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Minds and Hearts Herlev 26-27 May 2011 www.mindsandhearts.net
The Minds and Hearts Clinic
Cognition in Asperger’s Syndrome/ High Functioning Autism
Programme <ul><li>Verbalizers and Visualizers </li></ul><ul><li>Reading and Mathematics </li></ul><ul><li>Attention proble...
A Different Way of  Perceiving, Thinking and Learning
<ul><li>Two reasons to attend school, to learn and to socialize.  </li></ul><ul><li>If the child with Asperger’s syndrome ...
A different way of learning <ul><li>Many children with Asperger’s syndrome: </li></ul><ul><ul><li>perform at the extremes ...
Verbalizers <ul><li>About 50 per cent of children with Asperger’s syndrome have relatively advanced verbal reasoning skill...
Visualizers <ul><li>About one in five children with Asperger’s syndrome Asperger’s syndrome has relatively advanced visual...
Curriculum on CD-Rom
Reading and Mathematics <ul><li>One in five children have a problem with reading. </li></ul><ul><li>Nearly 50% have proble...
Reading and Mathematics <ul><li>Numbers can be perceived as shapes not quantity. </li></ul><ul><li>Difficulty explaining i...
Similarities to Attention Deficit Disorder <ul><li>At least 75 per cent of children with Asperger’s syndrome also have a p...
All Components of Attention <ul><li>The ability to sustain attention. </li></ul><ul><li>Pay attention to relevant informat...
Executive Function <ul><li>organizational and planning abilities  </li></ul><ul><li>working memory  </li></ul><ul><li>inhi...
Need an Executive Secretary
One Track Mind
<ul><li>Train track. </li></ul><ul><li>One-track mind.  </li></ul><ul><li>The last to know and seek help if they are on th...
<ul><li>Continue using incorrect strategies and not learning from mistakes. </li></ul><ul><li>Compulsion for completion (s...
Fear of Making a Mistake <ul><li>Don’t try, you don’t make a mistake. </li></ul><ul><li>Fear of appearing stupid and being...
Fear of Making a Mistake <ul><li>Fear of failure leads to a need to be right </li></ul><ul><li>Criticise to feel good abou...
Coping With Mistakes <ul><li>Perfectionist. </li></ul><ul><li>Self-perception as an adult. </li></ul><ul><li>Cognitive sty...
Strategies <ul><li>In play and learning, an adult’s ability is not perfect. </li></ul><ul><li>Model how to cope with frust...
Strategies <ul><li>Approach an error as an opportunity and data. </li></ul><ul><li>Alternative options. </li></ul><ul><li>...
Consistency and Certainty <ul><li>Drive to seek consistency and certainty. </li></ul><ul><li>Appeal of mathematics and sci...
Preparation for Change <ul><li>Explanation, preparation and reassurance. </li></ul><ul><li>Social Stories. </li></ul><ul><...
Organised and Structured <ul><li>Sequence of activities. </li></ul><ul><li>Boxes or pictures. </li></ul><ul><li>What to do...
Weak Central Coherence <ul><li>Remarkably good at attending to detail but appear to have considerable difficulty perceivin...
Practical Example <ul><li>Room split into 2 groups </li></ul><ul><li>Group one to close their eyes, the other group to see...
Group 2 Eyes open
Group 1 open eyes, group 2 Close Eyes
Seen by Group 1
<ul><li>What was the room? </li></ul><ul><li>What was the time? </li></ul>
 
 
Visual Acuity Ashwin et al <ul><li>Used the Freiburg Visual acuity and Contrast Test </li></ul><ul><li>15 adult males with...
<ul><li>Noticing patterns not perceived by others. </li></ul><ul><li>Walking into a strange room. </li></ul><ul><li>Attent...
 
Therese Jolliffe <ul><li>Reality to an autistic person is a confusing, interacting mass of events, people, places, sounds ...
Donna Williams <ul><li>I loved to copy, create and order things.  I loved our set of encyclopaedias.  They had letters and...
Donna Williams <ul><li>I was exploring the concept of consistency.  It may have seemed that my world was upside down, but ...
Social Cognition <ul><li>Noticing objects and facts rather than thoughts, feelings and intentions. </li></ul>LDA Language ...
LDA Language Cards: Emotions Descriptions of pictures and events may not include thoughts and feelings.
 
 
Faulty Logic  Gunilla Gerland. <ul><li>I very much wanted to understand and that led me to think up something, a theory ab...
Gunilla Gerland <ul><li>What if that meant I had to be in the hall for her to come out at all? That’s what it was. That mu...
Gunilla Gerland <ul><li>I had actually never seen my mother in any other room except the hall, so I associated her appeara...
Gunilla Gerland <ul><li>Every thing had to hang together in some logical way and now I had probably found it: as long as I...
Social Stories <ul><li>Explore when and how the faulty logic started </li></ul><ul><li>Use Comic Strip Conversations and S...
Asperger Friendly Classroom Motivation <ul><li>Completion </li></ul><ul><li>No errors </li></ul><ul><li>Special interest <...
Classroom <ul><li>Quiet, well-structured classroom. </li></ul><ul><li>Avoid sensory overload.  </li></ul><ul><li>Minimal c...
Classroom <ul><li>A work station or ‘office’. </li></ul><ul><li>A ‘to do’ list.  </li></ul><ul><li>Extra time to complete ...
The Knowledge and Personality of the Teacher <ul><li>These children often show a surprising sensitivity to the personality...
 
<ul><li>Teachers who show an empathic understanding of the child.  </li></ul><ul><li>Are flexible in their teaching strate...
Nita Jackson  <ul><li>Mr Osbourne was always bubbly and ready to make a light-hearted joke out of anything. He rarely got ...
Hans Asperger <ul><li>While demonstrations of love, affection and flattery are pleasing to normal children and often induc...
Stress and Mental Exhaustion <ul><li>The education and social curriculum. </li></ul><ul><li>Absence of real breaks. </li><...
Homework <ul><li>Planning, prioritizing, time management, flexible thinking, distraction, working memory. </li></ul><ul><l...
Strategies <ul><li>Create a learning environment. </li></ul><ul><li>Homework timetable and diary. </li></ul><ul><li>Time a...
Teachers’ Preparation of Homework <ul><li>High-light key aspects. </li></ul><ul><li>Help formulate a plan, especially with...
Memory Problems <ul><li>Small audio recorder. </li></ul><ul><li>Contact another child. </li></ul>
Supervision <ul><li>Getting started. </li></ul><ul><li>Procrastination and distraction. </li></ul><ul><li>Advice. </li></u...
Alternative Options <ul><li>Homework in school time. </li></ul><ul><li>Homework tutor. </li></ul><ul><li>Duration of homew...
<ul><li>Pruning the High School Curriculum. </li></ul>
Talents and Interests  A Tree Growing in a Forest Clearing
<ul><li>Mechanical ability </li></ul><ul><li>Mathematics </li></ul><ul><li>The Arts and Music </li></ul><ul><li>Imaginatio...
“ If the world was left to you socialites, we would still be in caves talking to each other” Temple Grandin
Association With Famous Individuals in Science and Art <ul><li>Ludwig Wittgenstein. </li></ul><ul><li>Albert Einstein. </l...
Making Friends Strategies to improve social understanding and friendship skills
“  The nature of these children is revealed most clearly in their behaviour towards other people. Indeed, their behaviour ...
Solitude <ul><li>The diagnostic criteria dissolve in solitude.  </li></ul><ul><li>Solitude is an effective emotional resto...
Stages in Friendship <ul><li>1. Physical world. </li></ul><ul><li>2. Wanting to have friends. </li></ul><ul><li>3. Functio...
 
Social Impairment <ul><li>Maturity in friendship skills. </li></ul><ul><li>Limited vocabulary for characterization. </li><...
French Driver
Please draw me a picture of your classroom or your playground?
9 Year old boy with Asperger’s syndrome: Classroom
8 Year old girl with Asperger’s Syndrome: Playground
10 year old girl with Asperger’s syndrome: Playground
8 Year old boy with Asperger’s syndrome: Playground
What is unusual about each of these drawings?
6 year old sister of 8 year old boy with Asperger’s syndrome: Playground
7 Year old boy with Asperger’s syndrome: Classroom
His 5 year old sister: Classroom
Girl with Asperger’s syndrome: Playground
Encourage Friendship Skills <ul><li>Behavioral strategies of observation and recording, task analysis, cues, prompting and...
Social Stories <ul><li>Start with a story about a social success. </li></ul><ul><li>Half of Social Stories to record socia...
Level 1: Approximately 3 to 6 Years <ul><li>Recognition of sharing and turn taking. </li></ul><ul><li>Friend has toys the ...
Level 1: Approximately 3 to 6 Years <ul><li>Why is  ….. your friend? </li></ul><ul><li>“ He sits next to me.” </li></ul><u...
An Adult ‘Acting’ As a Friend <ul><li>Observe the natural play of the child’s peers, learn the games and rules. </li></ul>...
An Adult ‘Acting’ As a Friend <ul><li>What else could it be? </li></ul><ul><li>Video replay of social play scenes at schoo...
An Adult ‘Acting’ As a Friend <ul><li>‘ Follow my leader’ games. </li></ul><ul><li>Chasing and hiding games. </li></ul><ul...
An Adult ‘Acting’ As a Friend <ul><li>Watch other children as a model of what to do. </li></ul><ul><li>‘ Rent a friend.’ <...
 
Level 2: Approximately 6 to 9 Years <ul><li>Reciprocity and being fair. </li></ul><ul><li>Mutual assistance. </li></ul><ul...
Level 2: Approximately 6 to 9 Years <ul><li>Why is …. your friend? </li></ul><ul><li>“ She comes to my party and I go to h...
Level 2 <ul><li>Role play activities, rehearsal, feedback and rewards. </li></ul><ul><li>Social engineering (modelling and...
Books on Friendship ( www.tonyattwood.com.au )
Theory Of Mind Skills
 
 
A Social Story on Assistance <ul><li>Sometimes children help me. They do this to be friendly. Yesterday, I missed three ma...
Observation Schedule
Social Signals <ul><li>Road signs: Traffic lights  </li></ul>
Teacher Assistant: An anthropologist in the classroom <ul><li>Identify the relevant social cues </li></ul><ul><li>Guidance...
Level 3: Approximately 9 to 13 Years <ul><li>Aware of other’s opinion of them and how their words and actions affect the f...
Level 3: Approximately 9 to 13 Years <ul><li>Personality characteristics, audacious, humor. </li></ul><ul><li>Helps in tim...
Level 3: Approximately 9 to 13 Years <ul><li>Gender split. (Boy and girl activities). </li></ul><ul><li>Trust, loyalty and...
Books on Friendship
 
 
 
 
 
 
 
 
 
Friendship <ul><li>‘ Nerds’ </li></ul><ul><li>Social rebels </li></ul><ul><li>Unconventional children </li></ul><ul><li>I ...
<ul><li>Clubs. </li></ul><ul><li>Buddy system. </li></ul><ul><li>Team work program. </li></ul><ul><li>Drama classes. </li>...
Home Is a Castle
Moving to Manhood and Self-Identity
The Transition From Being a Child to an Adult <ul><li>Who am I? </li></ul><ul><li>Who do I want to become? </li></ul><ul><...
Moving to Manhood <ul><li>8 X 1.5 hour sessions + 1 follow-up at 2 months </li></ul><ul><li>13-17 year olds </li></ul><ul>...
2009-2010 <ul><li>Group 1: 2007 – 6 boys </li></ul><ul><li>Group 2: 2009 – 8 boys </li></ul><ul><li>Group 3: 2010 – 9 boys...
Session 1: Qualities in Abilities and Personality <ul><li>Introductions by way of career aspirations </li></ul><ul><li>Qua...
Examples <ul><li>Damon: Wolf: strong sense of family, yet strong individualistic urge, a pathfinder </li></ul><ul><li>Jame...
Session 2: Diminishing the Difficulties <ul><li>Executive Function (strategies from the participants) </li></ul><ul><li>An...
Session 3: Compliments and Criticism <ul><li>Why we say compliments </li></ul><ul><li>Compliments for specific people </li...
Session4: Self-Identity <ul><li>Exploring the future (self in 5 years) </li></ul><ul><li>Roving reporter (interviewing eac...
<ul><li>“ I AM” </li></ul><ul><li>Needlessly  Technical </li></ul><ul><li>Outwardly  Secretive </li></ul><ul><li>Inwardly ...
Session 5: Managing Anxiety –part 1 <ul><li>Why do we feel anxious? (neurology and survival) </li></ul><ul><li>Situations ...
Session 6: Managing Anxiety –part 2 <ul><li>An emotion toolbox </li></ul><ul><li>Physical, relaxation, social, thinking, t...
Session 7: Managing Anger <ul><li>What makes me angry </li></ul><ul><li>Tool box </li></ul><ul><li>Repairing the anger of ...
Session 8: Optimism <ul><li>What makes you feel sad? </li></ul><ul><li>Have you felt sad in the last week? </li></ul><ul><...
<ul><li>Stuart: character from Lethal Weapon who was very depressed and wanted to die. </li></ul><ul><li>Group responses: ...
Measurement <ul><li>Pre-, post- and follow-up at 2 months </li></ul><ul><li>We measured: </li></ul><ul><li>-Severity of AS...
Quantitative Results <ul><li>Self-concept: 6 changed in a positive direction (3, 3, 7, 7, 20, 21) Rest stayed same except ...
Qualitative Results <ul><li>All groups:attendance </li></ul><ul><li>Parents observations: </li></ul><ul><li>“ Following th...
Parents <ul><li>“ Malcolm (age 13) was able to look at the older guys and see himself in a different light and realize, “I...
The boys <ul><li>“ I learned there is more than one way to solve a problem.”  </li></ul><ul><li>“ Going through the group ...
The boys <ul><li>“ I would probably have gone on dateless for the rest of my life if I hadn’t learned about the importance...
The boys <ul><li>“ They all have bits of me. I have never had the opportunity to talk about these things” </li></ul><ul><l...
Asperger ’ s Syndrome in Girls and Women <ul><li>Only 1 in 20 of Hans Asperger’s clinical sample of children with autistic...
Pathways to a Diagnosis <ul><li>Diagnosis when at school due to concerns regarding friendships, the art of conversation, u...
Pathways to a Diagnosis <ul><li>Diagnosis of a relative with ASD and information parents read on Asperger’s syndrome leads...
Pathways to a Diagnosis <ul><li>Secondary disorder diagnosed in adolescence, such as an anxiety disorder, depression, Bord...
Pathways to a Diagnosis <ul><li>Problems with employment or relationships leads to a search for an explanation  for being ...
Profile of Abilities in Girls and Women <ul><li>The invisible end of the spectrum (Ruth Baker). </li></ul><ul><li>Fly unde...
Profile of Abilities in Girls <ul><li>Observe and try to understand before they make the first step. </li></ul><ul><li>Rea...
Profile of Abilities in Girls <ul><li>Apologise and appease </li></ul><ul><li>Chameleon </li></ul>
Profile of Abilities in Girls <ul><li>Less disruptive and so less likely to be noticed. </li></ul><ul><li>We think that if...
Characteristics from age 5-12 Years
Self-taught reader Advanced vocabulary
Play <ul><li>Doll play to replay and understand social situations. </li></ul><ul><li>I played with dolls until I was fourt...
Fascination with symmetry and order <ul><li>“ The fun came from setting up and arranging things. Maybe this desire to orga...
Gender Specific Toys  <ul><li>I loved playing with Lego for years and had many thousands as a child. I also loved cardboar...
Gender Specific Toys  <ul><li>I was given gender specific toys such as Barbie dolls but I did not play with them the same ...
Friendships <ul><li>Peer support (not bitchy). </li></ul><ul><li>Single friend who provides guidance and security. </li></ul>
Friendship Characteristics <ul><li>She doesn’t play with toys very often but if she does she lines things up and groups th...
Conversation <ul><li>I tend to be didactic and pedantic, and I strive for precision in an imprecise world. </li></ul><ul><...
A Tomboy <ul><li>Many stereotypical girls activities were stupid, boring and inexplicable. </li></ul><ul><li>It is more ac...
A Tomboy <ul><li>I was very much a tom boy (to my mother’s disappointment) and still have those tendencies, but I have alw...
A Tomboy <ul><li>It was easier to identify with boys because they just wanted to have fun. Girls had more social rules to ...
Reaction to Being Different <ul><li>I’m a foreigner forever trying to adapt to a new country. </li></ul><ul><li>I never se...
The Child ’ s Reaction to Being Different Before the Diagnosis <ul><li>Four reactions: </li></ul><ul><li>Depression and is...
Depression and Isolation <ul><li>Increased social withdrawal. </li></ul><ul><li>Reduced motivation and energy. </li></ul><...
Imagination <ul><li>Imaginary friends. </li></ul><ul><li>Inhabiting an imaginary world. </li></ul><ul><li>Interest in othe...
Arrogance <ul><li>Over compensation for feeling incompetent in social situations.  </li></ul><ul><li>Anyone can get a styl...
Arrogance <ul><li>Limited ability to accept they may be wrong. </li></ul><ul><li>Desperate not to appear stupid in a socia...
Imitation <ul><li>Observation and absorption of the speech, mannerisms and character, even persona of someone who is socia...
Imitation <ul><li>Learning how to act in real social situations. </li></ul><ul><li>I am an exceptional mimic and have used...
Imitation <ul><li>I have done such a great job at pretending to be normal that nobody really believes I have Asperger’s. <...
Teenagers
Adolescence <ul><li>Power of the peer group for self-esteem. </li></ul><ul><li>In high school, girls treated me like I was...
Recovery from Social Exhaustion <ul><li>It drains me mentally and physically. I am exhausted after having spent a lot of t...
Social Swimming <ul><li>I describe my social life with this analogy. Swimming in the water is nice at first, but if it goe...
The Mask <ul><li>Emily masks in public and will meltdown the second she is out of the situation. </li></ul><ul><li>Dr Jeky...
The Inner Self <ul><li>I don’t know who I am </li></ul><ul><li>I cannot communicate my inner self with those I want to. I ...
Conversation <ul><li>I have learned how to be polite to others and fake a conversation. But I am happiest with my three ca...
Emotions and the Special Interest <ul><li>My emotional range is quite extreme and somewhat rudimentary. However, when I en...
Clothing and Fashion <ul><li>Most of my clothing is gender-neutral. I generally don’t like dresses or skirts and find many...
Clothing and Fashion <ul><li>Girl clothes fit better, but I always try to find androgynous ones. </li></ul><ul><li>Guy clo...
Make Up and Perfumes <ul><li>I can’t stand the feel of foundation on my skin and eye makeup stings my eyes. I do wear lips...
Relationships <ul><li>I’m not really interested in pursuing a romantic relationship or being sexually attractive. The idea...
Relationships <ul><li>Expectations of affection and intimacy. </li></ul><ul><li>Sometimes it is hard to be intimate. </li>...
Sexuality <ul><li>I’m straight, but inside I’ve always felt mentally androgynous. Although I look very female. </li></ul><...
Sexuality <ul><li>I’m interested in alternative sexual expression/sado-masochism/leather fetishism. </li></ul><ul><li>I co...
High Functioning Autism and Celibacy <ul><li>‘ Can I deal with sharing a house with someone who might possibly touch my mo...
Adults
After the Diagnosis <ul><li>Before  I self-diagnosed Asperger’s Syndrome, I was depressed about not fitting in and not kno...
Interest in the Supernatural <ul><li>Perceiving sensory experiences not perceived by others </li></ul><ul><li>Psychic Sens...
Relationships <ul><li>Sometimes I would like to be by myself and he feels like I’m pulling away from him… which I’m not. <...
Sexuality <ul><li>I had a very strong libido and appreciation of the sensual when I was a young woman; strong sex drive an...
Being a Parent <ul><li>Confidence in maternal abilities </li></ul><ul><li>Liane Holiday Willey. </li></ul><ul><li>Unconven...
Books and Resources
 
Autobiographies <ul><li>www.jkp.com </li></ul>
 
www.fhautism.com
Exploring Feelings Cognitive Behaviour Therapy to manage anxiety, sadness and anger
The Perception, Expression and Regulation of Emotions <ul><li>An inherent characteristic of Asperger’s syndrome? </li></ul>
Amygdala
Anxiety <ul><li>Very good at worrying. </li></ul><ul><li>Generalised anxiety (pessimist) </li></ul><ul><li>Obsessive Compu...
Coping with Anxiety <ul><li>“ Stimming” reduces stress and anxiety levels </li></ul><ul><li>Calms the child down </li></ul>
Coping with Anxiety <ul><li>Controlling your experiences </li></ul><ul><li>If you share you lose control </li></ul><ul><li...
Coping with Anxiety <ul><li>Oppositional and defiant (will not comply) </li></ul><ul><li>Parent becomes a ‘slave’, lack of...
Coping with Anxiety <ul><li>Routines and rituals </li></ul><ul><li>Soothing and relaxing </li></ul><ul><li>Can become comp...
Coping with Anxiety <ul><li>A ‘superstitious’ behaviour </li></ul><ul><li>The Curious Incident of the Dog in the Night tim...
Coping with Anxiety <ul><li>Thought blocker </li></ul><ul><li>Special interest </li></ul><ul><li>From a spinning coin to c...
Meltdown versus Tantrum From Anxiety to Meltdown  by Deborah Lipsky Meltdown <ul><li>Overwhelmed by social, cognitive and ...
Depression <ul><li>Occurs in one in three adolescents and adults </li></ul><ul><li>Low self-esteem due to being rejected a...
Depression <ul><li>Loneliness </li></ul><ul><li>Mental exhaustion </li></ul><ul><li>Depression ‘attack’ </li></ul><ul><li>...
Anger <ul><li>Two out of three people with Asperger’s syndrome have a problem with anger management. </li></ul><ul><li>Sad...
Sadness Expressed As Anger
Anger <ul><li>Achieve solitude </li></ul><ul><li>Dominance and control (anxiety) </li></ul><ul><li>Limited tolerance of fr...
Exploring Feelings: Affection
The Understanding and Expression of Affection <ul><li>Ability to read the signals when someone expects affection. </li></u...
The Understanding and Expression of Affection <ul><li>Affection to repair someone’s feelings. </li></ul><ul><li>An immatur...
<ul><li>“ We feel and show affection but not often enough, and at the wrong intensity ” </li></ul>
Edgar Schneider <ul><li>At one point my mother, exasperated at me, said, “You know what the trouble is? You don’t know how...
The Asperger’s Perspective <ul><li>Why are typical people so obsessed with expressing reciprocal love and affection? </li>...
The Asperger’s Perspective <ul><li>Enjoy a very brief and low intensity expression of affection. </li></ul><ul><li>Confuse...
The Asperger’s Perspective <ul><li>Compassion for someone’s physical suffering (broken wrist) and a practical expression o...
Asperger’s Perspective <ul><li>The capacity for affection, a cup versus a bucket. </li></ul>
Parent’s or Partner’s Perspective <ul><li>Rare use of gestures and words of affection lamented by a parent or partner. </l...
Temple Grandin <ul><li>My brain scan shows that some emotional circuits between the frontal cortex and the amygdala just a...
The Exploring Affection Program <ul><li>For children with a diagnosis of Asperger’s syndrome who have:  </li></ul><ul><li>...
Aims of the Program <ul><li>Affection education to ‘de-mystify’ affection. </li></ul><ul><li>To understand why people need...
Construction and Evaluation of 3 Affection Measures for Children with Asperger’s syndrome <ul><li>The Affection for Others...
Results: Lee, Sofronoff, Sheffield and Attwood (in press) <ul><li>126 families, children 4-13 years </li></ul><ul><li>Dive...
Program <ul><li>4 sessions, each session was for one hour with the children, then 30 minutes with their parents. </li></ul...
Session 1 <ul><li>Ten activities or experiences you enjoy. </li></ul><ul><li>Write the number from 0 to 100 for how much y...
Session 1 <ul><li>Ten people you like and how much you like that person (pets). </li></ul><ul><li>Each person’s name writt...
Session 1 <ul><li>How do those people express their feelings that they like or love you? </li></ul><ul><li>Reasons why we ...
How liking or loving someone can affect your feelings, thoughts and abilities <ul><li>When someone likes or loves you, the...
<ul><li>When someone likes or loves you, you are able to relax, talk to the person, and express your feelings. </li></ul><...
Project <ul><li>Collect pictues or drawings of people your age expressing that they like or love someone. </li></ul><ul><l...
Session 2 <ul><li>Placing the pictures collected for the project on the like to love thermometer. </li></ul><ul><li>What c...
Session 2 <ul><li>What can you say or do to show that you  love  someone? </li></ul><ul><li>For each suggestion, how much ...
Session 2 <ul><li>When do we show affection and how much? </li></ul><ul><li>Getting the balance right. </li></ul><ul><li>G...
Project <ul><li>The situations at home that someone expects an expression of affection that the child finds difficult to e...
Project <ul><li>Think of some of the expressions discussed today that you could use in that situation. </li></ul><ul><li>H...
Session 3 <ul><li>Review the project, when, what type of affection, what did the person say or do, how did you feel? </li>...
Session 3 <ul><li>When do we use affection? </li></ul><ul><li>Game of matching a list of situations with different types o...
Session 3 <ul><li>How can you tell if someone needs affection? </li></ul><ul><li>How can you tell if you have given  too m...
Project <ul><li>A log book for the child and a parent that provides a record of when the child expressed affection and som...
Person completing the log book of affection: Please place a    in the box when you have expressed each type of affection....
Session 4 <ul><li>Why do we give affection? </li></ul><ul><li>What would happen if nobody showed you that they liked or lo...
Session 4 <ul><li>If you did not get enough affection, how could you make yourself feel better? </li></ul><ul><li>Review o...
The Cat-kit
Emotional Toolbox:  To Fix The Feeling
Physical Activity Tools .  Quick release of emotional energy <ul><li>Physical exercise, walk, run, trampoline. </li></ul><...
Physical Activity Tools .  <ul><li>Drum Kit. </li></ul><ul><li>Swing. </li></ul><ul><li>Orange squeezing. </li></ul><ul><l...
Relaxation Tools . Slow release of emotional energy <ul><li>Relaxation training. </li></ul><ul><li>Music. “Feelings put in...
Social Tools <ul><li>Time with a family member or friend.  </li></ul><ul><li>Disclosure (typing, music, poetry) </li></ul>...
Social Tools: Affection <ul><li>Approval </li></ul><ul><li>Intensity </li></ul><ul><li>Duration </li></ul>
Thoughts and perspective <ul><li>Put the events in perspective. </li></ul><ul><li>Imagine what you would like to do or say...
Special Interests <ul><li>A means of relaxation, pleasure. </li></ul><ul><li>Knowledge to overcome fear. </li></ul><ul><li...
Special Interest <ul><li>Collecting and cataloguing (personal defrag).  </li></ul><ul><li>Distraction during a meltdown.  ...
Sensory Tools <ul><li>Sounds.  Ear plugs, headphones. </li></ul><ul><li>Light.  Irlen Lenses, hat, sun glasses. </li></ul>...
Medication As a Tool <ul><li>Treatment of an anxiety disorder or a clinical depression. (SSRI). </li></ul><ul><li>Impulsiv...
Inappropriate Tools <ul><li>Fight. </li></ul><ul><li>Being alone too long. </li></ul><ul><li>Taking stress out on someone ...
Inappropriate Tools <ul><li>Affection. </li></ul><ul><li>“ Would a hug help?-no- I get madder. </li></ul><ul><li>Punishmen...
<ul><li>Different tools at different points on the thermometer. </li></ul><ul><li>Relaxation tools at low stress levels, p...
Managing a Crisis <ul><li>Reduce social and sensory confusion or overload </li></ul><ul><li>Remain calm with a quiet and r...
Managing a Crisis <ul><li>Be cautious regarding affection </li></ul><ul><li>Do not ask what happened </li></ul><ul><li>Dis...
 
Evaluation Studies <ul><li>Sofronoff, K  et al  (2005) ‘A randomised controlled trial of a CBT intervention for anxiety in...
Sexuality
<ul><li>Don’t “invade people’s space”-that means get too close to them. </li></ul><ul><li>Don’t stare at someone whatever ...
<ul><li>Don’t tell dirty, sexist or racist jokes or make sexual innuendos. </li></ul><ul><li>Don’t hug or touch people unl...
<ul><li>Here comes the but… you just watch and listen to a group of teenage boys or girls. They tell dirty jokes and make ...
Sexuality <ul><li>Delay of about five years in experiencing a romantic relationship </li></ul><ul><li>Crush (celebrities, ...
Sexuality <ul><li>Inappropriate comments “Is it OK if I ************? </li></ul><ul><li>Vulnerability </li></ul><ul><li>So...
The relationship continuum Sexual Behaviours Flirting (showing off, looking, smiling, etc.) Meeting, noticing Spending tim...
Sexuality <ul><li>The dating game. </li></ul><ul><li>The art of flirting and romance </li></ul><ul><li>Signals of mutual a...
 
 
 
Talking to Girls
 
 
Affection <ul><li>. </li></ul>
Love and Relationships
Falling in Love with an Aspie
Typical History of Relationships. <ul><li>Late developer in social/emotional maturity. </li></ul><ul><li>Not sexist, ageis...
What Attracted You to Your Aspie Partner? <ul><li>The silent, handsome stranger. </li></ul><ul><li>Admiration of intellect...
What Attracted You to Your Aspie Partner? <ul><li>Compassion for his/her limited social skills. </li></ul><ul><li>Better l...
What Attracted You to Your Aspie Partner? <ul><li>Shared interests (hobbies, animals). </li></ul><ul><li>The degree of adu...
What Attracted You to Your Aspie Partner? <ul><li>‘ Pillar’ of the community. </li></ul><ul><li>Child like quality, a ‘Pet...
What Attracted You to Your Aspie Partner? <ul><li>A challenge to get to know. </li></ul><ul><li>“ I was his first serious ...
Oscar Wilde <ul><li>‘ Women love men for their defects’   </li></ul>
What Attracted You to Your  Typical  Partner? <ul><li>Good in social situations, network of friends </li></ul><ul><li>Acce...
Other Qualities <ul><li>Someone who likes me, doesn’t want to change me </li></ul><ul><li>Expressiveness and compassion </...
Other Qualities <ul><li>Takes care of emotional problems e.g. with in-laws </li></ul><ul><li>Direct speech- no hidden mean...
 
 
The Social Quotient
High Functioning Autism and Celibacy <ul><li>‘ Can I deal with sharing a house with someone who might possibly touch my mo...
 
Derogatis Scale Normal range <ul><li>Fantasy (50) </li></ul><ul><li>Attitude (46) </li></ul><ul><li>Drive (44) </li></ul>S...
The Effects of the Relationship on Each Partner: Neurotypical
Loneliness
Affection Deprivation <ul><li>Fixes rather than empathizes </li></ul><ul><li>Love and affection as an emotional restorativ...
 
The Communication of Affection <ul><li>Ability to read the signals when someone expects affection. </li></ul><ul><li>Abili...
In love with the special interest
Mirroring <ul><li>‘ Mirror’ the Aspie partners behaviour, life style and thinking to survive. </li></ul><ul><li>Aspie is d...
<ul><li>‘ I have developed into the person necessary for him” </li></ul><ul><li>“ Take your self-confidence and energy” </...
One thing that I love about my Aspie partner <ul><li>Detailed and practical brain </li></ul><ul><li>Always tries so hard t...
Cassandra Phenomenon
Intimacy <ul><li>Romance, sensuality and foreplay. </li></ul><ul><li>Tactile sensitivity. </li></ul><ul><li>Frequency and ...
Sexuality <ul><li>Pornography </li></ul><ul><li>Fetish </li></ul><ul><li>Bisexuality and homosexuality </li></ul>
Intimacy <ul><li>Romantic and passionate relationship with someone you often have to look after as a child. </li></ul><ul>...
Aspie Partner <ul><li>May also feel irritated and depressed.  </li></ul><ul><li>Feeling of being unable to meet his or her...
Aspie Partner <ul><li>“ You should know” </li></ul><ul><li>“ The longer I live with them, the less I know about my partner...
Aspie Partner <ul><li>Expression of inner thoughts and feelings, </li></ul><ul><li>Coping with change, the sanctuary of ho...
Stages in the Relationship <ul><li>Greater depth of love (Winnie’s research) </li></ul><ul><li>Delirious and denial </li><...
What Strategies Strengthen the Relationship? <ul><li>Recognition of the diagnosis. </li></ul><ul><li>Motivation of both pa...
What Strategies Strengthen the Relationship? <ul><li>Support from other family members and one’s children. </li></ul><ul><...
What Strategies Strengthen the Relationship? <ul><li>An occasional escape. </li></ul><ul><li>A mutual understanding of two...
 
 
 
Resources  <ul><li>Partner support group. </li></ul><ul><li>Sydney support group, ASPIA </li></ul><ul><li>Asperger’s Syndr...
The Parent with Asperger’s Syndrome
Issues for the Aspie parent <ul><li>Understanding natural childhood abilities and behaviour. </li></ul><ul><li>The role an...
Child’s Perception <ul><li>Lack of affection, understanding, emotional support, acceptance, reassurance, encouragement. </...
<ul><li>I almost had an Australian pen friend when I was 6 years old. I was very excited to receive a letter from the othe...
Child’s Perception <ul><li>Fear of the parent’s mood and not to antagonize. </li></ul><ul><li>The ‘cold’ touch of affectio...
 
Magnets <ul><li>Two magnets - that either attract or repel each other.  </li></ul><ul><li>Adored or despised. </li></ul><u...
Child’s Reaction <ul><li>Repel:  Desire to leave home or move inter-state or abroad.  </li></ul><ul><li>Hatred. </li></ul>...
Brisbane Support Group <ul><li>Support group for children and teenagers with a parent who has Asperger’s syndrome </li></u...
Experiences <ul><li>My dad sometimes can be in a childish mood where he would be silly or jealous. It is very difficult fo...
<ul><li>Sometimes you question their love for you </li></ul><ul><li>Favouritism </li></ul><ul><li>He does not know how to ...
Coping <ul><li>Give him the signals to show you are upset </li></ul><ul><li>Tell my friends why he does it </li></ul><ul><...
Coping <ul><li>I force him to hug me </li></ul><ul><li>I Know that his actions don’t always portray his love </li></ul><ul...
Happy Families?
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Autism Conference - May 26th-27th 2011 - Denmark

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This is the slides from a two day Autism Conference with Tony Attwood and Michelle Garnett in Denmark. The conference was hosted by Psychological Resource Centre.

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Transcript of "Autism Conference - May 26th-27th 2011 - Denmark"

  1. 1. Minds and Hearts Herlev 26-27 May 2011 www.mindsandhearts.net
  2. 2. The Minds and Hearts Clinic
  3. 3. Cognition in Asperger’s Syndrome/ High Functioning Autism
  4. 4. Programme <ul><li>Verbalizers and Visualizers </li></ul><ul><li>Reading and Mathematics </li></ul><ul><li>Attention problems </li></ul><ul><li>One track mind </li></ul><ul><li>Fear of making a mistake </li></ul><ul><li>Consistency and certainty </li></ul><ul><li>Weak Central Coherence </li></ul><ul><li>Faulty logic </li></ul><ul><li>Asperger friendly classroom </li></ul><ul><li>Talents and interests </li></ul>
  5. 5. A Different Way of Perceiving, Thinking and Learning
  6. 6. <ul><li>Two reasons to attend school, to learn and to socialize. </li></ul><ul><li>If the child with Asperger’s syndrome is not successful socially then academic success becomes more important for self-esteem. </li></ul>
  7. 7. A different way of learning <ul><li>Many children with Asperger’s syndrome: </li></ul><ul><ul><li>perform at the extremes of cognitive ability. </li></ul></ul><ul><ul><li>have a conspicuously uneven profile of academic achievement. </li></ul></ul><ul><ul><li>have a distinctive learning style. </li></ul></ul>
  8. 8. Verbalizers <ul><li>About 50 per cent of children with Asperger’s syndrome have relatively advanced verbal reasoning skills. </li></ul><ul><li>Understanding may be improved by reading about the concept or engaging in a one to one discussion. </li></ul>
  9. 9. Visualizers <ul><li>About one in five children with Asperger’s syndrome Asperger’s syndrome has relatively advanced visual reasoning skills. </li></ul><ul><li>Learning may be facilitated by observation and visual imagery. </li></ul><ul><li>‘ A picture is worth a thousand words’ </li></ul><ul><li>Converting thought and images to speech. </li></ul>
  10. 10. Curriculum on CD-Rom
  11. 11. Reading and Mathematics <ul><li>One in five children have a problem with reading. </li></ul><ul><li>Nearly 50% have problems with mathematics. </li></ul><ul><li>Conventional remedial reading programs have not been as effective as with typical children. </li></ul>
  12. 12. Reading and Mathematics <ul><li>Numbers can be perceived as shapes not quantity. </li></ul><ul><li>Difficulty explaining in words how they achieved the answer. </li></ul>
  13. 13. Similarities to Attention Deficit Disorder <ul><li>At least 75 per cent of children with Asperger’s syndrome also have a profile indicative of Attention Deficit Disorder. </li></ul>
  14. 14. All Components of Attention <ul><li>The ability to sustain attention. </li></ul><ul><li>Pay attention to relevant information. </li></ul><ul><li>Shift attention when needed. </li></ul><ul><li>Encode attention - to remember what was attended to. </li></ul><ul><li>Distracted by imagination. </li></ul>
  15. 15. Executive Function <ul><li>organizational and planning abilities </li></ul><ul><li>working memory </li></ul><ul><li>inhibition and impulse control </li></ul><ul><li>self-reflection and self-monitoring </li></ul><ul><li>time management and prioritizing </li></ul><ul><li>understanding complex or abstract concepts </li></ul><ul><li>using new strategies. </li></ul><ul><li>Estimate how long to complete the task </li></ul>
  16. 16. Need an Executive Secretary
  17. 17. One Track Mind
  18. 18. <ul><li>Train track. </li></ul><ul><li>One-track mind. </li></ul><ul><li>The last to know and seek help if they are on the wrong track. </li></ul><ul><li>Lose train of thought if interrupted. </li></ul>
  19. 19. <ul><li>Continue using incorrect strategies and not learning from mistakes. </li></ul><ul><li>Compulsion for completion (switch tracks) </li></ul><ul><li>Anxiety increases cognitive rigidity </li></ul><ul><li>Programs to encourage flexible thinking – What else could it be?, What else could you do? </li></ul><ul><li>Relaxation programs </li></ul>
  20. 20. Fear of Making a Mistake <ul><li>Don’t try, you don’t make a mistake. </li></ul><ul><li>Fear of appearing stupid and being ridiculed by peers. </li></ul><ul><li>Advice perceived as criticism. </li></ul>
  21. 21. Fear of Making a Mistake <ul><li>Fear of failure leads to a need to be right </li></ul><ul><li>Criticise to feel good about themselves, </li></ul><ul><li>Point out errors to demonstrate intelligence </li></ul>
  22. 22. Coping With Mistakes <ul><li>Perfectionist. </li></ul><ul><li>Self-perception as an adult. </li></ul><ul><li>Cognitive style of noticing details and errors. (Weak Central Coherence and pessimism). </li></ul><ul><li>Limited ability to tolerate frustration. </li></ul><ul><li>Frustration volume control an on/off switch. </li></ul>
  23. 23. Strategies <ul><li>In play and learning, an adult’s ability is not perfect. </li></ul><ul><li>Model how to cope with frustration. </li></ul><ul><li>We learn more from our failures than our successes. </li></ul><ul><li>Intellectual strength </li></ul>
  24. 24. Strategies <ul><li>Approach an error as an opportunity and data. </li></ul><ul><li>Alternative options. </li></ul><ul><li>Being calm is being smart. </li></ul><ul><li>If I stay calm, I’ll find the solution quicker. </li></ul>
  25. 25. Consistency and Certainty <ul><li>Drive to seek consistency and certainty. </li></ul><ul><li>Appeal of mathematics and science. </li></ul><ul><li>Concern if there is more than one right answer. </li></ul><ul><li>Difficulty accepting value judgments (English literature). </li></ul>
  26. 26. Preparation for Change <ul><li>Explanation, preparation and reassurance. </li></ul><ul><li>Social Stories. </li></ul><ul><li>Compulsion for completion. </li></ul><ul><li>Transfer to another school. </li></ul><ul><li>Buddy system. </li></ul>
  27. 27. Organised and Structured <ul><li>Sequence of activities. </li></ul><ul><li>Boxes or pictures. </li></ul><ul><li>What to do, </li></ul><ul><li>Who with, </li></ul><ul><li>Duration (completed, music, clock) </li></ul><ul><li>What next. </li></ul>
  28. 28. Weak Central Coherence <ul><li>Remarkably good at attending to detail but appear to have considerable difficulty perceiving and understanding the overall picture or gist. </li></ul><ul><li>Rolled up paper. </li></ul><ul><li>What is relevant and redundant. </li></ul><ul><li>Deciphering the pattern or meaning. </li></ul>
  29. 29. Practical Example <ul><li>Room split into 2 groups </li></ul><ul><li>Group one to close their eyes, the other group to see the following slide </li></ul>
  30. 30. Group 2 Eyes open
  31. 31. Group 1 open eyes, group 2 Close Eyes
  32. 32. Seen by Group 1
  33. 33. <ul><li>What was the room? </li></ul><ul><li>What was the time? </li></ul>
  34. 36. Visual Acuity Ashwin et al <ul><li>Used the Freiburg Visual acuity and Contrast Test </li></ul><ul><li>15 adult males with HFA or AS compared to controls </li></ul><ul><li>Visual acuity 20:7 So superior it lies in the region reported for birds of prey </li></ul><ul><li>Discriminate detail on a object 20 feet away that a typical person can see from 7 feet away </li></ul>
  35. 37. <ul><li>Noticing patterns not perceived by others. </li></ul><ul><li>Walking into a strange room. </li></ul><ul><li>Attention to detail in art </li></ul>
  36. 39. Therese Jolliffe <ul><li>Reality to an autistic person is a confusing, interacting mass of events, people, places, sounds and sights. There seem to be no clear boundaries, order or meaning to anything. A large part of my life is spent just trying to work out the pattern behind everything. Set routines, times, particular routes and rituals, all help to get order into an unbearably chaotic life. </li></ul>
  37. 40. Donna Williams <ul><li>I loved to copy, create and order things. I loved our set of encyclopaedias. They had letters and numbers on the side, and I was always checking to make sure they were in order or putting them that way. I was making order out of chaos. Searching for categories did not stop with the encyclopaedias. I would read the telephone directory, counting the number of Browns listed, or counting the number of variations on a particular name, or the rarity of others. </li></ul>
  38. 41. Donna Williams <ul><li>I was exploring the concept of consistency. It may have seemed that my world was upside down, but I was looking to get a grip on consistency. The constant change of most things never seemed to give me any chance to prepare myself for them. Because of this I found pleasure and comfort in doing the same things over and over again </li></ul>
  39. 42. Social Cognition <ul><li>Noticing objects and facts rather than thoughts, feelings and intentions. </li></ul>LDA Language Cards: Emotions
  40. 43. LDA Language Cards: Emotions Descriptions of pictures and events may not include thoughts and feelings.
  41. 46. Faulty Logic Gunilla Gerland. <ul><li>I very much wanted to understand and that led me to think up something, a theory about how things worked, that always applied to whatever I saw. Every time my mother came ( to collect her from school), one thing was always the same: she always came into the hall . </li></ul>
  42. 47. Gunilla Gerland <ul><li>What if that meant I had to be in the hall for her to come out at all? That’s what it was. That must be it, I thought. If she came in and I wasn’t in the hall, if she didn’t see me, would she then go home again? And perhaps it also meant that if I wanted to go home, then she would appear if I went out into the hall . </li></ul>
  43. 48. Gunilla Gerland <ul><li>I had actually never seen my mother in any other room except the hall, so I associated her appearance with the actual room, as if she just materialised in the doorway. </li></ul>
  44. 49. Gunilla Gerland <ul><li>Every thing had to hang together in some logical way and now I had probably found it: as long as I was in the hall, the room to which my mother always came, then she would come. If on the other hand I was in the wrong room, in any of the rooms into which she never came, then she wouldn’t come”. </li></ul>
  45. 50. Social Stories <ul><li>Explore when and how the faulty logic started </li></ul><ul><li>Use Comic Strip Conversations and Social Stories developed by Carl Gray </li></ul>
  46. 51. Asperger Friendly Classroom Motivation <ul><li>Completion </li></ul><ul><li>No errors </li></ul><ul><li>Special interest </li></ul><ul><li>Intellectual vanity </li></ul>
  47. 52. Classroom <ul><li>Quiet, well-structured classroom. </li></ul><ul><li>Avoid sensory overload. </li></ul><ul><li>Minimal changes in routines and staff. </li></ul><ul><li>Visible daily schedule of activities and preparation for transitions. </li></ul><ul><li>Benevolent peers as guides. </li></ul>
  48. 53. Classroom <ul><li>A work station or ‘office’. </li></ul><ul><li>A ‘to do’ list. </li></ul><ul><li>Extra time to complete an activity or assignment. </li></ul><ul><li>Access to a special education support teacher or learning support unit. </li></ul>
  49. 54. The Knowledge and Personality of the Teacher <ul><li>These children often show a surprising sensitivity to the personality of the teacher. However difficult they are, even under optimal conditions, they can be guided and taught, but only by those who give them understanding and genuine affection, people who show kindness towards them and yes, humour. The teacher’s underlying emotional attitude influences, involuntarily and unconsciously, the mood and behaviour of the child. Of course, the management and guidance of such children essentially requires a proper knowledge of their peculiarities as well as genuine pedagogic talent and experience. Mere teaching efficiency is not enough . </li></ul><ul><li>Hans Asperger 1944. </li></ul>
  50. 56. <ul><li>Teachers who show an empathic understanding of the child. </li></ul><ul><li>Are flexible in their teaching strategies, assessments and expectations. </li></ul><ul><li>Like and admire the child, respect his or her abilities and know the child’s motivators and learning profile. </li></ul><ul><li>An Asperger friendly environment </li></ul>
  51. 57. Nita Jackson <ul><li>Mr Osbourne was always bubbly and ready to make a light-hearted joke out of anything. He rarely got angry or raised his voice like most of my other teachers did. He let me hide in the music department’s store cupboard at break time, without even blinking an eye, it was as though he understood and accepted why I needed to go to ridiculous measures to separate myself from society. I respected him for not probing for answers like everyone else did. Occasionally he would tap on the door, say ‘boo!’ and offer me a biscuit (which I never declined). On the last day of term, I bought him a tin of biscuits in return for the amount of biscuity yumminess he had allowed me </li></ul>
  52. 58. Hans Asperger <ul><li>While demonstrations of love, affection and flattery are pleasing to normal children and often induce in them desired behaviour, such approaches only succeed in irritating Fritz, as well as all other similar children. </li></ul><ul><li>All educational transactions have to be done with the affect ‘turned off’. The teacher must never become angry nor should he aim to become loved. The teacher must, at all costs, be calm and collected and must remain in control . </li></ul>
  53. 59. Stress and Mental Exhaustion <ul><li>The education and social curriculum. </li></ul><ul><li>Absence of real breaks. </li></ul><ul><li>School is for learning, home is for fun and relaxation. </li></ul>
  54. 60. Homework <ul><li>Planning, prioritizing, time management, flexible thinking, distraction, working memory. </li></ul><ul><li>Stress, duration of homework. </li></ul>
  55. 61. Strategies <ul><li>Create a learning environment. </li></ul><ul><li>Homework timetable and diary. </li></ul><ul><li>Time allocation. </li></ul><ul><li>Segments with breaks. </li></ul><ul><li>Motivation. </li></ul>
  56. 62. Teachers’ Preparation of Homework <ul><li>High-light key aspects. </li></ul><ul><li>Help formulate a plan, especially with essays. </li></ul><ul><li>Check draft versions and progress. </li></ul><ul><li>Homework to consolidate known material. </li></ul>
  57. 63. Memory Problems <ul><li>Small audio recorder. </li></ul><ul><li>Contact another child. </li></ul>
  58. 64. Supervision <ul><li>Getting started. </li></ul><ul><li>Procrastination and distraction. </li></ul><ul><li>Advice. </li></ul><ul><li>Alternative solutions. </li></ul><ul><li>Emotion management. </li></ul><ul><li>Teacher’s home telephone number. </li></ul>
  59. 65. Alternative Options <ul><li>Homework in school time. </li></ul><ul><li>Homework tutor. </li></ul><ul><li>Duration of homework. </li></ul><ul><li>Exemption from homework. </li></ul>
  60. 66. <ul><li>Pruning the High School Curriculum. </li></ul>
  61. 67. Talents and Interests A Tree Growing in a Forest Clearing
  62. 68. <ul><li>Mechanical ability </li></ul><ul><li>Mathematics </li></ul><ul><li>The Arts and Music </li></ul><ul><li>Imagination </li></ul><ul><li>Animals </li></ul>
  63. 69. “ If the world was left to you socialites, we would still be in caves talking to each other” Temple Grandin
  64. 70. Association With Famous Individuals in Science and Art <ul><li>Ludwig Wittgenstein. </li></ul><ul><li>Albert Einstein. </li></ul><ul><li>Mozart. </li></ul><ul><li>Alan Turing. </li></ul><ul><li>Bill Gates. </li></ul><ul><li>Thomas Jefferson. </li></ul><ul><li>Howard Hughes. </li></ul><ul><li>Napoleon. </li></ul>
  65. 71. Making Friends Strategies to improve social understanding and friendship skills
  66. 72. “ The nature of these children is revealed most clearly in their behaviour towards other people. Indeed, their behaviour in the social group is the clearest sign of their disorder and the source of conflicts from earliest childhood.” Hans Asperger. Assessment of Social Interaction Skills and Social Reasoning
  67. 73. Solitude <ul><li>The diagnostic criteria dissolve in solitude. </li></ul><ul><li>Solitude is an effective emotional restorative. </li></ul><ul><li>Preference for learning in solitude. </li></ul>
  68. 74. Stages in Friendship <ul><li>1. Physical world. </li></ul><ul><li>2. Wanting to have friends. </li></ul><ul><li>3. Functional friends. </li></ul><ul><li>4.Loneliness. </li></ul><ul><li>5. Partner. </li></ul>
  69. 76. Social Impairment <ul><li>Maturity in friendship skills. </li></ul><ul><li>Limited vocabulary for characterization. </li></ul><ul><li>Limited response to peer pressure. </li></ul><ul><li>Conspicuous preference for solitude. </li></ul><ul><li>Unaware of the codes of social conduct. </li></ul>
  70. 77. French Driver
  71. 78. Please draw me a picture of your classroom or your playground?
  72. 79. 9 Year old boy with Asperger’s syndrome: Classroom
  73. 80. 8 Year old girl with Asperger’s Syndrome: Playground
  74. 81. 10 year old girl with Asperger’s syndrome: Playground
  75. 82. 8 Year old boy with Asperger’s syndrome: Playground
  76. 83. What is unusual about each of these drawings?
  77. 84. 6 year old sister of 8 year old boy with Asperger’s syndrome: Playground
  78. 85. 7 Year old boy with Asperger’s syndrome: Classroom
  79. 86. His 5 year old sister: Classroom
  80. 87. Girl with Asperger’s syndrome: Playground
  81. 88. Encourage Friendship Skills <ul><li>Behavioral strategies of observation and recording, task analysis, cues, prompting and rewards. </li></ul><ul><li>Practice using role play games and drama activities. </li></ul><ul><li>Cognitive strategies to learn the theory and script using Social Stories. </li></ul>
  82. 89. Social Stories <ul><li>Start with a story about a social success. </li></ul><ul><li>Half of Social Stories to record social successes. </li></ul><ul><li>A particularly successful occasion is recorded in a Social Story. </li></ul><ul><li>Social articles for teenagers (Compliments) </li></ul>
  83. 90. Level 1: Approximately 3 to 6 Years <ul><li>Recognition of sharing and turn taking. </li></ul><ul><li>Friend has toys the child wants to play with. </li></ul><ul><li>One way assistance (he helps me). </li></ul><ul><li>Proximity. </li></ul>
  84. 91. Level 1: Approximately 3 to 6 Years <ul><li>Why is ….. your friend? </li></ul><ul><li>“ He sits next to me.” </li></ul><ul><li>Momentary friends. </li></ul><ul><li>Conflict resolved by force and a referee. </li></ul>
  85. 92. An Adult ‘Acting’ As a Friend <ul><li>Observe the natural play of the child’s peers, learn the games and rules. </li></ul><ul><li>Learn ‘child’ speak. </li></ul><ul><li>Turn taking. </li></ul><ul><li>Ask for help. </li></ul>
  86. 93. An Adult ‘Acting’ As a Friend <ul><li>What else could it be? </li></ul><ul><li>Video replay of social play scenes at school. </li></ul><ul><li>Pause button. </li></ul>
  87. 94. An Adult ‘Acting’ As a Friend <ul><li>‘ Follow my leader’ games. </li></ul><ul><li>Chasing and hiding games. </li></ul><ul><li>Share interesting moments and activities. </li></ul>
  88. 95. An Adult ‘Acting’ As a Friend <ul><li>Watch other children as a model of what to do. </li></ul><ul><li>‘ Rent a friend.’ </li></ul><ul><li>Inclusion with typical children as they can modify their social play to accommodate the child. </li></ul><ul><li>Carol Gray’s Sixth Sense (the Social sense). </li></ul>
  89. 97. Level 2: Approximately 6 to 9 Years <ul><li>Reciprocity and being fair. </li></ul><ul><li>Mutual assistance. </li></ul><ul><li>Like the same activities. </li></ul>
  90. 98. Level 2: Approximately 6 to 9 Years <ul><li>Why is …. your friend? </li></ul><ul><li>“ She comes to my party and I go to hers.” </li></ul><ul><li>Conflict: Who started it not how it finished. </li></ul><ul><li>Offender needs to retract the action (an eye for an eye). </li></ul>
  91. 99. Level 2 <ul><li>Role play activities, rehearsal, feedback and rewards. </li></ul><ul><li>Social engineering (modelling and protection). </li></ul><ul><li>Resources. </li></ul>
  92. 100. Books on Friendship ( www.tonyattwood.com.au )
  93. 101. Theory Of Mind Skills
  94. 104. A Social Story on Assistance <ul><li>Sometimes children help me. They do this to be friendly. Yesterday, I missed three math problems. Amy put her arm around me and said, “ It’s okay, Juanita.” She was trying to help me feel better. On my first day at school, Billy showed me my desk. That was helpful. Children have helped me in other ways. Here is my list: </li></ul><ul><li>I will try to say “thank you” ! When children help me. </li></ul>
  95. 105. Observation Schedule
  96. 106. Social Signals <ul><li>Road signs: Traffic lights </li></ul>
  97. 107. Teacher Assistant: An anthropologist in the classroom <ul><li>Identify the relevant social cues </li></ul><ul><li>Guidance in what to do or say. </li></ul><ul><li>Provide encouragement and positive feedback. </li></ul><ul><li>Explanations, guidance and feedback to peers </li></ul><ul><li>Help manage emotions and conflict </li></ul>
  98. 108. Level 3: Approximately 9 to 13 Years <ul><li>Aware of other’s opinion of them and how their words and actions affect the feelings of others.(white lie). </li></ul><ul><li>Need for companionship rather than functional play. </li></ul><ul><li>Cooperation more than competition. </li></ul><ul><li>Share thoughts rather than toys. </li></ul>
  99. 109. Level 3: Approximately 9 to 13 Years <ul><li>Personality characteristics, audacious, humor. </li></ul><ul><li>Helps in times of emotional distress. </li></ul><ul><li>Help the child feel good about themselves (compliments). </li></ul><ul><li>Greater selectivity and durability. </li></ul>
  100. 110. Level 3: Approximately 9 to 13 Years <ul><li>Gender split. (Boy and girl activities). </li></ul><ul><li>Trust, loyalty and keeping promises. </li></ul><ul><li>Why is ….. your friend? </li></ul><ul><li>“ I can trust her with my secrets.” </li></ul><ul><li>Conflict resolved by discussion that can strengthen the relationship. </li></ul><ul><li>Conflicts forgiven. </li></ul>
  101. 111. Books on Friendship
  102. 121. Friendship <ul><li>‘ Nerds’ </li></ul><ul><li>Social rebels </li></ul><ul><li>Unconventional children </li></ul><ul><li>I had to learn the school rules and the cool rules </li></ul>
  103. 122. <ul><li>Clubs. </li></ul><ul><li>Buddy system. </li></ul><ul><li>Team work program. </li></ul><ul><li>Drama classes. </li></ul>
  104. 123. Home Is a Castle
  105. 124. Moving to Manhood and Self-Identity
  106. 125. The Transition From Being a Child to an Adult <ul><li>Who am I? </li></ul><ul><li>Who do I want to become? </li></ul><ul><li>What do people think of me? </li></ul>
  107. 126. Moving to Manhood <ul><li>8 X 1.5 hour sessions + 1 follow-up at 2 months </li></ul><ul><li>13-17 year olds </li></ul><ul><li>Adolescents – 1hr </li></ul><ul><li>Parents- 30 min </li></ul><ul><li>After school </li></ul><ul><li>Project work </li></ul>
  108. 127. 2009-2010 <ul><li>Group 1: 2007 – 6 boys </li></ul><ul><li>Group 2: 2009 – 8 boys </li></ul><ul><li>Group 3: 2010 – 9 boys </li></ul><ul><li>Group 4: 2011 – 9 boys </li></ul><ul><li>All AS </li></ul><ul><li>Co-morbidities: GAD, depression, tic disorder, ADHD </li></ul>
  109. 128. Session 1: Qualities in Abilities and Personality <ul><li>Introductions by way of career aspirations </li></ul><ul><li>Qualities in personality </li></ul><ul><li>Advantages in making friends, self-esteem and self-identity, enjoyment of life, employment </li></ul><ul><li>Representing character by an animal </li></ul>
  110. 129. Examples <ul><li>Damon: Wolf: strong sense of family, yet strong individualistic urge, a pathfinder </li></ul><ul><li>James: Skunk: powerful and smelly; other skunks hang around him, humans stay away; seeks his own kind </li></ul><ul><li>Keenan: Owl: can scare my Mum and take years off her life, I can be quiet and wise, I can see the truth </li></ul>
  111. 130. Session 2: Diminishing the Difficulties <ul><li>Executive Function (strategies from the participants) </li></ul><ul><li>An intense emotion </li></ul><ul><li>Drawing difficulties as a cartoon </li></ul>
  112. 131. Session 3: Compliments and Criticism <ul><li>Why we say compliments </li></ul><ul><li>Compliments for specific people </li></ul><ul><li>Compliments you could think to yourself </li></ul><ul><li>Compliments on abilities, appearance and personality </li></ul><ul><li>How often to give a compliment and how to respond </li></ul><ul><li>Giving criticism in a constructive way </li></ul>
  113. 132. Session4: Self-Identity <ul><li>Exploring the future (self in 5 years) </li></ul><ul><li>Roving reporter (interviewing each other) </li></ul><ul><li>What was your most memorable moment in the past? </li></ul><ul><li>What are you looking forward to in the future? </li></ul><ul><li>Collage to represent your character </li></ul><ul><li>Self descriptions “I am……..” </li></ul>
  114. 133. <ul><li>“ I AM” </li></ul><ul><li>Needlessly Technical </li></ul><ul><li>Outwardly Secretive </li></ul><ul><li>Inwardly Friendly </li></ul><ul><li>Openly Opinionated </li></ul><ul><li>Constantly Thinking </li></ul>
  115. 134. Session 5: Managing Anxiety –part 1 <ul><li>Why do we feel anxious? (neurology and survival) </li></ul><ul><li>Situations that create anxiety (comparing across participants) </li></ul><ul><li>Cable game (3 students who tease and bully you are approaching you at lunchtime) </li></ul><ul><li>Anxiety thermometer </li></ul>
  116. 135. Session 6: Managing Anxiety –part 2 <ul><li>An emotion toolbox </li></ul><ul><li>Physical, relaxation, social, thinking, though blocking, inappropriate tools </li></ul><ul><li>Suggestions from the participants </li></ul>
  117. 136. Session 7: Managing Anger <ul><li>What makes me angry </li></ul><ul><li>Tool box </li></ul><ul><li>Repairing the anger of a friend </li></ul>
  118. 137. Session 8: Optimism <ul><li>What makes you feel sad? </li></ul><ul><li>Have you felt sad in the last week? </li></ul><ul><li>Feeling optimistic </li></ul><ul><li>Exercise, relaxation, people and pets, thoughts </li></ul><ul><li>Happy memories </li></ul><ul><li>Events to look forward to Comments and quotations </li></ul><ul><li>Pleasures diary </li></ul>
  119. 138. <ul><li>Stuart: character from Lethal Weapon who was very depressed and wanted to die. </li></ul><ul><li>Group responses: </li></ul><ul><li>“ Suicide is a way of permanently freezing things/yourself the way you are and doesn’t give you a chance to look at the issues and solve them.” - Andrew </li></ul>
  120. 139. Measurement <ul><li>Pre-, post- and follow-up at 2 months </li></ul><ul><li>We measured: </li></ul><ul><li>-Severity of AS (ASASD) </li></ul><ul><li>-Social Skills (Parent and child; Spence) </li></ul><ul><li>-Self-concept (Beck Self-Concept Inventory-Youth) </li></ul><ul><li>-Self-esteem (Rosenberg) </li></ul>
  121. 140. Quantitative Results <ul><li>Self-concept: 6 changed in a positive direction (3, 3, 7, 7, 20, 21) Rest stayed same except 1 (-11) </li></ul><ul><li>Self-esteem: 6 changed in positive direction (3,3,3,4,4,9) </li></ul><ul><li>Emotion Management – no change </li></ul><ul><li>Perspective-taking – mixed results (up and down) </li></ul><ul><li>Social skills – adolescents marked an increase in social skills (7/8; range 3-13) </li></ul>
  122. 141. Qualitative Results <ul><li>All groups:attendance </li></ul><ul><li>Parents observations: </li></ul><ul><li>“ Following the group Scott can now see himself from an observer’s point of view.” </li></ul><ul><li>“ Huge change. Cameron now has a plan, he knows where he’s going.” </li></ul>
  123. 142. Parents <ul><li>“ Malcolm (age 13) was able to look at the older guys and see himself in a different light and realize, “I am not that different.” </li></ul><ul><li>“ The group has encouraged Mitchell to have a say and to express his need to give his opinion on things relating to him at school and at home.” </li></ul><ul><li>“ As parents we takes the kids so far, we need professionals and peers to keep it moving.” </li></ul>
  124. 143. The boys <ul><li>“ I learned there is more than one way to solve a problem.” </li></ul><ul><li>“ Going through the group was like evolving.” </li></ul><ul><li>“ Helps you find out who you really are.” </li></ul><ul><li>“ Fun. Life-changing.” </li></ul><ul><li>“ The group has made it possible to look at people on the inside instead of the label, gives the bigger picture.” </li></ul>
  125. 144. The boys <ul><li>“ I would probably have gone on dateless for the rest of my life if I hadn’t learned about the importance of empathy.” </li></ul><ul><li>“ (The group was) not as I expected, not as focussed on AS. I liked trying to find out who you are on the inside.” </li></ul>
  126. 145. The boys <ul><li>“ They all have bits of me. I have never had the opportunity to talk about these things” </li></ul><ul><li>Toby and Sam’s farewell </li></ul>
  127. 146. Asperger ’ s Syndrome in Girls and Women <ul><li>Only 1 in 20 of Hans Asperger’s clinical sample of children with autistic personality were girls. </li></ul><ul><li>Male Female Ratio 3.4 to one </li></ul>
  128. 147. Pathways to a Diagnosis <ul><li>Diagnosis when at school due to concerns regarding friendships, the art of conversation, unusual interests and learning style, emotion expression and management. </li></ul>
  129. 148. Pathways to a Diagnosis <ul><li>Diagnosis of a relative with ASD and information parents read on Asperger’s syndrome leads to a diagnostic assessment. </li></ul>
  130. 149. Pathways to a Diagnosis <ul><li>Secondary disorder diagnosed in adolescence, such as an anxiety disorder, depression, Borderline Personality Disorder, Anorexia Nervosa. </li></ul><ul><li>Detailed developmental history indicates a diagnosis of Asperger’s syndrome. </li></ul><ul><li>Selective mutism triggered by severe social anxiety </li></ul>
  131. 150. Pathways to a Diagnosis <ul><li>Problems with employment or relationships leads to a search for an explanation for being different. </li></ul><ul><li>Having a child with Asperger’s syndrome. </li></ul>
  132. 151. Profile of Abilities in Girls and Women <ul><li>The invisible end of the spectrum (Ruth Baker). </li></ul><ul><li>Fly under the radar of a diagnosis </li></ul><ul><li>Coping and camouflaging mechanisms of ‘hiding’ and mimicking. </li></ul><ul><li>Tendency to ‘disappear’ in a crowd. </li></ul>
  133. 152. Profile of Abilities in Girls <ul><li>Observe and try to understand before they make the first step. </li></ul><ul><li>Reading fiction (or watching soap operas) helps learn about inner thoughts and feelings. </li></ul>
  134. 153. Profile of Abilities in Girls <ul><li>Apologise and appease </li></ul><ul><li>Chameleon </li></ul>
  135. 154. Profile of Abilities in Girls <ul><li>Less disruptive and so less likely to be noticed. </li></ul><ul><li>We think that if we are very, very good, people will like us and all will be well </li></ul><ul><li>Learn that if you are good, you are left alone. </li></ul><ul><li>Special interests more likely to be unusual in terms of the intensity rather than the focus. </li></ul><ul><li>Imaginary friends. </li></ul>
  136. 155. Characteristics from age 5-12 Years
  137. 156. Self-taught reader Advanced vocabulary
  138. 157. Play <ul><li>Doll play to replay and understand social situations. </li></ul><ul><li>I played with dolls until I was fourteen years old. </li></ul>
  139. 158. Fascination with symmetry and order <ul><li>“ The fun came from setting up and arranging things. Maybe this desire to organise things rather than play with things is the reason I never had any great interest in my peers.” </li></ul>
  140. 159. Gender Specific Toys <ul><li>I loved playing with Lego for years and had many thousands as a child. I also loved cardboard boxes, and drawing/writing. I always ignored the dolls I was given. </li></ul><ul><li>Are model aircraft considered ‘toys’? Is there a gender attached to them? I preferred nature or animals to toys. </li></ul>
  141. 160. Gender Specific Toys <ul><li>I was given gender specific toys such as Barbie dolls but I did not play with them the same way that all other girls I knew played with them. The other girls wanted to play out getting married scenarios whereas I played out adventure scenarios such as replacing Tarzan with my Barbie as the hero rescuing my brother’s Action Man in the jungle. </li></ul>
  142. 161. Friendships <ul><li>Peer support (not bitchy). </li></ul><ul><li>Single friend who provides guidance and security. </li></ul>
  143. 162. Friendship Characteristics <ul><li>She doesn’t play with toys very often but if she does she lines things up and groups them . </li></ul><ul><li>I never identified with my female classmates </li></ul><ul><li>We create our own world in which to do our own thing </li></ul>
  144. 163. Conversation <ul><li>I tend to be didactic and pedantic, and I strive for precision in an imprecise world. </li></ul><ul><li>Sometimes say serious things with a strait face. </li></ul><ul><li>Sometimes my emotions do not match my facial expressions. </li></ul><ul><li>I smile when I am upset. </li></ul>
  145. 164. A Tomboy <ul><li>Many stereotypical girls activities were stupid, boring and inexplicable. </li></ul><ul><li>It is more accurate to say that I am gender-neutral. As a child I liked to play with boys because I enjoyed toy cars, Lego,, building blocks, sports and that kind of thing, and sadly girls are not often given toys like cars and blocks; also girls were more complicated, and unkind in ways I didn’t understand. </li></ul><ul><li>Boys are more logical . </li></ul>
  146. 165. A Tomboy <ul><li>I was very much a tom boy (to my mother’s disappointment) and still have those tendencies, but I have always been interested only in men. Not a good way to attract them! </li></ul><ul><li>Being a tom boy is socially acceptable in the pre-puberty years but less acceptable after puberty </li></ul>
  147. 166. A Tomboy <ul><li>It was easier to identify with boys because they just wanted to have fun. Girls had more social rules to follow or blunder. They had more gossip and didn’t like to get dirty. The guys were fun and I could almost be myself around them. </li></ul><ul><li>I don’t know how to do girl things. </li></ul>
  148. 167. Reaction to Being Different <ul><li>I’m a foreigner forever trying to adapt to a new country. </li></ul><ul><li>I never seem to fit in. I can’t share my emotions easily. </li></ul><ul><li>I don’t connect with people like I do with nature and animals or kids who interact in simpler ways. </li></ul>
  149. 168. The Child ’ s Reaction to Being Different Before the Diagnosis <ul><li>Four reactions: </li></ul><ul><li>Depression and isolation. </li></ul><ul><li>Imagination and fantasy. </li></ul><ul><li>Arrogance. </li></ul><ul><li>Imitation. </li></ul>
  150. 169. Depression and Isolation <ul><li>Increased social withdrawal. </li></ul><ul><li>Reduced motivation and energy. </li></ul><ul><li>Risk of self-harm and impulsive or planned suicide attempts. </li></ul><ul><li>Need for Cognitive Behaviour Therapy, social success and medication. </li></ul>
  151. 170. Imagination <ul><li>Imaginary friends. </li></ul><ul><li>Inhabiting an imaginary world. </li></ul><ul><li>Interest in other worlds and role play games. </li></ul><ul><li>Become an author of fiction. </li></ul><ul><li>I used my love of fantasy to cope with reality (Caroline). </li></ul><ul><li>Unusual fantasy life could be included in the diagnostic criteria (Wolff and McGuire 1995) </li></ul>
  152. 171. Arrogance <ul><li>Over compensation for feeling incompetent in social situations. </li></ul><ul><li>Anyone can get a stylist, Not everyone can get an intellect </li></ul><ul><li>Invariably someone else’s fault (‘Teflon coated’). </li></ul><ul><li>Argumentative: use accurate recall of what was said or done to prove the point. </li></ul>
  153. 172. Arrogance <ul><li>Limited ability to accept they may be wrong. </li></ul><ul><li>Desperate not to appear stupid in a social context. </li></ul><ul><li>Due to delay in Theory of Mind Skills, tend to attribute malicious intent to accidental or friendly acts. </li></ul>
  154. 173. Imitation <ul><li>Observation and absorption of the speech, mannerisms and character, even persona of someone who is socially successful. </li></ul><ul><li>Becoming an expert mimic (successful strategy that is popular with peers). </li></ul><ul><li>Using speech and drama lessons. </li></ul>
  155. 174. Imitation <ul><li>Learning how to act in real social situations. </li></ul><ul><li>I am an exceptional mimic and have used this to survive. I was previously diagnosed with Multiple Personality Disorder. </li></ul><ul><li>I try to be who they want me to be. </li></ul>
  156. 175. Imitation <ul><li>I have done such a great job at pretending to be normal that nobody really believes I have Asperger’s. </li></ul>
  157. 176. Teenagers
  158. 177. Adolescence <ul><li>Power of the peer group for self-esteem. </li></ul><ul><li>In high school, girls treated me like I was something else, not boy, not girl, just an it </li></ul>
  159. 178. Recovery from Social Exhaustion <ul><li>It drains me mentally and physically. I am exhausted after having spent a lot of time with others and I need to recover in solitude. </li></ul><ul><li>Cinderella at the ball at midnight </li></ul><ul><li>I relished isolation and solitude and when I was by myself I thoroughly enjoyed the company of an empty room . (Caroline) </li></ul>
  160. 179. Social Swimming <ul><li>I describe my social life with this analogy. Swimming in the water is nice at first, but if it goes on for too long, or too often, I start to drown. (Yeshe) </li></ul>
  161. 180. The Mask <ul><li>Emily masks in public and will meltdown the second she is out of the situation. </li></ul><ul><li>Dr Jekyl and Mr Hyde. </li></ul><ul><li>Compliant at school, passive aggressive at home </li></ul>
  162. 181. The Inner Self <ul><li>I don’t know who I am </li></ul><ul><li>I cannot communicate my inner self with those I want to. I am unable to communicate on a really deeper level. </li></ul><ul><li>I’m afraid to be myself. If they see me for what I really am, they might not like me. </li></ul>
  163. 182. Conversation <ul><li>I have learned how to be polite to others and fake a conversation. But I am happiest with my three cats being alone. </li></ul><ul><li>It was like I was looking at the same traffic light the other students were looking at but I had not seen the red light that warned me to stop talking and I just saw the green light which said go. (Caroline) </li></ul>
  164. 183. Emotions and the Special Interest <ul><li>My emotional range is quite extreme and somewhat rudimentary. However, when I engage in my special interest on my own, I can access a greater emotional realm and landscape that is wonderful and safe for me, in that context. </li></ul>
  165. 184. Clothing and Fashion <ul><li>Most of my clothing is gender-neutral. I generally don’t like dresses or skirts and find many of them impractical, too ornamental, and uncomfortable; likewise women’s dress shoes. I usually wear unisex sneakers or brown loafer shoes. </li></ul><ul><li>Nothing feminine or fancy! </li></ul><ul><li>Just make sure there are no florals and frilly bits </li></ul>
  166. 185. Clothing and Fashion <ul><li>Girl clothes fit better, but I always try to find androgynous ones. </li></ul><ul><li>Guy clothes are generally more practical </li></ul><ul><li>I like jeans and shirts because I don’t have to think about what to wear. Clothes styles don’t really interest me. I feel odd when I dress fashionably and I am not sure whether I am overdressed or underdressed. </li></ul>
  167. 186. Make Up and Perfumes <ul><li>I can’t stand the feel of foundation on my skin and eye makeup stings my eyes. I do wear lipstick a lot. Make up is greasy and disgusting. </li></ul><ul><li>Olfactory sensitivity for perfumes. </li></ul><ul><li>I have a major aversion to perfume on people. </li></ul><ul><li>I don’t care about fashion or hair styles and I stopped wearing makeup once I got married . </li></ul>
  168. 187. Relationships <ul><li>I’m not really interested in pursuing a romantic relationship or being sexually attractive. The idea of being in close physical contact with someone is repulsive to me. </li></ul><ul><li>Sensory sensitivity, especially tactile. </li></ul>
  169. 188. Relationships <ul><li>Expectations of affection and intimacy. </li></ul><ul><li>Sometimes it is hard to be intimate. </li></ul><ul><li>I’m not physically affectionate or conventionally nurturing. </li></ul><ul><li>High level of AS husbands </li></ul>
  170. 189. Sexuality <ul><li>I’m straight, but inside I’ve always felt mentally androgynous. Although I look very female. </li></ul><ul><li>I’m bisexual and think it fits neatly into my aspieness. </li></ul>
  171. 190. Sexuality <ul><li>I’m interested in alternative sexual expression/sado-masochism/leather fetishism. </li></ul><ul><li>I consider myself to be bi-sexual but I am celibate due to religious reasons. </li></ul>
  172. 191. High Functioning Autism and Celibacy <ul><li>‘ Can I deal with sharing a house with someone who might possibly touch my model airplane collection?’ </li></ul><ul><li>‘ Model airplanes do not decide that they want to be built by someone else who is more attractive or less needy’ </li></ul>
  173. 192. Adults
  174. 193. After the Diagnosis <ul><li>Before I self-diagnosed Asperger’s Syndrome, I was depressed about not fitting in and not knowing why. Now that I’ve met other adults with AS, I’m more happy to know where I belong. </li></ul><ul><li>We still have the same reaction to things but now we know the all-important why </li></ul><ul><li>You can be happy with Asperger’s or miserable with Asperger’s. I’ve tried both. I prefer happy </li></ul>
  175. 194. Interest in the Supernatural <ul><li>Perceiving sensory experiences not perceived by others </li></ul><ul><li>Psychic Sensitivity </li></ul><ul><li>“ I’m an energy healer ” </li></ul>
  176. 195. Relationships <ul><li>Sometimes I would like to be by myself and he feels like I’m pulling away from him… which I’m not. </li></ul><ul><li>You are having to trust someone else that you have no control over with important things in your life, so that if they plan badly or make a mistake you have to cope with the consequences. </li></ul>
  177. 196. Sexuality <ul><li>I had a very strong libido and appreciation of the sensual when I was a young woman; strong sex drive and was able to enjoy sex without emotional attachment. </li></ul><ul><li>Lack of sexual drive. </li></ul><ul><li>When it comes to romantic partners, I look for someone who doesn’t buy into gender stereotypes (all my boyfriends have been bisexual or at least slightly feminine). </li></ul>
  178. 197. Being a Parent <ul><li>Confidence in maternal abilities </li></ul><ul><li>Liane Holiday Willey. </li></ul><ul><li>Unconventional yet conservative mothers; strict, safe, logical, protective and intellectually stimulating </li></ul><ul><li>Distrust of the school system and may advocate for home schooling </li></ul>
  179. 198. Books and Resources
  180. 200. Autobiographies <ul><li>www.jkp.com </li></ul>
  181. 202. www.fhautism.com
  182. 203. Exploring Feelings Cognitive Behaviour Therapy to manage anxiety, sadness and anger
  183. 204. The Perception, Expression and Regulation of Emotions <ul><li>An inherent characteristic of Asperger’s syndrome? </li></ul>
  184. 205. Amygdala
  185. 206. Anxiety <ul><li>Very good at worrying. </li></ul><ul><li>Generalised anxiety (pessimist) </li></ul><ul><li>Obsessive Compulsive Disorder (25% of adults with Asperger’s syndrome) </li></ul>
  186. 207. Coping with Anxiety <ul><li>“ Stimming” reduces stress and anxiety levels </li></ul><ul><li>Calms the child down </li></ul>
  187. 208. Coping with Anxiety <ul><li>Controlling your experiences </li></ul><ul><li>If you share you lose control </li></ul><ul><li>Passive aggressive </li></ul><ul><li>Emotional blackmail </li></ul>
  188. 209. Coping with Anxiety <ul><li>Oppositional and defiant (will not comply) </li></ul><ul><li>Parent becomes a ‘slave’, lack of respect and to be punished if you do not do what the master orders. </li></ul><ul><li>Child intoxicated with his or her power. </li></ul><ul><li>Be assertive, decision is non-negotiable, be impervious to the emotional blackmail </li></ul>
  189. 210. Coping with Anxiety <ul><li>Routines and rituals </li></ul><ul><li>Soothing and relaxing </li></ul><ul><li>Can become compulsions to alleviate feeling anxious </li></ul><ul><li>Become prolonged and more elaborate </li></ul>
  190. 211. Coping with Anxiety <ul><li>A ‘superstitious’ behaviour </li></ul><ul><li>The Curious Incident of the Dog in the Night time(Red cars good) </li></ul><ul><li>Classical Conditioning(House plant) </li></ul><ul><li>Negatively reinforced </li></ul><ul><li>An anticipated sequence </li></ul><ul><li>Change the context or cue for the sequence (examples getting dressed and coming home) </li></ul>
  191. 212. Coping with Anxiety <ul><li>Thought blocker </li></ul><ul><li>Special interest </li></ul><ul><li>From a spinning coin to computer games </li></ul><ul><li>If denied access when anxious, frustration at not being able to cope without the blocking activity turns to anger </li></ul><ul><li>Need more strategies to manage anxiety </li></ul><ul><li>See Tool Box </li></ul>
  192. 213. Meltdown versus Tantrum From Anxiety to Meltdown by Deborah Lipsky Meltdown <ul><li>Overwhelmed by social, cognitive and sensory experiences </li></ul><ul><li>Catastrophic reaction </li></ul><ul><li>Involuntary response </li></ul><ul><li>Escape </li></ul><ul><li>Solitude, reassurance </li></ul>Tantrum <ul><li>Response to frustration </li></ul><ul><li>Emotional backmail </li></ul><ul><li>End quickly </li></ul><ul><li>Non-negotiable </li></ul><ul><li>Assertive and calm </li></ul>
  193. 214. Depression <ul><li>Occurs in one in three adolescents and adults </li></ul><ul><li>Low self-esteem due to being rejected and ridiculed by peers </li></ul><ul><li>Painful awareness of being different </li></ul>
  194. 215. Depression <ul><li>Loneliness </li></ul><ul><li>Mental exhaustion </li></ul><ul><li>Depression ‘attack’ </li></ul><ul><li>Suicide attempts in adults </li></ul>
  195. 216. Anger <ul><li>Two out of three people with Asperger’s syndrome have a problem with anger management. </li></ul><ul><li>Sadness and anxiety expressed as anger </li></ul>
  196. 217. Sadness Expressed As Anger
  197. 218. Anger <ul><li>Achieve solitude </li></ul><ul><li>Dominance and control (anxiety) </li></ul><ul><li>Limited tolerance of frustration </li></ul><ul><li>Not knowing what else to do </li></ul><ul><li>Anger due to not being successful (activities and socially) </li></ul><ul><li>Agitated externalized depression </li></ul>
  198. 219. Exploring Feelings: Affection
  199. 220. The Understanding and Expression of Affection <ul><li>Ability to read the signals when someone expects affection. </li></ul><ul><li>Ability to express the appropriate level of affection. </li></ul>
  200. 221. The Understanding and Expression of Affection <ul><li>Affection to repair someone’s feelings. </li></ul><ul><li>An immature expression of affection. </li></ul><ul><li>A limited vocabulary of expression that may not include subtle or age appropriate expressions. </li></ul><ul><li>Sometimes needing frequent expressions of affection for reassurance. </li></ul>
  201. 222. <ul><li>“ We feel and show affection but not often enough, and at the wrong intensity ” </li></ul>
  202. 223. Edgar Schneider <ul><li>At one point my mother, exasperated at me, said, “You know what the trouble is? You don’t know how to love! You need to learn how to love!” I was taken aback totally. I hadn’t the faintest notion what she meant. I still don’t. </li></ul>
  203. 224. The Asperger’s Perspective <ul><li>Why are typical people so obsessed with expressing reciprocal love and affection? </li></ul><ul><li>A hug can be an uncomfortable, constricting squeeze. </li></ul><ul><li>Don’t cry because someone will squeeze you. </li></ul><ul><li>Not comforted by affection to the degree that neurotypicals expect. </li></ul>
  204. 225. The Asperger’s Perspective <ul><li>Enjoy a very brief and low intensity expression of affection. </li></ul><ul><li>Confused or overwhelmed with greater levels of expression. </li></ul>
  205. 226. The Asperger’s Perspective <ul><li>Compassion for someone’s physical suffering (broken wrist) and a practical expression of love and affection. </li></ul><ul><li>Comfortable with expressing affection for an animal. </li></ul>
  206. 227. Asperger’s Perspective <ul><li>The capacity for affection, a cup versus a bucket. </li></ul>
  207. 228. Parent’s or Partner’s Perspective <ul><li>Rare use of gestures and words of affection lamented by a parent or partner. </li></ul><ul><li>Not being soothed or comforted by gestures and words of affection. </li></ul><ul><li>Too intense an adoration or ‘crush’ on someone who has expressed an act of kindness. </li></ul>
  208. 229. Temple Grandin <ul><li>My brain scan shows that some emotional circuits between the frontal cortex and the amygdala just aren’t hooked up- circuits that affect my emotions and are tied to my ability to feel love. I experience the emotion of love, but it’s not the same way that most neurotypical people do. Does this mean my love is less valuable than what other people feel? </li></ul>
  209. 230. The Exploring Affection Program <ul><li>For children with a diagnosis of Asperger’s syndrome who have: </li></ul><ul><li>Immaturity in the understanding or expression of affection. </li></ul><ul><li>Anxiety or become agitated in family situations when affection is expected or expressed. </li></ul>
  210. 231. Aims of the Program <ul><li>Affection education to ‘de-mystify’ affection. </li></ul><ul><li>To understand why people need and enjoy affection. </li></ul><ul><li>Explain and encourage appropriate expressions of affection. </li></ul><ul><li>Explain to parents the perspective of the child with Asperger’s syndrome. </li></ul>
  211. 232. Construction and Evaluation of 3 Affection Measures for Children with Asperger’s syndrome <ul><li>The Affection for Others Questionnaire (20 items) </li></ul><ul><li>Affection for You Questionnaire (19 items) </li></ul><ul><li>General Affection Questionnaire (12 items) </li></ul>
  212. 233. Results: Lee, Sofronoff, Sheffield and Attwood (in press) <ul><li>126 families, children 4-13 years </li></ul><ul><li>Diverse range of difficulties </li></ul><ul><li>Affectionate gestures almost entirely absent to excessive gestures </li></ul><ul><li>Inappropriate and immature understanding and expression </li></ul><ul><li>Associated with Theory of Mind and sensitivity to touch </li></ul>
  213. 234. Program <ul><li>4 sessions, each session was for one hour with the children, then 30 minutes with their parents. </li></ul><ul><li>Practical and entertaining activities. </li></ul><ul><li>Social Stories. </li></ul><ul><li>Projects. </li></ul>
  214. 235. Session 1 <ul><li>Ten activities or experiences you enjoy. </li></ul><ul><li>Write the number from 0 to 100 for how much you like each one. </li></ul><ul><li>Each activity written on a ‘Post It’ and placed on a ‘thermometer’ to measure the degree of enjoyment. </li></ul>
  215. 236. Session 1 <ul><li>Ten people you like and how much you like that person (pets). </li></ul><ul><li>Each person’s name written on a ‘Post It’ and placed on a ‘thermometer’ to measure the degree of liking or loving. </li></ul><ul><li>Explanation of the dimension from like to love. </li></ul>
  216. 237. Session 1 <ul><li>How do those people express their feelings that they like or love you? </li></ul><ul><li>Reasons why we express our feelings of liking or loving someone. </li></ul><ul><li>The things that are nice and not so nice about being liked or loved. </li></ul><ul><li>Social Story </li></ul>
  217. 238. How liking or loving someone can affect your feelings, thoughts and abilities <ul><li>When someone likes or loves you, there can be a change to the way you feel, think and what you can do. </li></ul><ul><li>The feelings you can have when someone likes or loves you are feelings of being happy, excited, comfortable and warm. These are really nice feelings that can make you feel good. </li></ul><ul><li>Your thinking can be better when someone likes or loves you. You can think you are Okay, likeable, and that life is good. </li></ul>
  218. 239. <ul><li>When someone likes or loves you, you are able to relax, talk to the person, and express your feelings. </li></ul><ul><li>There are some not so nice things about being liked or loved. </li></ul><ul><li>The person could worry about you and you could worry about them. They could disappear from your life and you would feel sad and miss them. They could be annoying sometimes. </li></ul><ul><li>But if you like someone or love someone, they can play with you, talk to you, say nice things about you, buy things for you, protect you and help you. </li></ul><ul><li>Life is easier and happier when people like and love each other. </li></ul>
  219. 240. Project <ul><li>Collect pictues or drawings of people your age expressing that they like or love someone. </li></ul><ul><li>Discover with your family, situations where they would expect you to express that you like or love them, but that you find difficult. </li></ul>
  220. 241. Session 2 <ul><li>Placing the pictures collected for the project on the like to love thermometer. </li></ul><ul><li>What can you say or do to show that you like someone? </li></ul><ul><li>For each suggestion, how much liking does this show from 1-50. </li></ul>
  221. 242. Session 2 <ul><li>What can you say or do to show that you love someone? </li></ul><ul><li>For each suggestion, how much love does this show from 51-100. </li></ul>
  222. 243. Session 2 <ul><li>When do we show affection and how much? </li></ul><ul><li>Getting the balance right. </li></ul><ul><li>Game of matching the type of affection for each person. </li></ul><ul><li>List of people (from strangers to a parent) and types of affection (from a smile to a kiss) </li></ul>
  223. 244. Project <ul><li>The situations at home that someone expects an expression of affection that the child finds difficult to express. </li></ul><ul><li>Think of one situation. </li></ul><ul><li>What was that situation? </li></ul>
  224. 245. Project <ul><li>Think of some of the expressions discussed today that you could use in that situation. </li></ul><ul><li>Have a go at expressing affection. </li></ul>
  225. 246. Session 3 <ul><li>Review the project, when, what type of affection, what did the person say or do, how did you feel? </li></ul>
  226. 247. Session 3 <ul><li>When do we use affection? </li></ul><ul><li>Game of matching a list of situations with different types of affection. </li></ul>
  227. 248. Session 3 <ul><li>How can you tell if someone needs affection? </li></ul><ul><li>How can you tell if you have given too much affection? </li></ul><ul><li>How can you tell if you have given not enough affection? </li></ul>
  228. 249. Project <ul><li>A log book for the child and a parent that provides a record of when the child expressed affection and some examples of the type of affection. </li></ul>
  229. 250. Person completing the log book of affection: Please place a  in the box when you have expressed each type of affection. See if you can express each type of affection at least twice a day. Types of Affection Wednesday Thursday Friday Saturday Sunday Monday Tuesday 1 Listen                             2 Spend fun time with the person                             3 Do something helpful for the person                             4 Say “I Love You”                             5 Kiss or hug the person                             6 Give the Person a compliment                            
  230. 251. Session 4 <ul><li>Why do we give affection? </li></ul><ul><li>What would happen if nobody showed you that they liked or loved you? </li></ul><ul><li>How would you feel, what would you say, what would you do? </li></ul><ul><li>What would happen if you stopped showing your friends that you liked them? </li></ul><ul><li>How would your friend feel etc. </li></ul>
  231. 252. Session 4 <ul><li>If you did not get enough affection, how could you make yourself feel better? </li></ul><ul><li>Review of the program, what have you learned? </li></ul><ul><li>What can you do in the future? </li></ul><ul><li>Certificate of achievement. </li></ul>
  232. 253. The Cat-kit
  233. 254. Emotional Toolbox: To Fix The Feeling
  234. 255. Physical Activity Tools . Quick release of emotional energy <ul><li>Physical exercise, walk, run, trampoline. </li></ul><ul><li>Sport. (Basket Ball, golf, weight lifting) or dancing. </li></ul><ul><li>Creative destruction (recycling). </li></ul>
  235. 256. Physical Activity Tools . <ul><li>Drum Kit. </li></ul><ul><li>Swing. </li></ul><ul><li>Orange squeezing. </li></ul><ul><li>Bite an apple. </li></ul><ul><li>Break a pencil. </li></ul>
  236. 257. Relaxation Tools . Slow release of emotional energy <ul><li>Relaxation training. </li></ul><ul><li>Music. “Feelings put into sound” Matthew. </li></ul><ul><li>Solitude. </li></ul><ul><li>Massage. </li></ul><ul><li>Comedy programs. </li></ul><ul><li>Repetitive action. </li></ul><ul><li>Sleep </li></ul><ul><li>Routines are comforting (replace affection) </li></ul>
  237. 258. Social Tools <ul><li>Time with a family member or friend. </li></ul><ul><li>Disclosure (typing, music, poetry) </li></ul><ul><li>Seek advice. </li></ul><ul><li>Being with a pet. </li></ul>
  238. 259. Social Tools: Affection <ul><li>Approval </li></ul><ul><li>Intensity </li></ul><ul><li>Duration </li></ul>
  239. 260. Thoughts and perspective <ul><li>Put the events in perspective. </li></ul><ul><li>Imagine what you would like to do or say. </li></ul><ul><li>Being calm is being smart (IQ) </li></ul>
  240. 261. Special Interests <ul><li>A means of relaxation, pleasure. </li></ul><ul><li>Knowledge to overcome fear. </li></ul><ul><li>Keeps anxiety under control </li></ul><ul><li>Thought blocking. </li></ul><ul><li>Interest or OCD. Is it irresistible? </li></ul>
  241. 262. Special Interest <ul><li>Collecting and cataloguing (personal defrag). </li></ul><ul><li>Distraction during a meltdown. </li></ul><ul><li>The ‘off switch’ </li></ul><ul><li>Motivation and conceptualization ( Dr Who) </li></ul>
  242. 263. Sensory Tools <ul><li>Sounds. Ear plugs, headphones. </li></ul><ul><li>Light. Irlen Lenses, hat, sun glasses. </li></ul><ul><li>Aroma. deodorants, cleaning products. </li></ul><ul><li>Tactile. Clothing. </li></ul>
  243. 264. Medication As a Tool <ul><li>Treatment of an anxiety disorder or a clinical depression. (SSRI). </li></ul><ul><li>Impulsive. (Stimulants). </li></ul><ul><li>Mood cycles. (anti-convulsants). </li></ul><ul><li>Sedation. (anti-psychotics) </li></ul>
  244. 265. Inappropriate Tools <ul><li>Fight. </li></ul><ul><li>Being alone too long. </li></ul><ul><li>Taking stress out on someone else. </li></ul><ul><li>Hurt yourself. </li></ul><ul><li>Arguing. </li></ul><ul><li>Rude behaviour a quick stress release. </li></ul>
  245. 266. Inappropriate Tools <ul><li>Affection. </li></ul><ul><li>“ Would a hug help?-no- I get madder. </li></ul><ul><li>Punishment. </li></ul><ul><li>Talking. </li></ul><ul><li>Emotional. </li></ul><ul><li>Adults: Use of alcohol and illegal drugs. </li></ul>
  246. 267. <ul><li>Different tools at different points on the thermometer. </li></ul><ul><li>Relaxation tools at low stress levels, physical tools at high stress levels. </li></ul>
  247. 268. Managing a Crisis <ul><li>Reduce social and sensory confusion or overload </li></ul><ul><li>Remain calm with a quiet and reassuring voice. </li></ul><ul><li>Do not express agitation or anxiety </li></ul><ul><li>Try not to touch or restrain the child </li></ul>
  248. 269. Managing a Crisis <ul><li>Be cautious regarding affection </li></ul><ul><li>Do not ask what happened </li></ul><ul><li>Distract with a special interest </li></ul><ul><li>Avoid stating consequences </li></ul><ul><li>Just stay quietly with the person until he or she has calmed down, reinforcing being calmer </li></ul>
  249. 271. Evaluation Studies <ul><li>Sofronoff, K et al (2005) ‘A randomised controlled trial of a CBT intervention for anxiety in children with Asperger syndrome.’ Journal of Child Psychology and Psychiatry 46, 1143-1151. </li></ul><ul><li>Sofronoff, K et al (2007) ‘A randomized controlled trial of a CBT intervention for anger management in children diagnosed with Asperger syndrome.’ Journal of Autism and Developmental Disorders 37, (1203-1214). </li></ul>
  250. 272. Sexuality
  251. 273. <ul><li>Don’t “invade people’s space”-that means get too close to them. </li></ul><ul><li>Don’t stare at someone whatever reason (however fit they are!). </li></ul><ul><li>Don’t make comments about people’s bodies, good or bad. </li></ul>
  252. 274. <ul><li>Don’t tell dirty, sexist or racist jokes or make sexual innuendos. </li></ul><ul><li>Don’t hug or touch people unless they are part of your family or they have agreed to be your boyfriend or girlfriend and you have both agreed to it. </li></ul>
  253. 275. <ul><li>Here comes the but… you just watch and listen to a group of teenage boys or girls. They tell dirty jokes and make sexual innuendos at every opportunity and they will often touch someone when they are not a member of their family. It seems that when boys and girls are in their teenage packs, performing their adolescent rituals, then these rules go out of the window. What a strange world we live in. </li></ul>
  254. 276. Sexuality <ul><li>Delay of about five years in experiencing a romantic relationship </li></ul><ul><li>Crush (celebrities, strangers, class mates) </li></ul><ul><li>Pursue the person for longer than typical peers. </li></ul><ul><li>More likely to touch the person inappropriately. </li></ul><ul><li>Believe the person has reciprocal feelings. </li></ul>
  255. 277. Sexuality <ul><li>Inappropriate comments “Is it OK if I ************? </li></ul><ul><li>Vulnerability </li></ul><ul><li>Sources of information </li></ul>
  256. 278. The relationship continuum Sexual Behaviours Flirting (showing off, looking, smiling, etc.) Meeting, noticing Spending time together Giving gifts, sharing Asking out (Option 1) Going out (alone) Asking out (Option 2) Arm around each other Kissing lightly on cheek light kiss on lips (mouth closed) longer kiss on lips (mouth open) deep open mouth kiss, using tongues Touching - with clothes - without clothes Sexual intercourse Body responses Heart beats faster Sweaty palms Blushing Going out (in a group) Standing or sitting close together Holding hands Hugging Oral sex Right at the start (‘Wow! I like you!’) Getting to know you/maintaining the relationship (‘You’re special – I care about you’) Touching (‘I love being close to you’)
  257. 279. Sexuality <ul><li>The dating game. </li></ul><ul><li>The art of flirting and romance </li></ul><ul><li>Signals of mutual attraction </li></ul><ul><li>Expression of affection </li></ul><ul><li>Misinterpretation of intentions </li></ul><ul><li>Wait until girls mature and become maternal </li></ul>
  258. 283. Talking to Girls
  259. 286. Affection <ul><li>. </li></ul>
  260. 287. Love and Relationships
  261. 288. Falling in Love with an Aspie
  262. 289. Typical History of Relationships. <ul><li>Late developer in social/emotional maturity. </li></ul><ul><li>Not sexist, ageist or culturally biased in choice of friends and partner. </li></ul><ul><li>“ Wanting to be a friend and lover but with little intuitive knowledge and experience of how to do either.” </li></ul>
  263. 290. What Attracted You to Your Aspie Partner? <ul><li>The silent, handsome stranger. </li></ul><ul><li>Admiration of intellect or abilities. </li></ul>
  264. 291. What Attracted You to Your Aspie Partner? <ul><li>Compassion for his/her limited social skills. </li></ul><ul><li>Better looking than I would expect my partner to be. </li></ul><ul><li>Belief his or her character was due to childhood circumstances and the person will change in a new relationship. </li></ul>
  265. 292. What Attracted You to Your Aspie Partner? <ul><li>Shared interests (hobbies, animals). </li></ul><ul><li>The degree of adulation. </li></ul><ul><li>Fidelity in relationships. </li></ul><ul><li>‘ I saw the heart not the behaviour’ </li></ul>
  266. 293. What Attracted You to Your Aspie Partner? <ul><li>‘ Pillar’ of the community. </li></ul><ul><li>Child like quality, a ‘Peter Pan’. </li></ul><ul><li>Creative in his/her work and good career prospects. </li></ul><ul><li>Similar characteristics to a parent (learned the language and culture in childhood). </li></ul>
  267. 294. What Attracted You to Your Aspie Partner? <ul><li>A challenge to get to know. </li></ul><ul><li>“ I was his first serious relationship.” </li></ul><ul><li>A lateral thinker. </li></ul><ul><li>A child like personality. </li></ul><ul><li>Not ‘macho’. </li></ul>
  268. 295. Oscar Wilde <ul><li>‘ Women love men for their defects’ </li></ul>
  269. 296. What Attracted You to Your Typical Partner? <ul><li>Good in social situations, network of friends </li></ul><ul><li>Accepting & listening, good to talk to </li></ul><ul><li>Good looking </li></ul><ul><li>Executive secretary, well organized </li></ul>
  270. 297. Other Qualities <ul><li>Someone who likes me, doesn’t want to change me </li></ul><ul><li>Expressiveness and compassion </li></ul><ul><li>Translator of the AS point of view </li></ul><ul><li>A tutor in terms of what to do socially </li></ul>
  271. 298. Other Qualities <ul><li>Takes care of emotional problems e.g. with in-laws </li></ul><ul><li>Direct speech- no hidden meanings </li></ul><ul><li>Nurturing </li></ul><ul><li>Positive and shared sense of humor </li></ul>
  272. 301. The Social Quotient
  273. 302. High Functioning Autism and Celibacy <ul><li>‘ Can I deal with sharing a house with someone who might possibly touch my model airplane collection?’ </li></ul><ul><li>‘ Model airplanes do not decide that they want to be built by someone else who is more attractive or less needy’ </li></ul>
  274. 304. Derogatis Scale Normal range <ul><li>Fantasy (50) </li></ul><ul><li>Attitude (46) </li></ul><ul><li>Drive (44) </li></ul>Significantly below normal range <ul><li>Information (41) </li></ul><ul><li>Satisfaction (40) </li></ul><ul><li>Experience (39) </li></ul><ul><li>Body Image (34) </li></ul>
  275. 305. The Effects of the Relationship on Each Partner: Neurotypical
  276. 306. Loneliness
  277. 307. Affection Deprivation <ul><li>Fixes rather than empathizes </li></ul><ul><li>Love and affection as an emotional restorative. </li></ul><ul><li>Affection capacity (bucket or a cup). </li></ul>
  278. 309. The Communication of Affection <ul><li>Ability to read the signals when someone expects affection. </li></ul><ul><li>Ability to express the appropriate level of affection. </li></ul><ul><li>“ How does a hug and closeness solve the problem?” </li></ul>
  279. 310. In love with the special interest
  280. 311. Mirroring <ul><li>‘ Mirror’ the Aspie partners behaviour, life style and thinking to survive. </li></ul><ul><li>Aspie is dominant in a household and infectious </li></ul>
  281. 312. <ul><li>‘ I have developed into the person necessary for him” </li></ul><ul><li>“ Take your self-confidence and energy” </li></ul>
  282. 313. One thing that I love about my Aspie partner <ul><li>Detailed and practical brain </li></ul><ul><li>Always tries so hard to understand my emotions </li></ul><ul><li>Different from anyone else </li></ul><ul><li>Passionate about certain things </li></ul><ul><li>Nobody else interests me, he is unique </li></ul>
  283. 314. Cassandra Phenomenon
  284. 315. Intimacy <ul><li>Romance, sensuality and foreplay. </li></ul><ul><li>Tactile sensitivity. </li></ul><ul><li>Frequency and value of intimacy. </li></ul><ul><li>Response to counseling. </li></ul>
  285. 316. Sexuality <ul><li>Pornography </li></ul><ul><li>Fetish </li></ul><ul><li>Bisexuality and homosexuality </li></ul>
  286. 317. Intimacy <ul><li>Romantic and passionate relationship with someone you often have to look after as a child. </li></ul><ul><li>Love making script. </li></ul><ul><li>Fraudulent and artificial attempts at real intimacy </li></ul>
  287. 318. Aspie Partner <ul><li>May also feel irritated and depressed. </li></ul><ul><li>Feeling of being unable to meet his or her partner’s expectations in terms of social, emotional and intimacy expectations. </li></ul>
  288. 319. Aspie Partner <ul><li>“ You should know” </li></ul><ul><li>“ The longer I live with them, the less I know about my partners” </li></ul><ul><li>“ Safety exists for me only when I am by myself” </li></ul>
  289. 320. Aspie Partner <ul><li>Expression of inner thoughts and feelings, </li></ul><ul><li>Coping with change, the sanctuary of home </li></ul><ul><li>Conversation </li></ul><ul><li>Household responsibilities from budgeting to taking care of the children. </li></ul>
  290. 321. Stages in the Relationship <ul><li>Greater depth of love (Winnie’s research) </li></ul><ul><li>Delirious and denial </li></ul><ul><li>Realization of difficulties </li></ul><ul><li>Depression (loneliness, affection deprivation, solo parent, self-identity) – lack of energy </li></ul><ul><li>Anger, separation </li></ul><ul><li>Diagnosis positive (know why) and negative (difficulty in encouraging partner to change) </li></ul><ul><li>Develop accommodating strategies </li></ul>
  291. 322. What Strategies Strengthen the Relationship? <ul><li>Recognition of the diagnosis. </li></ul><ul><li>Motivation of both partners to change and learn. </li></ul><ul><li>Relationship information and counselling. </li></ul>
  292. 323. What Strategies Strengthen the Relationship? <ul><li>Support from other family members and one’s children. </li></ul><ul><li>Having good friends (soul mate). </li></ul><ul><li>Having an independent social life. </li></ul><ul><li>Not to feel guilty about having an alternative social life. </li></ul>
  293. 324. What Strategies Strengthen the Relationship? <ul><li>An occasional escape. </li></ul><ul><li>A mutual understanding of two different cultures and ways of thinking. </li></ul><ul><li>Emotion management strategies. </li></ul><ul><li>Guidance in social skills. </li></ul><ul><li>Open and effective communication. </li></ul>
  294. 328. Resources <ul><li>Partner support group. </li></ul><ul><li>Sydney support group, ASPIA </li></ul><ul><li>Asperger’s Syndrome Partners Information Australia </li></ul><ul><li>www.aspia.org.au </li></ul><ul><li>www.faaas.org </li></ul>
  295. 329. The Parent with Asperger’s Syndrome
  296. 330. Issues for the Aspie parent <ul><li>Understanding natural childhood abilities and behaviour. </li></ul><ul><li>The role and responsibilities of being a parent. </li></ul><ul><li>Wants the children to succeed but using criticism not compliments. </li></ul><ul><li>Not intuitively knowing how to be a good parent. </li></ul>
  297. 331. Child’s Perception <ul><li>Lack of affection, understanding, emotional support, acceptance, reassurance, encouragement. </li></ul><ul><li>Feel invisible or a nuisance. </li></ul><ul><li>High expectations. </li></ul><ul><li>Embarrassment in public and with friends. </li></ul><ul><li>Not understanding the child’s perspective. </li></ul>
  298. 332. <ul><li>I almost had an Australian pen friend when I was 6 years old. I was very excited to receive a letter from the other side of the world, long before the Internet existed. I could hardly contain my excitement and couldn’t wait to write to this new friend and exchange my news. I had read the letter and wanted to answer her questions, but my mother had other ideas. ‘There are spelling mistakes in this letter, first you must correct her spelling mistakes and send the corrected letter back to her. This is how she will learn to spell’. I don’t know whether this little girl learned to spell because I never heard from her again. </li></ul>
  299. 333. Child’s Perception <ul><li>Fear of the parent’s mood and not to antagonize. </li></ul><ul><li>The ‘cold’ touch of affection. </li></ul><ul><li>Affection for pets or time spent engaged in the special interest greater than for the child. </li></ul><ul><li>Educates rather than plays with the child. </li></ul>
  300. 335. Magnets <ul><li>Two magnets - that either attract or repel each other. </li></ul><ul><li>Adored or despised. </li></ul><ul><li>Attract : Seek affection and approval. </li></ul><ul><li>Seek a partner with a similar profile of abilities. </li></ul>
  301. 336. Child’s Reaction <ul><li>Repel: Desire to leave home or move inter-state or abroad. </li></ul><ul><li>Hatred. </li></ul><ul><li>Escape using imagination, solitude, alternative family. </li></ul>
  302. 337. Brisbane Support Group <ul><li>Support group for children and teenagers with a parent who has Asperger’s syndrome </li></ul><ul><li>Run by the Asperger Partner’s Support Group </li></ul>
  303. 338. Experiences <ul><li>My dad sometimes can be in a childish mood where he would be silly or jealous. It is very difficult for me to have to boss him around . </li></ul><ul><li>Controlling and anger </li></ul>
  304. 339. <ul><li>Sometimes you question their love for you </li></ul><ul><li>Favouritism </li></ul><ul><li>He does not know how to join in other’s happy moments. When I shared an achievement or happy news, he would always respond with a ‘but’. Whenever there is anything exciting or enjoyable, he would take you down. </li></ul>
  305. 340. Coping <ul><li>Give him the signals to show you are upset </li></ul><ul><li>Tell my friends why he does it </li></ul><ul><li>My dog comes to my rescue </li></ul><ul><li>Lock myself in my room </li></ul>
  306. 341. Coping <ul><li>I force him to hug me </li></ul><ul><li>I Know that his actions don’t always portray his love </li></ul><ul><li>Visiting homes of extended family and friends </li></ul><ul><li>Mum jumps in to back me up </li></ul>
  307. 342. Happy Families?

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