This document discusses cultural awareness and differences between those with Asperger's syndrome and neurotypicals. It provides an overview of Asperger's symptoms and challenges with social skills, central coherence, theory of mind, and executive functioning. The social integration model for assisting those with Asperger's to improve social functioning in real-world settings is also examined. Examples of individual development and a call to celebrate differences in perspective are presented.

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

2. The “Stuff” People Say...

3. Cultural Awareness
Preparing for Discovery

4. Cultural Awareness
Purpose
Cultural Awareness is the foundation of
communication and it involves the ability of standing
back from ourselves and becoming aware of our
cultural values, beliefs and perceptions. Why do we
do things in that way? How do we see the world?
Why do we react in that particular way? (Stephanie
Quappe &Giovanne Cantatore, 2005)
Cultural awareness becomes central when we have to
interact with people from other cultures.
Aspergers – Innate Culture

5. Multicultural Approach
Culture: "any group of people who identify or
associate with one another on the basis of some
common purpose, need, or similarity of background"
(Axelson, 1999)
Multiculture: Distinct group uniqueness and
concepts that facilitate attention to individual
differences (Gladding, 2009)
Asperger's Syndrome is unique and diverse in
symptom presentations and prognosis. Each person
with AS has unique strengths, deficits, and needs.

6. Cultural Awareness
Increasing cultural awareness means to see both the
positive and negative aspects of cultural differences
– celebrating discovery
Degrees of Awareness
My Way is the only way
I know their way, but my way is better
My way and Their way
Our Way (shared meaning – participatory)
“Labels are for soup cans”

7. Let’s Travel ….

8. Discover Differences
Asperger Syndrome (AS) is considered a pervasive developmental
disorder at the higher functioning end of the autism spectrum.
It is characterized by sustained impairment in:
Social interaction and
limited interests
stereotyped and repetitive behavior (Stiefel, Shields, Swain, &
Innes , 2008)
In contrast to autism, there are no obvious delays in language or
cognitive development, or in age appropriate self-help skills and
adaptive behaviors though there are subtle impairments.
More common in males then females
Officially recognized in 1994 in the DSM-IV (Elkis-Abuhoff, 2004)

9. Aspergers
Left Handed
Neurotypicals
Right Handed
Discover
Differences

10. Neurotypicals are Better
FALSE

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

12. Common Traits &
Characteristics
socially awkward and clumsy physically awkward in sports
naive and gullible very accurate memory for
details
unaware of others' feelings
trouble understanding things
unable to carry on they have heard or read
conversation
inappropriate body language &
easily upset by changes expression
literal in speech and repetitive and irrelevant
understanding comments
sensitive to loud sounds, lights, unusually loud, high or
odors monotonous voice
fixated on one subject or object rock, fidget or pace while
concentrating

13. Central Coherence
Ability to focus on both details as well as wholes
Challenges with Central Coherence suggests that a
person with Aspergers struggles with information
processing leading to limitations with understanding
the “big picture” and getting stuck on details.
Weak central coherence leads to an inability to bring
together various details from perception to make a
meaningful whole AKA Gestalt

14. Central Coherence
Heightened focus on details rather than wholes
Sensory struggles (hypersensitive sensory perception)
Reading comprehension
Theory of Mind
Executive Functioning
The inability to hold information in mind in order to
use it later (poor working memory)

15. Assess current skills &
needs in order to develop
intervention plan
Keep structural timetable
Consistent is key – limits Central
possible confusion or
distress Coherence
Keep instructions simple
& clear (resume style)
Tips
Be aware of possible
distractions
Start simple/easy and
work up

16. Group I
Group II

17. Group I

18. Group II

19. Theory of Mind
Challenges with Theory of Mind suggests that a
person with Aspergers has an arduous time gaining
insight to the thoughts, feelings, and beliefs that are
distinctive to others AKA perspective.
An inability to recognize that other people have
thought's, feelings and intentions that are different to
one’s own and an inability to intuitively guess what
these might be

20. Theory of Mind
Mind Blindness – difficulty conceptualizing and appreciating
the thoughts and feelings of others
Being able to relate to and understand the behaviors of others
(distinguishing whether someone's actions are intentional or
accidental).
Mind Blindness leads to Social Struggle
Poor communication skills
Difficulty with:
Providing adequate information
Commenting on conversation
Organizing thoughts
Inability to take another’s perspective, predict outcomes and
decipher intentions
Difficulty generalizing tasks to everyday situations

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

22. Theory of Mind
Social Need Perspective

23. Executive Functioning
Challenges in Executive Functioning suggests that the cognitive
process makes it difficult to execute some practical living
functions.
Some examples:
Organizing
Planning
Sequencing
Getting tasks and/or activities started (initiating)
Completing
Changes/Transitions
Focus
Emotional Control

24. Executive Functioning
The way people monitor and control their thoughts
and actions (Carlson & Moses, 2001).
Impairment or deficits in the higher-order processes
that enable us to plan, sequence, initiate and sustain
our Bx towards some goal, incorporating feedback
and making adjustments along the way.
Involves working memory, planning, cognitive
flexibility and inhibitory control (language
development).

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

26. Awarness
Perception Perspective
He/She doesn’t care – Theory of Mind –
Struggles with Mind
has No Empathy Blindness
He/She doesn’t care – Weak Central Coherence
they never listen or pay – Struggle with details vs
whole (lost/confused/left
attention behind)
He/She doesn’t care - Executive Functioning –
Struggle with
lazy, and careless organization, prioritizing

27. Awareness

28. Social Integration Model
Social Integration Model is rooted in the belief that it is the
responsibility of healthcare providers to prepare clients for life outside
of Tx - designed to assist individuals in reaching the highest level of
individual functioning possible.
Emotional and psychological support are foundational. Focus on
facilities is less important than how individuals act, behave and
function outside of contained four walls. What really matters is how
individuals function in the real world – that is the premise of the
Social Integration Model.
Social Integration Model immerses individuals into real life activities
within the community.
Recreational, social, cultural and life skills activities within the
community with healthcare professionals form the core treatment
interventions in the Social Integration Model

29. Within the community, licensed
healthcare professionals observes clients
in real life situations, and intervene, as
appropriate, right there, on the spot and
in the moment. These observations are
then incorporated into the individuals
ongoing treatment plan.
Social Integration Model
How Does It Work

30. Benefits of Social Integration
Reduces being marginalized – Exposure for
individuals exposure for the community (Demystify)
Practicing coping skills in the moment with support
from healthcare providers with immediate feedback.
Social involvement with therapeutic support
promotes effective participation in family,
occupational, community and societal life.

31. Real Life – Real Time – Relevant
Social Integration Model for Aspergers
The adaptation of the social integration model is to
help normalize behaviors. The philosophical goal is
to assist individuals with Aspergers to achieve
maximum social functioning so that they integrate
into their families and society at large and can thus
enjoy those benefits of belonging and participating.
Social and Life Skills development - through
modeling, active training, exposure, experience,
practice, repetition, etc.
Kinesthetic

32. Social Integration Model
Delivery of therapeutic learning to eat with proper
manners at the table
services in the natural maintaining an organized
environment is embedded personal space
developing habits that establish
in the DNA of the Social proper ADLs
Integration Model. learning to behave in proper
fashion in public places such as
Every activity must be stores & restaurants
learning conflict resolution in
looked at as an public settings
opportunity to provide establishing an ability to function
therapeutic services that in high stimulus environments
(i.e. theme parks & other
increase social recreational activities)
functioning. developing healthy eating habits
developing healthy exercise
regimens

33. Experience, Exposure,
Opportunity
Social Integration Model

34. Colors of Development
Hunter
Sage

35. Felt different
Emotionally Reactive
Poor sense of self
Direct and Blunt
Loves animals
Unable to follow-
through with goals Hunter– His Story
Kicked out of multiple “The basement
schools couch is my future!”
Unable to complete
college
Unable to go to a
restaurant with family

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

37. Poor perception of self
Obsessive/Irrational thoughts
Strong imagination
High IQ
Sage
Her Story
Gifted in languages “I belong in a special
farm for special people
Unable to pass class who get fake jobs to
help them feel that they
Multiple medical leaves have purpose.”
Struggled with making friends

38. Sage
Colors of Development
Acceptance (public
mistakes)
Positive self-talk "Being happy doesn't
mean that everything is
Strong imagination perfect, it means that
you've decided to look
Tutoring – both ways beyond the
imperfections"
In college (library)
Friends – study dates

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

40. A Different Perspective …
Celebrate Differences
Qualitative advantage in social interaction, as manifested by a majority of the
following:
peer relationships characterized by absolute loyalty and impeccable
dependability
free of sexist, "age-ist", or culturalist biases; ability to regard others at "face
value“
speaking one’s mind irrespective of social context or adherence to personal
beliefs
ability to pursue personal theory or perspective despite conflicting
evidence
seeking an audience or friends capable of: enthusiasm for unique interests
and topics;
consideration of details; spending time discussing a topic that may not be
of primary interest
listening without continual judgment or assumption
interested primarily in significant contributions to conversation; preferring
to avoid ‘ritualistic small talk’ or socially trivial statements and superficial
conversation.
seeking sincere, positive, genuine friends with an unassuming sense of
humor

41. A Different Perspective …
Celebrate Differences
Cognitive skills characterized by at least four of the following:
strong preference for detail over gestalt
original, often unique perspective in problem solving
exceptional memory and/or recall of details often forgotten or
disregarded by others, for example: names, dates, schedules,
routines
avid perseverance in gathering and cataloguing information on a
topic of interest
persistence of thought
encyclopedic or ‘CD ROM’ knowledge of one or more topics
knowledge of routines and a focused desire to maintain order and
accuracy
clarity of values/decision making unaltered by political or
financial factors

42. A Different Perspective …
Celebrate Differences
Additional possible features:
acute sensitivity to specific sensory experiences and stimuli,
for example: hearing, touch, vision, and/or smell
strength in individual sports and games, particularly those
involving endurance or visual accuracy, including rowing,
swimming, bowling, chess
“social unsung hero” with trusting optimism: frequent victim of
social weaknesses of others, while steadfast in the belief of the
possibility of genuine friendship
increased probability over general population of attending
university after high school
often take care of others outside the range of typical development

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

44. Enrich Yourself
The Ode to the Autistic Man by Scott Lentine
Try to understand the challenges that I face
I would like to be accepted as a human in all places
Where I will end up in life I don’t know
But I hope to be successful wherever I go
I would like to expand my social skills in life
Making new friends would be very nice
Stand proud for the autistic man
For he will find a new fan
I hope to overcome the odds I face today
Increased acceptance will lead me to a brighter day
By the age of 20, I will have made tremendous strides
I know in the future, life will continue to be an interesting ride
I have made new friends by the year
I will be given tremendous respect by my family and peers
I hope to get noted for bringing the issue of autism to the common man
So that autistic people can be accepted in this great land
Stand proud for the autistic man
For he will find a new fan
I hope to overcome the odds I face today
Increased acceptance will lead me to a brighter day

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

46. Resources
Organizations
Advancing Futures for Adults with Autism
Center for Autism and Related Disabilities
Autism Speaks
CARD
AANE
Websites
www.aane.org
www.tonyattwood.com
www.pasadenavilla.com
www.autisminternetmodules.org
www.autismvotes.org
www.centerforautism.com
Books
The Complete Guide to Asperger's Syndrome by Tony Attwood
Asperger's Syndrome: A Guide for Parents and Professionals by Tony
Attwood
A Self-Determined Future with Asperger's Syndrome: Solution Focused
Approaches by E. Veronica Bliss and Genevieve Edmonds
Look Me in the Eye: My Life with Aspergers by John E. Robison

47. References
American Psychiatric Association. (1994). Diagnostic and statistical
manual of mental disorders (4th ed.). Washington, DC.
Attwood, Tony. "The Discovery of ." Morning News. 11.3 (1999): n.
page. Web.
Garcia, Winner. "Three Core Deficits of Aspergers
Syndrome." www.sacramentooasis.com. Sacramento Aspergers
Syndrome Information and Support. Web
Attwood, Tony. "What is Asperger's
Syndrome?."WWW.tonyattwood.com. Tony Attwood, n.d. Web.
Pasadena, . "Social Integration Model."WWW.pasadenavilla.com.
Appleton Creative , n.d. Web.
Quappe, Stephenie. "What is Cultural Awareness, anyway? How
do I build it?." Adler, Organizational Behavior. (1991): n. page. Web.
21 Mar. 2013. <www.culturosity.com>.