Teaching social skills: Focusing on individuals with autism and Asperger syndrome Ireland November 2005 [email protected]

Teaching social skills:

Focusing on individuals with autism and Asperger syndrome

Ireland November 2005

[email protected]

Introduction

• Misa• Autism and Asperger syndrome • In the workplace• Social stories• Reward systems• Other methods - Solution focused therapy - Aggression Replacement Training (ART)

• Founded in 1994• 7 units in Stockholm• Turn over ~3.5 million Euro/year• 70 employees• Offer support to 200 individuals• Cooperates with over 150 workplaces

Facts

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• M ethod development• I ndividual Support• S ociety Orientation – social integration• A ctivity – job oriented activity in worksettings

Our name

Presentation

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… that individuals with disabilities are able to participate in working life with the right kind of support!

We know…

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• Normalisation• Integration• Self determination

We take for granted

Presentation

Supported Employment/ISA• Job-matching• Misa staff learn the worktasks• 100% level of support – to be faded when possible • Real assignments• Work colleagues• Importance of participation in working life

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• Municipalities within and around the city of Stockholm• Regional social insurance offices• Unemployment offices• Employers

Our clients

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Autism and Asperger syndrome


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Autism

Asperger syndrome

Social and emotional

Difficulties with:

• Friendships• Managing unstructured parts of the day• Working co-operatively

Language and communication:

Difficulty processing and retaining verbal information

Difficulties understanding:• Jokes and sarcasm Social use of language Literal interpretation Body language, facial expression and gesture

Flexibility of thought(imagination)

Difficulty with:

Empathy Generalisation Coping with changes in routine

”Suppose you’re colourblind and can’t differ between red and green. You’re in a room with other people where everyone has normal sight. No one, not even you, know that you’re colourblind. Everyone gets a list of instructions. They’re printed in red against a green background. Everyone except you know what to do. They can’t understand why you just sit there. The sheet of paper looks blank to you and you can’t understand how all the others can know what to do. Imagine how you would feel, especially if the others stared, whispered or laughed at you.

Asperger syndrome - Quote

In the workplace

Fitting in

• Structuring the day• Managing breaks and lunchtime• Appropriate topics of conversation• Obsessions and rituals• Clothing

Teaching social skills

People with AS learn social skills cognitively and analytically rather

than intuitively


• Ways of teaching social skills: role playing, social stories, videotape social situations.

• To make situations: less intimidating, uncomfortable and unpredictable -

reduce stress.

• To increase: the understanding of the social world – promote social

inclusion.


Marc Segar – A survival guide for people with Asperger Syndrome.

“ This is a book designed to make you aware of the many unwritten rules which most people instinctively know and take for granted. When people disobey these unwritten rules, sometimes they get away with it, but usually they who break informal rules are made to suffer informal punishments. These punishments may include being laughed at, being treated as a less important person or being isolated”


Distortions of the truth

Sarcasm is when someone says one thing but means the opposite. For example, in response to hearing someone burp, someone else might say "how polite". The easiest way of picking up on sarcasm is by listening to tone of voice. You may need to defend yourself against sarcasm at times and this will be covered in following chapters. (Segar, p. 8)


From “Asperger’s…What Does It Mean To Me”, Faherty, 2000

• Developed by Carol Gray

• Presents appropriate social behaviour in the

form of a story.

• Can be individualized to incorporate the specific needs of the person for whom the story is written

What is a social story?

Social stories

• Deal with compulsions and feelings such as fear, aggression, obsessions, fixations etc.

• Clarify rules, changes, norms, time etc. • Explain social situations• Make abstract social situations and theoretical

knowledge more concrete

Social stories

Social stories can

Social stories

• Describe situations in a realistic manner• Describe the individual´s reactions• Describe other peoples´ reactions• Teach appropriate behaviour by giving alternate strategies

to deal with situations• Should be individualized• Should be written in first-person

• Descriptive sentences

• Directive sentences

• Perspective sentences

• Control

Social stories

Sentence types

• Cooperative sentences

• Affirmative sentences

Additional sentence types

Social stories

Social stories

What do you need?

• General knowledge about the disability

• Specific knowledge about the individual

• Specific knowledge about the situation/context for which the story is written

• What to keep in mind - length of story

- level of reasoning - language: avoid overload, concrete, length of

sentences - context - theme

• Check comprehension

Social stories

Individualizing the story

Social stories

Social stories– what can go wrong?Clothing in the workplace

The clothes I wear influence what people think about me. Thismeans that wearing particular clothing make people hold certainexpectations about me. For example, if I wear skimpyclothing to work, such as a very short skirt and a top with low

cleavageit can attract unwanted attention from men and might make them

think I am not serious about my work. It is a good idea to try to wear

clothesthat cover up my body and avoid bright clashing colours.

Why does this not work?

Social stories - individualizing

What clothes to wear in the office

When working in the office it is appropriate to dress in business casual clothing. If I wearother types of clothing my colleagues might stare at me. That would make me feeluncomfortable and insecure. Business casual clothing for women is either casual trousers or a skirt. The skirt should come at least to the knees while standing. If the skirt comes to just below the knee, a slit to just above the knee might be acceptable. Tailored shirts or blouses, tailored knit sweaters and sweater sets are appropriate business casual choices for women. The top should cover the bosom. The colours of the clothes and shoes should be neutral like for example black, grey, brown, white or beige. I will try to choose clothes according to these guidelines. I will also try to make sure that my clothes are clean and wrinkle-free. If I try to dress in this way people will think that I dress nicely and that I am professional and serious about my work. This will make me feel more confident at work and when socializing with my colleagues.If I am unsure about how to dress I can ask a colleague or someone that I trust.

Social stories

What to wear?

Have look in a magazine and write the story together.

• 45 years old• South America• High-functioning autism• Co-existence of obsessions and compulsions• Special interest: chess

Carmen

Social stories

What I should think about when I eat lunch in the restaurantWhen I eat I use a fork and knife. (descriptive) This shows that I am eating in the correct manner. I will try to eat slowly. (directive) Eating slowly will make me less stressed, which is good for my stomach. I want my tray to look nice. This shows that I have good tablemanners. When I am finished I put my tray in the traycart. This will make the staff happy because it makes it easier for them. I put the chair back in its place when I leave. The staff is happy when they see that I behave appropriately (perspective).

Social stories

• This method is all about rewards

• Realistic goal

• Clear instructions

Basic principles

Rewards systems

• What is being rewarded has to be concrete and specific.

• All of the people involved have to agree on adhering to the reward system point by point.

• It has to put across what the individual should do, not what he/she should not do.

Basic principles:

Rewards systems

Reward systems

There is a difference between a reward and a bribe

Carmen’s shop

Every morning after I have taken the dishes out of the dishwasher and set the table before the coffeebreak I get:1 point

If I put my dirty dishes in the dishwasher I get:1 point

If I go to the restaurant without my jacket on, eat in the correct manner and keep my plates on my tray I get:3 points

Reward system

Carmen’s shop

If I refrain from talking about my compulsions I get:1 point a.m. 1 point p.m.

What I can use my points for:

15 points 15 min conversation with the staff20 points 1 lunch coupon25 points 1 extra hour on the internet30 points 100 credits for mobile phone

Reward system

Reward systemContract

• This contract is between XXXXXX and Katarina Larsson• The aim of this contract is that XXXX will practice being on time at

her workplacement in Topshop. • This contract is valid between the 050812 – 051012.• The working day begins at 9.00 and ends at 14.00 on Monday -

Wednesday. XXXXX will meet Katarina outside of the staff entrance at 9.10 at the latest.

Bonus points• If XXXXXX is on time between 9.00-9.10 1 point will be awarded. 3

points is the maximum number of points to be awarded per week.

1 point = 30 minutes off4 points = one cinema ticket

8 points = 1 day off

Reward system

Important!

• It is not possible to use bonus points to get time off in the morning.

• No points will be awarded if XXXX arrives at work after 9.10 no matter the circumstances.

• XXXX and Katarina´s watches have been syncronized on 050812.

Stockholm 050812

XXXXXXXXXX Katarina Larsson

• Focusing on failures and inadequacies can make people feel worse rather than better.

• The solution-focused way of thinking is based on the assumption that it is easier and more rewarding to create solutions instead of solving problems.

Keeping things positive

Solution focused therapy


• The solution-focused therapy method offer “tools” that you can use when conversing with the client.

• Ask questions about: the client’s behaviour; how people around the client react to the client’s behaviour.

• If it’s not broken - don’t fix it

• When you know what works - do more of it

• When it doesn’t work - do something different

Three basic principles


• Emphasize what is healthy, the things that work

• Here and now and the future

• Change is always present and an unavoidable process

Keep in mind


• Use the individual’s own way of looking at life

• Cooperation • Be curious

• The individual chooses what the problem is

Keep in mind


Example questions 1st session

1. What is important for you that we talk about today?

2. Suppose a miracle happens- what is the first thing that would be different tomorrow?

3. When did part of those things happen last time? What was different then? Look for exceptions – i.e. situations where the problem is absent or at least not as great.


4. On a scale of 0 - 10:a. Where are you today? What has

happened that made you go from 0 to X?

b. What is the least you can do to move one step further? (small goal)

c. How willing are you to do something to get to the next step on the scale (0-10)?

d. How realistic is it?


Aggression Replacement Training

• ART

Component 1: Skillstreaming

• Teaching skills that serve to displace destructive out-of-control behaviour with constructive prosocial behaviour.

• An intervention in which a 50-skill curriculum of prosocial behaviours is taught.


Skillstreaming - Curriculum

• Beginning social skills• Advanced social skills• Skills for dealing with feelings• Alternatives to aggression• Skills for dealing with stress• Planning skills


Component 2: Anger Control Training

• Each person is required to bring to each session a description of a recent anger-arousing experience, which they record in a binder.

• For 10 weeks they are trained to respond

to their hassles with a chain of behaviours that include:


Anger Control Training – Curriculum

• Identifying triggers • Identifying cues• Using reminders• Using reducers• Using self-evaluation


Component 3: Moral Education

• Moral education is a set of procedures designed to raise the person's level of fairness, justice, and concern with the needs and rights of others.

• Discussions about moral dilemmas.


Asperger syndrome and autism

Social stories

Reward systems


Aggression Replacement Training (ART)

Summary

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References - Books

• DeJong, Peter & Berg, I. K., (1998). Interviewing for Solutions. Pacific Grove, CA: Brooks/Cole Publishing

• Goldstein, A.P., Glick, B., & Gibbs, J.C. (1998). ART, Aggression Replacement Training. A comprehensive Intervention for Aggressive Youth. Illinois: Research Press.

• Gray, C. (1993). The original social story book. Arlington: Future Horizons Inc.

• Segar, M. (1997). A survival guide for people with Asperger Syndrome.Available online: http://www.autismandcomputing.org.uk/marc2.en.html

Resources on the web

• ART: www.skillstreaming.com

• Autism: http://www.nas.org.uk/

• Online Asperger Syndrome Information and Support (O.A.S.I.S)http://www.udel.edu/bkirby/asperger/

• Social stories: http://www.thegraycenter.org

• Solution focused therapy: http://www.brief-therapy.org

Documents

Teaching social skills: Focusing on individuals with autism and Asperger syndrome Ireland November 2005 [email protected]