Bridging the Social Gap & Connecting Cultures:

Asperger’s

Lisa Hoang, LMHCRose 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

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

Cultural Awareness

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.

Multicultural Approach

Increasing cultural awareness means to see

both the positive and negative aspects of cultural differences – celebrating discovery

Degrees of Awareness 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”

Cultural Awareness

Let’s Travel ….

Right Click Here to Open the Hyperlink to the Video: Asperger's High - Coming This Fall on the CW!

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)

Discover Differences

Discover Differences

Aspergers Left Handed

Neurotypicals Right Handed

Neurotypicals are BetterFALSE

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

Cat People41%

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 people74%

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

naive and gullible

unaware of others' feelings

unable to carry on conversation

easily upset by changes

literal in speech and understanding

sensitive to loud sounds, lights, odors

fixated on one subject or object

physically awkward in sports

very accurate memory for details

trouble understanding things they have heard or read

inappropriate body language & expression

repetitive and irrelevant comments

unusually loud, high or monotonous voice

rock, fidget or pace while concentrating

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

Heightened focus on details rather than

wholes 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)

Central Coherence

Central Coherence

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

Tips

Let’s Experience

Group IGroup II

Group I

Group II

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

Theory of Mind

Theory of Mind

Teach using visuals Learn Check-ins Educate purpose of

Small talk & Practice (smart talk)

Role Playing Feedback from peers Repetition, Repetition,

Repetition

Tips

Theory of MindSocial Need Perspective

Challenges in Executive Functioning suggests that the

cognitive process makes it difficult to execute some practical living functions.

Some examples: 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).

Executive Functioning

Executive Functionin

g

Visuals (i.e. lists, charts)

Memory Techniques Technology Clear, Short & Sweet Routine/Repetition Sleep

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 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

Social Integration Model

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.

How Does It Work

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.

Benefits of Social Integration

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

Real Life – Real Time – Relevant

Social Integration Model for Aspergers

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

Social Integration Model

Experience, Exposure,

Opportunity

Hunter Sage

Colors of Development

Hunter– His Story

Felt different Emotionally Reactive Poor sense of self Direct and Blunt Loves animals Unable to follow-

through with goals Kicked out of multiple

schools Unable to complete

college Unable to go to a

restaurant with family

“The basement couch is my future!”

Hunter Colors of Development

Feels connected Lengthened the

fuse Loves animals -

Career Follow through

with goals Can go out to

eat with family

Sage Her Story

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

“I belong in a special farm for special people who get fake jobs to help them feel that they have purpose.”

SageColors of Development

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"

Cultural Awareness Social Differences DSM / Clinical Education Social Integration Model Examples of individual development

Now ….. Back to Purpose

Another View

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

A Different Perspective …Celebrate Differences

Become Culturally Aware Educate and Share with others

(key stakeholders) Self Explore (who needs Tx – video

game ex) Practice (Our Way)

Enrich Yourself

The Ode to the Autistic Man by Scott Lentine

Try to understand the challenges that I faceI would like to be accepted as a human in all places

Where I will end up in life I don’t knowBut I hope to be successful wherever I go

I would like to expand my social skills in lifeMaking new friends would be very nice

Stand proud for the autistic manFor he will find a new fan

I hope to overcome the odds I face todayIncreased acceptance will lead me to a brighter day

By the age of 20, I will have made tremendous stridesI know in the future, life will continue to be an interesting ride

I have made new friends by the yearI will be given tremendous respect by my family and peers

I hope to get noted for bringing the issue of autism to the common manSo that autistic people can be accepted in this great land

Stand proud for the autistic manFor he will find a new fan

I hope to overcome the odds I face todayIncreased acceptance will lead me to a brighter day

Enrich Yourself

Bridging the Gap & Connecting

Cultures

“Strangers in a new culture see only what they know” – Unknown

Become Aware …. Discover

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

Resources

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>.

References