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Lisa Hoang, LMHC Rose Augustine, MA Pasadena Villa Network of Services.

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Presentation on theme: "Lisa Hoang, LMHC Rose Augustine, MA Pasadena Villa Network of Services."— Presentation transcript:

1 Lisa Hoang, LMHC Rose Augustine, MA Pasadena Villa Network of Services

2 The Stuff People Say... Right Click Here to Open the Hyperlink to the Video: Stupid SH*T that people say to Aspies

3 Cultural Awareness Preparing for Discovery

4 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

5 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

6 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

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

8 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

9 Aspergers Left Handed Neurotypicals Right Handed

10 Neurotypicals are Better FALSE Right Click Here to Open the Hyperlink to the Video: ADAM - Theatrical Trailer

11 Aspergers and Neurotypicals: Social Differences Men are from Mars Women are from Venus Cat People 41% Loner – More likely to be solitary Affection typically displayed on cats terms During stress/moments of fear cats tend to hide/isolate Cats wont learn from punishment – they will avoid the source (discover wants). Arduous to train Dog people 74% Pack animal Look for and reciprocate affection During stress/moments of fear dogs protect & approach Dogs can learn from punishment Easy to train

12 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

13 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

14 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

15 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

16 Group I Group II

17 Group I

18 Group II

19 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 ones own and an inability to intuitively guess what these might be Theory of Mind

20 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 anothers perspective, predict outcomes and decipher intentions Difficulty generalizing tasks to everyday situations Theory of Mind

21 Teach using visuals Learn Check-ins Educate purpose of Small talk & Practice (smart talk) Role Playing Feedback from peers Repetition, Repetition, Repetition Tips

22 Theory of Mind Social Need Perspective

23 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

24 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

25 Visuals (i.e. lists, charts) Memory Techniques Technology Clear, Short & Sweet Routine/Repetition Sleep Tips

26 Awarness Perception He/She doesnt care – has No Empathy He/She doesnt care – they never listen or pay attention He/She doesnt 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

27 Awareness Right Click Here to Open the Hyperlink to the Video: Neurotypical documentary trailer

28 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

29 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

30 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

31 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

32 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

33 Social Integration Model Experience, Exposure, Opportunity

34 Hunter Sage Colors of Development

35 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!

36 Hunter Colors of Development Feels connected Lengthened the fuse Loves animals - Career Follow through with goals Can go out to eat with family

37 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.

38 Sage Colors 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"

39 Cultural Awareness Social Differences DSM / Clinical Education Social Integration Model Examples of individual development Now ….. Back to Purpose Another View

40 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 ones 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

41 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

42 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

43 Become Culturally Aware Educate and Share with others (key stakeholders) Self Explore (who needs Tx – video game ex) Practice (Our Way) Enrich Yourself

44 The Ode to the Autistic Man by Scott Lentine Try to understand the challenges that I face I would like to be accepted as a human in all places Where I will end up in life I dont know But I hope to be successful wherever I go I would like to expand my social skills in life Making new friends would be very nice Stand proud for the autistic man For he will find a new fan I hope to overcome the odds I face today Increased acceptance will lead me to a brighter day By the age of 20, I will have made tremendous strides I know in the future, life will continue to be an interesting ride I have made new friends by the year I will be given tremendous respect by my family and peers I hope to get noted for bringing the issue of autism to the common man So that autistic people can be accepted in this great land Stand proud for the autistic man For he will find a new fan I hope to overcome the odds I face today Increased acceptance will lead me to a brighter day Enrich Yourself

45 Strangers in a new culture see only what they know – Unknown Become Aware …. Discover

46 Organizations Advancing Futures for Adults with Autism Center for Autism and Related Disabilities Autism Speaks CARD AANE Websites 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

47 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." Sacramento Aspergers Syndrome Information and Support. Web Attwood, Tony. "What is Asperger's Syndrome?." Tony Attwood, n.d. Web. Pasadena,. "Social Integration Model." 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.. References

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