Asperger Syndrome

Rethinking the Glass House Rule

Dimitri Martin: Glass House Rule

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Complexity

• Perhaps student profiles and behaviors are becoming more complex…

The Real Question…• What is your professional and ethical

responsibility?

Understanding Asperger Syndrome Research – Yale

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Understanding Asperger - Research

• Break in the brain

• Cannot figure it out

• Cognitive ability does not = social skill development

• Not holding back on social skills

Activity: Conversation without looking at the person’s eyes

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

Fat lady in the grocery store

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

Atwood, 2007

The Truth

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

Cerebellum

Limbic System

Cerebrum

Amygdala

Progression of Etiological Theories

Progression of Etiological Theories

BRAIN research . . . Looking at brain differences

CorpusCollosum

Purkinje Neurons

Limbic System

Amygdala-Brain’s Fear Center

• November 22, 2006: Study (Davidson, Univ. of Wisconsin) confirms reduced size of amygdala in most socially withdrawn individuals with ASD.– Starts hyperactive and enlarged– Shrinks over time (toxic adaptation) which

correlates with length of eye contact and general fear of, withdrawal from, people.

Amygdala, Cont.

• Small amygdala: significantly slower in identification of happy, angry, sad facial expressions.– Spent least amount of time looking at eyes relative

to other facial regions.

• Smallest amygdala: 40% longer to recognize emotional expressions.

• Largest amygdala: looked at eyes 4 times longer than smaller amydgalae.

Cerebrum (Cerebral Cortex)

Corpus Collosum

Neurons

• Mirror Neurons:A study by UCLA neuroscientists (Dapretto et al) featuring functional MRI suggests that mirror neurons help people understand the intentions of others – a key component to social interaction.

Faulty? Not cued into them?

• Cell-Adhesion Molecules: Help brain cells connect (Hakonarson, 2009, Center for Applied Genomics at Children’s Hospital of Philadelphia)

Yawning Study

Current results suggest that contagious yawning is impaired in ASD, which may relate to their impairment in empathy. It supports the claim that contagious yawning is based on the capacity for empathy.

Senju, et al, 2007

Cognitive Differences

• Cognitive development typically ranges from average to very superior IQ.

• Difficulties may include:– Difficulty shifting attention– Difficulty processing two

cognitive tasks simultaneously– Generalizing information– Retrieving information on

demand– Developing problem-specific

solutions– Difficulty with sense of time

RED BLUE BLACK YELLOW

PINK GREEN WHITE RED

PURPLE ORANGE BLUE

BROWN GRAY PINK GREEN

BLUE BLACK YELLOW RED

SOLUTION SOLUTION

SOLUTION

PROBLEM

J.Janzen, Understanding the Nature of Autism

PROBLEM PROBLEM

PROBLEM

SOLUTION

J.Janzen, Understanding the Nature of Autism

• Studies have suggested at least 75% of children with Aspergers also have a profile indicative of ADHD.

• Difficulty with four aspects of attention:– Ability to sustain attention– Attention to relevant information– Shifting attention– Storing/encoding information

(episodic vs. semantic memory)

Attention

Attwood, 2007

Executive FunctioningResearch confirms that some children, but especially

adolescents and adults with AS, have impaired executive functioning.

Elementary:Difficulty with:

• Inhibition (age 8)• working memory• using new strategies

Middle School and older:Additional difficulties with:

• organization and planning• self-reflection and self-

monitoring (mental conversations)

• time management and prioritizing

• understanding abstract concepts

• weak central coherenceAttwood, 2007

Things to think about• One guy vs. “thousands/billions”

– Neurons– Inefficient, slow retrieval– Misfilings

• Shredder– Can’t “forget” any information– Can’t differentiate between important & non-important

information• Microphone

– Isn’t used much (visual stronger than auditory)– Uses the big computer screen

• Memory storage—no sound• Power Cords• Brain Bacteria

– Interferes with storage of information• Different Levels of Storage• Daydreaming (processing?)

Activity: Executive Functioning

O T T F F S S

Look Me in the Eye Clip (CD 6 – 09) –

• Planning for human contact

• Self-reflection

• Self-monitoring

• Understanding abstract concepts– “Woof”

Because of the executive functioning differences, social interaction becomes a cognitive task

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

coherence)

Create rigid rule structures to make order in ambiguity

• Playing with toys for young children and the child molester

• “NO LEFT TURNS!”• Men go to bars and women are maids• “Jocks”, “People that don’t make good

decisions” and “friends”• Pass four red cars and it’s a good day• Blue gel pen = good assignment• Grocery Store Scenario• Exchanging Christmas presents

How do you navigate cultural expectations?

• Taarof (Iranian Politeness)– How would you handle the picture

problem?– What about the ice issue?– Would you know what to do?

Cognitive Strengths• Processing whole chunks of information

quickly

• Good rote memory

• Good long-term memory

• Process visual information meaningfully

• Understand and use context-free information and rules

Learning Characteristics of ASDUneven skill development

Tends to resist change in learning environment

Difficulty generalizing skills/information

Difficulty with abstract concepts

Relies on cues and learned routines

May tend to function more reliably with consistency and structure within activities and environments

Learning Characteristics of ASDOrganizational issues

Focus on unimportant information

Difficulties processing multiple sensory input under certain conditions

Difficulty seeing the “big picture”

Over-selectivity

Good long-term and rote memory

Prefers sequences and routines

May demonstrate desirable persistence with a task if motivated

Tendency toward literalness – difficulty with multiple meaning word

By Cannon Clouse

“Numbers”

This American Life

Meet Jerry—Adult with Aspergers

My Response…

The most powerful idea that strikes me after hearing this clip is…

3 things that I will accept in students with Aspergers and no longer try to change…

Theory of Mind

(ToM) means the ability to recognize and

understand thoughts, beliefs, desires and

intentions of other people in order to

make sense of their behaviour and predict

what they are going to do. (Atwood, The Complete Guide to Aspergers Syndrome, 2007)

Experts on people

Experts on things

birth

Normal

ASD

Developmental Trajectories

Theory of Mind: Perspective Taking and Reciprocity

• “Mind reading” ability is located in the orbito-frontal cortex-superior temportal sulcus-amygdala area of the brain.

• Winning/losing concept difficult

• Difficult to engage in manipulation

• Difficult to engage in lying

Maturation The ability to understand the value of

deception and recognize when it might be expected occurs later in the development of the student with Aspergers, sometimes as late as early teens.

This can cause confusion to parents and teachers, as the previously honest, (perhaps to a fault) child recognizes that one can deceive people and avoid anticipated consequences. However the type of deception can be immature and the deceit easily identified by an adult. Atwood, 2007

Travis and Lying

Travis is 18 Years Old

Drives and attends a typical high school

Driving to school his check engine light came on

Communicated in the best way he knew how

Did not get any response

Got a response…Is this Lying

Background Information

• Staff explained…they could not believe what Travis said anymore…He was constantly lying.

• Used white board…invited Travis into the meeting

• Put the word liar on the white board• Travis said – “Everyone thinks I am a Liar”

• What was discovered by the facilitator and staff?

Travis’s Explanation

Travis’s Take on Things• “Telling the truth is not good enough for the

people”• Translation – I need help and the staff does not

help me• “The wrecker is better because my car blew up”• Translation – Ms. Black responded to the

wrecker is coming because my car blew up but did not respond to my check engine light coming on

Time for a Change• Most people with ASD will not wait until (the typical population - staff) perceives or does not perceive the situation as important as they do

• Most people with ASD are perceiving the problem right in front of them(right or wrong) a catastrophe

• Adults around students with ASD are saying words like “relax”…”not a big deal”… “we’ll get to that later” That does not work for this population.

• Students with ASD Want to - Solve the Problem

SOLUTION SOLUTION

SOLUTION

PROBLEM

J.Janzen, Understanding the Nature of Autism

PROBLEM PROBLEM

PROBLEM

SOLUTION

J.Janzen, Understanding the Nature of Autism

Maturation• Lying and Asperger Syndrome• Due to the impaired or delayed ToM abilities,

the person with Aspergers may not realize that the other person is likely to be more offended by the lie than by any apparent misdemeanor

• He may consider that a lie can be a way of avoiding consequences or a quick solution to a social problem

• Maintaining self esteem should he have an arrogant self image whereby the making of mistakes is unthinkable. Atwood, 2007

Typical children, especially after the age of five years, are remarkably astute at perceiving and understanding social cues that indicate thoughts and feelings. (Michelle Garcia, 11-08)

• Parents nor educators teach these skills• Parent and educators only notice when these

skills are not present• The lack of these skills makes students and

adults uncomfortable• Zero productive social skills curriculum

developed

It is as though their mind prioritizes social cues above other information in their environment and they have a mental theory as to what the social cues mean and how to respond. (Michelle Garcia, 11-08)• Minds of typically developing students work

differently• Lack of the prioritization of social skills• Lack of a mental theory • Eric example• Resulting response? How does this manifest

in a student you know?

This ability dominates the perception of typical people to such a degree that we become anthropomorphic and project

human social behaviour on animals and even objects. (Michelle Garcia, 11-08)

• Anthropomorphic - Attribution of human motivation, characteristics, or behavior to inanimate objects, animals, or natural phenomena.

• Factual or predictable information dominates the Asperger’s Population

Applying Human Emotions to Inanimate Objects – American Express

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Calvin and Hobbs

Social Attribution Task

S.A.T. Study – Aspergers• Significant differences

• Typical– Chasing, entrapping, and playing– Frightened, elated or frustrated

• Aspergers: Different terms to explain movement of shapes– Bouncing or oscillating vs. bravery or elation– Narratives – shorter with less elaborate plots– Fewer, more simplistic personality attributions– Focus on physical aspects of objects

Attribution Theory

• Every day we must guess how people will act, often from small shreds of evidence.

• We do this through a form of social cognition called attribution.

• As we observe others, we make inferences about them. We attribute people’s behavior to various causes.

• Whether we are right or wrong about the causes of their behavior, our conclusions affect how WE act.

Attribution• In 2005, in the aftermath of hurricane

Katrina, many celebrities went to New Orleans to help hurricane victims. As you watched these events, did you:

Attribute the celebrities’ actions to selfless concern for the suffering in New Orleans?

OR Were the celebrities motivated by a selfish

desire to hog the limelight?

Attribution Theory

Two people enter a restaurant and order different meals. Nell tastes her food, then salts it. Bert salts his food before he tastes it. How would you explain their behavior?

Introduction to Psychology: Gateways to Mind and Behavior: Twelfth Edition, 2010 Cengage Learning, Inc.

Fundamental Attribution Error(It IS human nature!)

• Attribution Theory• Erroneous cognitive tendency• Over-value dispositional-based explanation for

behaviors of others• Under-value potentiality of situational explanations

for behavioral motives of others

We predominantly presume that the actions of others are indicative of the "kind" of person they are, rather than the

kind of situations that compel their behavior.

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

(Crittenden 1983)

Professional Responsibility

Path A Path B

??

What do you attribute her behavior to?

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Attribution• Going to have prejudices/attribution errors • Lack of social skills – negates any viable

opportunities • Oddity about social characteristics• Physical appearance• Perceived cognitive ability• Are we going to be embarrassed?• Is she going to embarrass herself?• Make people uncomfortable

Susan Boyle

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What made you change what you attribute her behavior to?

She Started SingingStrengths Outweighed Public

Perception

Susan Boyle: Behavior Didn’t Change

• Walks off stage without results

• Doesn’t understand she won by reactions

• Wake up call

• Shut down the cynicism in the audience

• We are going to make attributions and attribution errors

Doesn’t Change Issues• Required Hospitalization

• Continued Difficulty with Social Situations

• Support Person – Britain’s Got Talent

• Greater Societal Understanding – Because of Talent

What would have happened to her without discovery of her talent?

Continued sneers and judgment of her lack of social understanding

Students with AspergersHave Strengths and Talents

How will we respond?

Will we give them a chance and overcome our own attribution errors?

Will we be judgmental and attribute their behaviors to their own control?

My Response…

Three things I will do when I am faced with my own attribution errors…three self-checks to precorrect my own judgements…

I will stop expecting the Susan Boyles of the world to prove themselves first by…

Michigan Definition to Determine Eligibility for ASD

• Qualitative Impairments in Reciprocal Social Interactions: 2 of 4 areas

• Qualitative Impairments in Communication: 1 of 4 areas

• Restricted, Repetitive and Stereotyped Behaviors: 1 of 4 areas

What Do You Attribute the Student’s Focus and/or Intensity of Interest Area

To?

• Pick Student: To what to you attribute focus and/or intensity of interest area?

• Worksheet

• Collin – Dinosaurs

Fundamental Attribution ErrorCollin - Outcomes

Path A Path B

Likely outcomes for Collin if his behavior is attributed to Aspergers and the situational context??

Likely outcomes for Collin if my attribution is dispositional based??

Cut the projector screen and leaf on plant;Pulled down his pants to show peers his underwear

Fundamental Attribution ErrorCollin - Outcomes

Path A Path B

Showing DinosaurDinosaur Scissors

Sexual HarassmentProperty Destruction

Cut the projector screen and leaf on plant;Pulled down his pants to show peers his underwear

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

(Crittenden 1983)

Intense Interests – Struggling with Life

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Focus and/or Intensity of Interest Area

The special interest has several functions:a. To overcome anxietyb. To provide pleasurec. To provide relaxationd. To ensure great predictability and certainty in lifee. To help understand the physical worldf. To create an alternative worldg. To create a sense of identityh. To occupy time, facilitate conversation

and indicate intellectual ability (Atwood, 2007)

Professional Responsibility Student’s Focus and/or Intensity of Interest

Your Own Student

Path A Path B

? ?

Michigan Definition to Determine Eligibility for ASD

• Qualitative Impairments in Reciprocal Social Interactions: 2 of 4 areas

• Qualitative Impairments in Communication: 1 of 4 areas

• Restricted, Repetitive and Stereotyped Behaviors: 1 or 4 areas

What Do You Attribute the Student’s

Communication Issues To?

• Pick Student: To what to you attribute communication difficulties?

• Worksheet

• Jarod—Facial Hair

Fundamental Attribution ErrorJarod - Outcomes

Path A Path B

Likely outcomes for Jarod if his behavior is attributed to Aspergers and the situational context??

Likely outcomes for Jarod if my attribution is dispositional based??

Told the teacher he liked her moustache

Fundamental Attribution ErrorJarod - Outcomes

Path A Path B

•Intense questioning about facial hair•Question about female teacher’s moustache•Lack of understanding

•Making Fun of Teacher•Disrespectful•10 Days Suspension

Told the teacher he liked her moustache

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

(Crittenden 1983, p. 426).

Look Me in the Eye - Communication

Pragmatic Language (Social Communication)

• Pedantic, formal– In this economy…– Calculate my percentage…– When in a rare conflict…

• Difficulty with relinquishing conversational turn--prompts

• Limited understanding of conversational partner (interest, cues, topic appropriateness)

• Tone of voice (often perceived as disrespectful)• Literal use of Language

Attribution Error of CommunicationMozart and the Whale – Breaking Records

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Ordering/ReOrderingSecretaries Name

• Baiba• Bunny• Bev• Blanche• June

• What is wrong with this place?• Get a normal name• At least they could all start with the same letter

Professional Responsibility Student’s Communication

Your Own Student

Path A Path B

? ?

Michigan Definition to Determine Eligibility for ASD

• Qualitative Impairments in Reciprocal Social Interactions: 2 of 4 areas

• Qualitative Impairments in Communication: 1 of 4 areas

• Restricted, Repetitive and Stereotyped Behaviors: 1 or 4 areas

What Do You Attribute the Student’s Social

Skill Differences To?

• Pick Student: To what to you attribute focus and/or intensity of interest area?

• Worksheet

• Jacob – Student attention

Fundamental Attribution ErrorJacob - Outcomes

Path A Path B

Likely outcomes for Jacob if his behavior is attributed to Aspergers and the situational context??

Likely outcomes for Jacob if my attribution is dispositional based??

Tickled peers on the back of the neck

Fundamental Attribution ErrorJacob - Outcomes

Path A Path B•Desperately wanted to •Interact with Kids•Tickle Back of Necks•Trying to Fit In•Incompatible Response•Tried Even Harder

•Targeting Students•Aggressive Toward Peers•Change of Classroom•Feared by Others•Threat of 10 Days Suspension

Tickled peers on the back of the neck

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

(Crittenden 1983, p. 426).

Look Me in the Eye: Social Reciprocity

We have a young man in our middle school who has autism (we actually have many young people with autism....however this story just focuses on one specific young man) and has been rather challenging so far this year. Well, today he decided that he didn't want to participate in class.....after losing all his tokens he was taken to "time-away". Of course, this didn't go as planned and MK had to assist the parapro in moving him to his designated timeout area. Once he was safely escorted to his time-away...he served his "time", completed his compliance task and immediately bolted for the bathroom. Of course, all the individuals working with him at this time were female and thus could not enter the bathroom.....so I was called. I entered the bathroom to find him just standing there....really doing nothing. The moment I enter...he runs into one of the stalls and attempts to slam the door shut. I quickly grab the door and walk in. At this point....he backs himself into a corner and in his deepest most convincing pirate voice....says " "You'll never get anything out of me...you lousy no good scum-sucker". I start laughing...tell him that is a great line and ask him what class he needs to be in? He says "room 104" At this point, we walk out of the bathroom, I hand him over to his parapro and they head down the hall to room 104. When they arrive...they walk into Mrs. Redker's class as she is teaching sex ed. The young man hears the topic......takes one look at his para and yells "I'm not ready for this" and bolts out of the room!!! Hey..Mr. Caine, do you think this is a "pragmatic" issue? Gotta love our jobs! Hope each of you are having a great day!

Problems with Reciprocity (ToM)• Difficulty explaining own behaviors• Difficulty understanding emotions• Difficulty predicting how others feel or think• Problems understanding the perspectives of

others• Problems inferring the intentions of others• Failure to understand that behavior impacts

how others think and/or feel• Problems with social conventions such as

turn-taking, politeness, and social space

Attribution Error of Social ReciprocityMozart and the Whale - McDonalds

Video clip

Reciprocity• Use of nonverbals (eye gaze, gestures,

modulation of voice)

• Understanding emotions of self and others– “G Force”– “I feel lonely when I’m lonely. How can I

describe it further?”– Getting tissues for boys

• Shifting back to own topic (Anyways, Guess what?)

At their core, they want to fit in and have friends

• Try to orchestrate the relationship with others

• Do what they want to do

• Others do not make sense

• Swearing/authority issues

• Vulnerable

• Isolating

• Social injustice

Big Bang Theory - Friendship

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Continuous Failure in…

• Trying to follow the rules

• Trying to get others to follow the rules

• Trying to understand nuances

• Generalizing information

• Making friends

• Leads to behavior or worse

Struggling with Life – Birthday Party

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SOLUTION SOLUTION

SOLUTION

PROBLEM

J.Janzen, Understanding the Nature of Autism

PROBLEM PROBLEM

PROBLEM

SOLUTION

J.Janzen, Understanding the Nature of Autism

Maturation• Lying and Asperger Syndrome• Due to the impaired or delayed ToM abilities,

the person with Aspergers may not realize that the other person is likely to be more offended by the lie than by any apparent misdemeanor

• He may consider that a lie can be a way of avoiding consequences or a quick solution to a social problem

• Maintaining self esteem should he have an arrogant self image whereby the making of mistakes is unthinkable. Atwood, 2007

Struggling with Life – Giving Up

Video clip

Professional Responsibility Student’s Social Skills

Your Own Student

Path A Path B

? ?

Reflection

Big Ideas

Thanks For Your Time!