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Asperger Syndrome Rethinking the Glass House Rule.

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Presentation on theme: "Asperger Syndrome Rethinking the Glass House Rule."— Presentation transcript:

1 Asperger Syndrome Rethinking the Glass House Rule

2 Dimitri Martin: Glass House Rule Video clip

3 Complexity: Have things changed? Are students really more challenging or are there other explanations? 1) High rates of symptom similarity between Asperger’s and EI (inattention, obsessive-compulsive behaviors, anxiety, impulsivity). 2) Students with EI are being labeled ASD because of better services, less stigma, problematic evaluation methods, overly broad ASD criteria, etc. 3) Students with AS were mislabeled in the past as EI, but are now properly labeled ASD (hence "EI" type behaviors may be characteristic of both populations) 4) Similar etiology and risk factors for ASD and EI (genetic risks, pregnancy/ birth complications, prenatal exposure) 5) More students are being served in general education settings

4 Complexity Perhaps student profiles and behaviors are becoming more complex… The Real Question… What is your professional and ethical responsibility?

5 Understanding Asperger Syndrome Research – Yale Video clip

6 Understanding Asperger - Research Break in the brain Cannot figure it out Cognitive ability does not = social skill development Not holding back on social skills Activity: Conversation without looking at the person’s eyes

7 Aspergers – Seeking guidance from someone who probably knows what to do is usually not a first or even a second thought. The student with Aspergers might be sitting next to someone who could obviously help but appears blinkered and determined to solve the problem by himself. Atwood, 2007

8 Fat lady in the grocery store Student with Aspergers remarks in his usual tone of voice and volume, “That lady is fat and needs to go on a diet” The child’s opinion is that she should be grateful for the observation and advice, the likelihood that his mother will be embarrassed or the woman would be offended at such a rude comment is not part of the thinking process. Atwood, 2007

9 The Truth Video clip

10 “People expect cognition and social functioning to be equally developed. When kids with Asperger’s Syndrome experience difficulty they [public] wrongly assume it is deliberate misconduct.” (A. Klin and F. Volkmar, 1997)

11 Cerebellum Limbic System Cerebrum Amygdala Progression of Etiological Theories BRAIN research... Looking at brain differences Corpus Collosum

12 Cerebellum Limbic System Amygdala Cerebrum Corpus Collosum Hippocampus Basal Ganglia Brain Stem BRAIN RESEARCH... Looking at brain differences

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14 Purkinje Neurons

15 Limbic System

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17 Amygdala-Brain’s Fear Center November 22, 2006: Study (Davidson, Univ. of Wisconsin) confirms reduced size of amygdala in most socially withdrawn individuals with ASD. –Starts hyperactive and enlarged –Shrinks over time (toxic adaptation) which correlates with length of eye contact and general fear of, withdrawal from, people.

18 Amygdala, Cont. Small amygdala: significantly slower in identification of happy, angry, sad facial expressions. –Spent least amount of time looking at eyes relative to other facial regions. Smallest amygdala: 40% longer to recognize emotional expressions. Largest amygdala: looked at eyes 4 times longer than smaller amydgalae.

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20 Cerebrum (Cerebral Cortex)

21 Corpus Collosum

22 Neurons Mirror Neurons: A study by UCLA neuroscientists (Dapretto et al)UCLA featuring functional MRI suggests that mirror neurons help people understand the intentions of others – a key component to social interaction. Faulty? Not cued into them? Cell-Adhesion Molecules: Help brain cells connect (Hakonarson, 2009, Center for Applied Genomics at Children’s Hospital of Philadelphia)

23 Yawning Study Current results suggest that contagious yawning is impaired in ASD, which may relate to their impairment in empathy. It supports the claim that contagious yawning is based on the capacity for empathy. Senju, et al, 2007

24 Cognitive Differences Cognitive development typically ranges from average to very superior IQ. Difficulties may include: –Difficulty shifting attention –Difficulty processing two cognitive tasks simultaneously –Generalizing information –Retrieving information on demand –Developing problem-specific solutions –Difficulty with sense of time

25 RED BLUE BLACK YELLOW PINK GREEN WHITE RED PURPLE ORANGE BLUE BROWN GRAY PINK GREEN BLUE BLACK YELLOW RED

26 PROBLEM SOLUTION J.Janzen, Understanding the Nature of Autism

27 SOLUTION PROBLEM J.Janzen, Understanding the Nature of Autism

28 Studies have suggested at least 75% of children with Aspergers also have a profile indicative of ADHD. Difficulty with four aspects of attention: –Ability to sustain attention –Attention to relevant information –Shifting attention –Storing/encoding information (episodic vs. semantic memory) Attention Attwood, 2007

29 Executive Functioning Research confirms that some children, but especially adolescents and adults with AS, have impaired executive functioning. Elementary: Difficulty with: Inhibition (age 8) working memory using new strategies Middle School and older: Additional difficulties with: organization and planning self-reflection and self- monitoring (mental conversations) time management and prioritizing understanding abstract concepts weak central coherence Attwood, 2007

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32 Things to think about One guy vs. “thousands/billions” –Neurons –Inefficient, slow retrieval –Misfilings Shredder –Can’t “forget” any information –Can’t differentiate between important & non-important information Microphone –Isn’t used much (visual stronger than auditory) –Uses the big computer screen Memory storage—no sound Power Cords Brain Bacteria –Interferes with storage of information Different Levels of Storage Daydreaming (processing?)

33 Activity: Executive Functioning O T T F F S S

34 Look Me in the Eye Clip (CD 6 – 09) – Planning for human contact Self-reflection Self-monitoring Understanding abstract concepts –“Woof” Because of the executive functioning differences, social interaction becomes a cognitive task

35 Cognitive Inflexibility Difficulty with change Insistence on sameness Rule-governed Routines/rituals Concrete thinking Difficulty letting go of thought and ideas Over-focus on details (weak central coherence)

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37 Create rigid rule structures to make order in ambiguity Playing with toys for young children and the child molester “NO LEFT TURNS!” Men go to bars and women are maids “Jocks”, “People that don’t make good decisions” and “friends” Pass four red cars and it’s a good day Blue gel pen = good assignment Grocery Store Scenario Exchanging Christmas presents

38 How do you navigate cultural expectations? Taarof (Iranian Politeness) –How would you handle the picture problem? –What about the ice issue? –Would you know what to do?

39 Cognitive Strengths Processing whole chunks of information quickly Good rote memory Good long-term memory Process visual information meaningfully Understand and use context-free information and rules

40 Learning Characteristics of ASD Uneven skill development Tends to resist change in learning environment Difficulty generalizing skills/information Difficulty with abstract concepts Relies on cues and learned routines May tend to function more reliably with consistency and structure within activities and environments

41 Learning Characteristics of ASD Organizational issues Focus on unimportant information Difficulties processing multiple sensory input under certain conditions Difficulty seeing the “big picture” Over-selectivity Good long-term and rote memory Prefers sequences and routines May demonstrate desirable persistence with a task if motivated Tendency toward literalness – difficulty with multiple meaning word

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43 “Numbers” This American Life Meet Jerry—Adult with Aspergers

44 My Response… The most powerful idea that strikes me after hearing this clip is… 3 things that I will accept in students with Aspergers and no longer try to change…

45 Theory of Mind (ToM) means the ability to recognize and understand thoughts, beliefs, desires and intentions of other people in order to make sense of their behaviour and predict what they are going to do. (Atwood, The Complete Guide to Aspergers Syndrome, 2007)

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48 Experts on people Experts on things birth Normal ASD Developmental Trajectories

49 Theory of Mind: Perspective Taking and Reciprocity “Mind reading” ability is located in the orbito-frontal cortex-superior temportal sulcus-amygdala area of the brain. Winning/losing concept difficult Difficult to engage in manipulation Difficult to engage in lying

50 Maturation The ability to understand the value of deception and recognize when it might be expected occurs later in the development of the student with Aspergers, sometimes as late as early teens. This can cause confusion to parents and teachers, as the previously honest, (perhaps to a fault) child recognizes that one can deceive people and avoid anticipated consequences. However the type of deception can be immature and the deceit easily identified by an adult. Atwood, 2007

51 Travis and Lying Travis is 18 Years Old Drives and attends a typical high school Driving to school his check engine light came on Communicated in the best way he knew how Did not get any response Got a response…Is this Lying

52 Background Information Staff explained…they could not believe what Travis said anymore…He was constantly lying. Used white board…invited Travis into the meeting Put the word liar on the white board Travis said – “Everyone thinks I am a Liar” What was discovered by the facilitator and staff?

53 Travis’s Explanation

54 Travis’s Take on Things “Telling the truth is not good enough for the people” Translation – I need help and the staff does not help me “The wrecker is better because my car blew up” Translation – Ms. Black responded to the wrecker is coming because my car blew up but did not respond to my check engine light coming on

55 Time for a Change Most people with ASD will not wait until (the typical population - staff) perceives or does not perceive the situation as important as they do Most people with ASD are perceiving the problem right in front of them(right or wrong) a catastrophe Adults around students with ASD are saying words like “relax”…”not a big deal”… “we’ll get to that later” That does not work for this population. Students with ASD Want to - Solve the Problem

56 PROBLEM SOLUTION J.Janzen, Understanding the Nature of Autism

57 SOLUTION PROBLEM J.Janzen, Understanding the Nature of Autism

58 Maturation Lying and Asperger Syndrome Due to the impaired or delayed ToM abilities, the person with Aspergers may not realize that the other person is likely to be more offended by the lie than by any apparent misdemeanor He may consider that a lie can be a way of avoiding consequences or a quick solution to a social problem Maintaining self esteem should he have an arrogant self image whereby the making of mistakes is unthinkable. Atwood, 2007

59 Typical children, especially after the age of five years, are remarkably astute at perceiving and understanding social cues that indicate thoughts and feelings. (Michelle Garcia, 11-08) Parents nor educators teach these skills Parent and educators only notice when these skills are not present The lack of these skills makes students and adults uncomfortable Zero productive social skills curriculum developed

60 It is as though their mind prioritizes social cues above other information in their environment and they have a mental theory as to what the social cues mean and how to respond. (Michelle Garcia, 11-08) Minds of typically developing students work differently Lack of the prioritization of social skills Lack of a mental theory Eric example Resulting response? How does this manifest in a student you know?

61 This ability dominates the perception of typical people to such a degree that we become anthropomorphic and project human social behaviour on animals and even objects. (Michelle Garcia, 11-08) Anthropomorphic - Attribution of human motivation, characteristics, or behavior to inanimate objects, animals, or natural phenomena. Factual or predictable information dominates the Asperger’s Population

62 Applying Human Emotions to Inanimate Objects – American Express Video clip

63 Calvin and Hobbs

64 Social Attribution Task

65 S.A.T. Study – Aspergers Significant differences Typical –Chasing, entrapping, and playing –Frightened, elated or frustrated Aspergers: Different terms to explain movement of shapes –Bouncing or oscillating vs. bravery or elation –Narratives – shorter with less elaborate plots –Fewer, more simplistic personality attributions –Focus on physical aspects of objects

66 Attribution Theory Every day we must guess how people will act, often from small shreds of evidence. We do this through a form of social cognition called attribution. As we observe others, we make inferences about them. We attribute people’s behavior to various causes. Whether we are right or wrong about the causes of their behavior, our conclusions affect how WE act.

67 Attribution In 2005, in the aftermath of hurricane Katrina, many celebrities went to New Orleans to help hurricane victims. As you watched these events, did you: Attribute the celebrities’ actions to selfless concern for the suffering in New Orleans? OR Were the celebrities motivated by a selfish desire to hog the limelight?

68 Attribution Theory Two people enter a restaurant and order different meals. Nell tastes her food, then salts it. Bert salts his food before he tastes it. How would you explain their behavior? Introduction to Psychology: Gateways to Mind and Behavior: Twelfth Edition, 2010 Cengage Learning, Inc.

69 Fundamental Attribution Error (It IS human nature!) Attribution Theory Erroneous cognitive tendency Over-value dispositional-based explanation for behaviors of others Under-value potentiality of situational explanations for behavioral motives of others We predominantly presume that the actions of others are indicative of the "kind" of person they are, rather than the kind of situations that compel their behavior.

70 An attribution is an inference about why an event occurred. More generally, "attribution is a process that begins with social perception, progresses through a causal judgment and social inference, and ends with behavioral consequences." (Crittenden 1983)

71 Professional Responsibility Path APath B ??

72 What do you attribute her behavior to? Video clip

73 Attribution Going to have prejudices/attribution errors Lack of social skills – negates any viable opportunities Oddity about social characteristics Physical appearance Perceived cognitive ability Are we going to be embarrassed? Is she going to embarrass herself? Make people uncomfortable

74 Susan Boyle Video clip

75 What made you change what you attribute her behavior to? She Started Singing Strengths Outweighed Public Perception

76 Susan Boyle: Behavior Didn’t Change Walks off stage without results Doesn’t understand she won by reactions Wake up call Shut down the cynicism in the audience We are going to make attributions and attribution errors

77 Doesn’t Change Issues Required Hospitalization Continued Difficulty with Social Situations Support Person – Britain’s Got Talent Greater Societal Understanding – Because of Talent What would have happened to her without discovery of her talent? Continued sneers and judgment of her lack of social understanding

78 Students with Aspergers Have Strengths and Talents How will we respond? Will we give them a chance and overcome our own attribution errors? Will we be judgmental and attribute their behaviors to their own control?

79 My Response… Three things I will do when I am faced with my own attribution errors…three self-checks to precorrect my own judgements… I will stop expecting the Susan Boyles of the world to prove themselves first by…

80 Michigan Definition to Determine Eligibility for ASD Qualitative Impairments in Reciprocal Social Interactions: 2 of 4 areas Qualitative Impairments in Communication: 1 of 4 areas Restricted, Repetitive and Stereotyped Behaviors: 1 of 4 areas

81 What Do You Attribute the Student’s Focus and/or Intensity of Interest Area To? Pick Student: To what to you attribute focus and/or intensity of interest area? Worksheet Collin – Dinosaurs

82 Fundamental Attribution Error Collin - Outcomes Path APath B Likely outcomes for Collin if his behavior is attributed to Aspergers and the situational context?? Likely outcomes for Collin if my attribution is dispositional based?? Cut the projector screen and leaf on plant; Pulled down his pants to show peers his underwear

83 Fundamental Attribution Error Collin - Outcomes Path APath B Showing Dinosaur Dinosaur Scissors Sexual Harassment Property Destruction Cut the projector screen and leaf on plant; Pulled down his pants to show peers his underwear

84 An attribution is an inference about why an event occurred. More generally, "attribution is a process that begins with social perception, progresses through a causal judgment and social inference, and ends with behavioral consequences" (Crittenden 1983)

85 Intense Interests – Struggling with Life Video clip

86 Focus and/or Intensity of Interest Area The special interest has several functions: a. To overcome anxiety b. To provide pleasure c. To provide relaxation d. To ensure great predictability and certainty in life e. To help understand the physical world f. To create an alternative world g. To create a sense of identity h. To occupy time, facilitate conversation and indicate intellectual ability (Atwood, 2007)

87 Professional Responsibility Student’s Focus and/or Intensity of Interest Your Own StudentStudent’s Focus and/or Intensity of Interest Your Own Student Path APath B ??

88 Michigan Definition to Determine Eligibility for ASD Qualitative Impairments in Reciprocal Social Interactions: 2 of 4 areas Qualitative Impairments in Communication: 1 of 4 areas Restricted, Repetitive and Stereotyped Behaviors: 1 or 4 areas

89 What Do You Attribute the Student’s Communication Issues To? Pick Student: To what to you attribute communication difficulties? Worksheet Jarod—Facial Hair

90 Fundamental Attribution Error Jarod - Outcomes Path APath B Likely outcomes for Jarod if his behavior is attributed to Aspergers and the situational context?? Likely outcomes for Jarod if my attribution is dispositional based?? Told the teacher he liked her moustache

91 Fundamental Attribution Error Jarod - Outcomes Path A Path B Intense questioning about facial hair Question about female teacher’s moustache Lack of understanding Making Fun of Teacher Disrespectful 10 Days Suspension Told the teacher he liked her moustache

92 An attribution is an inference about why an event occurred. More generally, "attribution is a process that begins with social perception, progresses through a causal judgment and social inference, and ends with behavioral consequences" (Crittenden 1983, p. 426).

93 Look Me in the Eye - Communication

94 Pragmatic Language (Social Communication) Pedantic, formal –In this economy… –Calculate my percentage… –When in a rare conflict… Difficulty with relinquishing conversational turn-- prompts Limited understanding of conversational partner (interest, cues, topic appropriateness) Tone of voice (often perceived as disrespectful) Literal use of Language

95 Attribution Error of Communication Mozart and the Whale – Breaking Records Video clip

96 Ordering/ReOrdering Secretaries Name Baiba Bunny Bev Blanche June What is wrong with this place? Get a normal name At least they could all start with the same letter

97 Professional Responsibility Student’s Communication Your Own Student Student’s Communication Your Own Student Path APath B ??

98 Michigan Definition to Determine Eligibility for ASD Qualitative Impairments in Reciprocal Social Interactions: 2 of 4 areas Qualitative Impairments in Communication: 1 of 4 areas Restricted, Repetitive and Stereotyped Behaviors: 1 or 4 areas

99 What Do You Attribute the Student’s Social Skill Differences To? Pick Student: To what to you attribute focus and/or intensity of interest area? Worksheet Jacob – Student attention

100 Fundamental Attribution Error Jacob - Outcomes Path APath B Likely outcomes for Jacob if his behavior is attributed to Aspergers and the situational context?? Likely outcomes for Jacob if my attribution is dispositional based?? Tickled peers on the back of the neck

101 Fundamental Attribution Error Jacob - Outcomes Path A Path B Desperately wanted to Interact with Kids Tickle Back of Necks Trying to Fit In Incompatible Response Tried Even Harder Targeting Students Aggressive Toward Peers Change of Classroom Feared by Others Threat of 10 Days Suspension Tickled peers on the back of the neck

102 An attribution is an inference about why an event occurred. More generally, "attribution is a process that begins with social perception, progresses through a causal judgment and social inference, and ends with behavioral consequences" (Crittenden 1983, p. 426).

103 Look Me in the Eye: Social Reciprocity

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105 Problems with Reciprocity (ToM) Difficulty explaining own behaviors Difficulty understanding emotions Difficulty predicting how others feel or think Problems understanding the perspectives of others Problems inferring the intentions of others Failure to understand that behavior impacts how others think and/or feel Problems with social conventions such as turn-taking, politeness, and social space

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107 Attribution Error of Social Reciprocity Mozart and the Whale - McDonalds Video clip

108 Reciprocity Use of nonverbals (eye gaze, gestures, modulation of voice) Understanding emotions of self and others –“G Force” –“I feel lonely when I’m lonely. How can I describe it further?” –Getting tissues for boys Shifting back to own topic (Anyways, Guess what?)

109 At their core, they want to fit in and have friends Try to orchestrate the relationship with others Do what they want to do Others do not make sense Swearing/authority issues Vulnerable Isolating Social injustice

110 Big Bang Theory - Friendship Video clip

111 Continuous Failure in… Trying to follow the rules Trying to get others to follow the rules Trying to understand nuances Generalizing information Making friends Leads to behavior or worse

112 Struggling with Life – Birthday Party Video clip

113 PROBLEM SOLUTION J.Janzen, Understanding the Nature of Autism

114 SOLUTION PROBLEM J.Janzen, Understanding the Nature of Autism

115 Maturation Lying and Asperger Syndrome Due to the impaired or delayed ToM abilities, the person with Aspergers may not realize that the other person is likely to be more offended by the lie than by any apparent misdemeanor He may consider that a lie can be a way of avoiding consequences or a quick solution to a social problem Maintaining self esteem should he have an arrogant self image whereby the making of mistakes is unthinkable. Atwood, 2007

116 Struggling with Life – Giving Up Video clip

117 Professional Responsibility Student’s Social Skills Your Own StudentStudent’s Social Skills Your Own Student Path APath B ??

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119 Reflection Big Ideas

120 Thanks For Your Time!


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