analysis.htm Myles, B. S., & Simpson, R. L. (2001). Understanding the hidden curriculum: An Essential social skill for children and youth with Asperger's’s syndrome. Intervention in School and Clinic, 36(5), 279-286. Ozonoff, S., & Miller, J. N. (1996). An exploration of right hemisphere contributions to the pragmatic impairments of autism. Brain and Language, 52, 411–434. Rao, P. A., Beidel, D. C., & Murray, M. J. (2007). Social skills intervention for children with Asperger’s syndrome or high-functioning autism: A Review and recommendations. Journal of Autism and Developmental Disorders, 38, 353-361. Sansosti, F. J., & Powell-Smith, K. A. (2006). High-functioning autism and Asperger's’s syndrome. In G. G. Bear, & K. M. Minke (Eds.), Children’s needs III: Development, prevention, and intervention, (pp. 949–963). Washington DC: National Association of School Psychologists. 70 Slide 46 References South M, Ozonoff S, McMahon W (2005) Repetitive behavior profiles in Apserger’s syndrome and high-functioning autism. Journal of Autism Developmental Disorders 35, 145–158. Stokes, M., & Kaur, A. (2005). High functioning autism and sexuality: A parental perspective. Autism, 9(3), 263–286. Stokes, M., Newton, N., & Kaur, A. (2007), Stalking, and social and romantic functioning among adolescents and adults with autism spectrum disorders. Journal of Autism Simpson, R. L. (2005). Evidence-based practices and students with autism spectrum disorder. Focus on Autism and Other Developmental Disabilities, 20(3), 140-149. Weiss, M. J., & Harris, S. L. (2001). Teaching social skills to people with autism. Behavior Modification, 25(5), 785–802. 71 Appendix B Presenter’s Manual 72 Introduction Adolescents with Asperger’s Syndrome (AS) face unique challenges in the educational setting. Specifically, adolescents with AS have difficulties with social skills and social communications. These students typically excel in the classroom, however they may struggle to initiate and maintain appropriate relationships with peers. School administrators, teachers, and other school personnel may not fully understand AS and how to best support adolescents with AS. A stronger grasp of the needs of students with AS and support strategies can ensure that these students are set up for success inside and outside of the classroom. The PowerPoint presentation and this manual were developed to provide information to educators about AS, as well as strategies to support the social needs of adolescents with AS. The information for the PowerPoint and manual were obtained from a literature review that was completed between September 2012 and December 2012. Nature of Presentation This presentation has been developed for administrators, teachers and other school staff members who provide instruction for students. The presentation is designed to last approximately three hours; a fifteen-minute break should be provided during the presentation. Discussions and audience participation are integral aspects of presentations, therefore to ensure a successful presentation, presenters should encourage discussions and provide opportunities for participants to ask questions. Presenters should familiarize 73 themselves with the content of the PowerPoint presentation, notes and citations in preparation of facilitating the workshop. Presenters must also make copies of all handouts before the start of the workshop. Guidance to Presenters The workshop is presented as a series of Microsoft PowerPoint slides. Each slide has all necessary information needed to present the workshop. To supplement the presenters, the notes section has general information needed to discuss individual slides. Sample language is provided in italics, however, presenters are encouraged to use their own words. To encourage participation, discussion questions have been provided in the note section of PowerPoint slides. Group activities and handouts have also been included in the presentation. Activities include small group discussions and handouts include resources. Participants should be provided adequate time to discuss information in small groups and to work on case studies. Handouts, with copies for each participant, should be distributed at appropriate times. Provide presenters’ contact information at the end of the workshop because participants may wish to ask questions or clarifications after the workshop. A recommended timeline is provided below: Slides Topic Duration #1-5 Introduction, Key Terms 10 Minutes #6-7 Diagnostic Criteria 10 Minutes 74 #8-11 Cognition, Academic 10 Minutes Performance #12-17 Communication, Social 15 Minutes Skills Deficits, Implications #18-28 #29-32 #33-42 Break 15 Minutes Hidden Curriculum 30 Minutes Questions 5-10 Minutes Applied Behavior Analysis 30 Minutes Questions 5-10 Minutes Social Stories 30 Minutes Questions, Handouts 5-10 Minutes About the Authors Gabriela Mariz and Quoc Le are both students in the School Psychology Graduate Program at California State University, Sacramento. Gabriela Mariz has a Masters in Education from California State University, Sacramento and is currently a School Psychologist Intern at Twin Rivers Unified School District. Quoc Le has a Masters in Education from California State University, Sacramento and is currently a School Psychologist Intern at Galt Joint Union Elementary School District and Galt Joint Union High School District. This workshop was developed to satisfy requirements for their Specialist in Education degrees. 75 Appendix C Presentation Handouts 76 Definition of Key Terms Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR): The standard diagnostic tool used by mental health professionals worldwide to promote reliable research, accurate diagnosis, and thus appropriate treatment and patient care. Qualitative impairment of social in social interactions: Marked impairment in the use of nonverbal behaviors such as eye contact, facial expression and body posture. Failure to develop peer relationships and a lack of social and emotional reciprocity. Social skills: Set of skills that allow individuals to communicate, relate, and socialize with others. Restrictive, repetitive and stereotyped patterns of behavior, interests, and activities: Preoccupation of interests that is abnormal in intensity or focus; repetitive use of objects or phrases; excessive attachment to routines, objects and interests; repetitive motor mannerisms; and inflexible adherence to routines or rituals. Adaptive Behavior: Age-appropriate behaviors that are necessary for independent living and functioning safely and appropriately in daily life. 77 What do cognitive strengths and weaknesses look like in the classroom? Strengths Weaknesses 78 What do deficits in social communication and social skills look like in the classroom? Subject/Task/Activity Deficits/Difficulty 79 Self Evaluation for Group Assignments This self evaluation is designed to assist you in becoming aware of and participate in behaviors that should occur as you participate in group activities. It is also designed to help you think about how you can improve your social skills. Name: _________________________________________Date:____________________ Class: ________________________ Assignment/Project: _________________________ Social Skill Never Sometimes Often How can I improve? What can I do differently? Did I participate in group discussion? Did I allow others to contribute ideas? Did I listen to group members? Did I look at group members when they spoke? Did I encourage others to participate? Did I follow all directions? Did I do my share of the work? Did I turn in assignment on time? Did I do good quality work? On this group assignment, I did well on: _____________________________________ ________________________________________________________________________ On this group assignment, I need to work on: ___________________________________ ________________________________________________________________________ 80 Teacher Checklist This checklist is designed to assist teachers in observing and monitoring classroom behaviors. Information gained by this checklist may be used to determine what appropriate classroom behaviors students and teachers should focus on. Name: __________________________________ Behavior Arrives to class on time Raises hand Participates in classroom discussion Works productively on classroom assignments Asks for help with specific problems Follows directions Works successfully with peers within small groups Is organized with classroom material and backpack Turns in homework on time Completes large projects on time Performs at student’s specific skill level Stays focused and is on-task Works well independently Date: _________________________ Never Sometimes Often How can I increase desired behavior? 81 Student Checklist This checklist is designed to assist you in becoming aware of the behaviors and task that should occur frequently within your classrooms. This checklist may be used to assist you in increasing appropriate classroom behaviors. Class/Subject: __________________________________ Behavior Do I arrive to class on time? Do I raise my hand when speaking? Do I participate in classroom discussion? Do I work productively on classroom assignments? Do I ask for help with specific problems? Do I follow directions? Do I work successfully with peers within small groups? Am I organized with classroom material and my backpack? Do I turn in homework on time? Can I complete large projects on time? Do I perform to the best of my abilities? Never Sometimes Date: ___________________ Often How can I improve? Who can help me? 82 Resources for Educators and Professionals Books on Aspergers Syndrome for educators and professionals Attwood, T. (1998). Asperger's Syndrome: A guide for parents and professionals. London, UK: Jessica Kingsley Publishers. Burrows, E.L., & Wagner, S.J. (2004) Understanding Asperger’s Syndrome: Fast FactsA guide to teachers and educators to address the needs of the student. Arlignton, TX: Future Horizones. Kluth, P. (2004). “You’re going to love this kid!-Teaching students with autism in the inclusive classroom (2nd Ed). Baltimoor, MD; Paul H. Brooks Publishing Co. Myles, B.S., Adreon, D. (2001). Asperger syndrome and adolescents: Practical solutions for school success. Shawnee Mission, KS: Autism Asperger Publishing. Myles, B. S., Adreon, D., Gitlitz, D. (2006). Simple strategies that work! Helpful hints for all educators of students with Asperger Syndrome, high-functioning autism, and related disabilities. Shawnee Mission, KS: Autism Asperger Publishing. Myles, B.S., Simpson, R.L. (2003). Asperger Syndrome: A guide for educators and parents. Austin, TX: Pro-Ed. Wagner, S. (2002). Inclusive programs for middle school student with Autism/Asperger’s Syndrome. Arlington, TX: Future Horizons. Wagner, S. (2009). Inclusive programming for high school students with Autism or Asperger’s Syndrome. Arlington, TX: Future Horizons. Winter, M. (2004). Asperger Syndrome: What teachers need to know. (2nd Ed.) London, UK: Special Needs Project. 83 Social Skills and Pragmatics Gray, C. & Attwood, T. (2010). The new social story book. Arlington, TX: Future Horizons. Martinovich, J. (2005). Creative expressive activities and Asperger’s Syndrome: Social and emotional skills and positive life goals for adolescents and young adults. London, UK: Jessica Kingsley Publishers. McAfee, J. (2001). Navigating the social world: A curriculum for individuals with Asperger's Syndrome, high functioning autism and related disorders. Arlington, TX: Future Horizons. Myles, B.S., Trautman, M.L., Schelvan, R.L., (2004). The hidden curriculum: Practical solutions for understanding rules in social situations. Shawnee Mission, KS: Autism Asperger Publishing Company. Stuart-Hamilton, I. (2005). An Asperger dictionary of everyday expressions. (2nd Ed.) London, UK: Jessica Kingsley Publishers. Winner, M. G. (2002). Inside out: What makes a person with social-cognitive deficits tick? London, UK: Jessica Kingsley Publishers. Bullying Beane, A.L. (1999). The bully free classroom: Over 100 tips and strategies for teachers K-8. Minneapolis, MN: Free Spirit Publishing. Dubin, N. (2007). Asperger Syndrome and bullying-strategies and solutions. London, UK: Jessica Kingsley Publishers. 84 Heinrichs, R. (2003). Perfect targets: Asperger Syndrome and bullying. Shawnee Mission, KS: Autism Asperger Publishing Co. Transitions Baker, J. (2005). Preparing for life: The complete guide for transitioning to adulthood for those with Autism and Asperger’s Syndrome. Arlington, TX: Future Horizons. Baker, J. (2006). The social skills picture book for high school and beyond. Arlington, TX: Future Horizons. 85 References Alcáantara, J. I., Weisblatt, E. J. L., Moore, B. C. J., & Bolton, P. F. (2004). Speech-innoiseperception in high-functioning students with autism or Asperger’s syndrome Journal of Child Psychology and Psychiatry, 45(6), 1107–1114. American Psychiatric Association (2004). Diagnostic and statistical manual of mental disorders,text revision (DSM-IV-TR). Washington, DC: Author. 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