Children with Asperger's Syndrome: Characteristics/Learning Styles and Intervention
Strategies
by Susan Stokes Autism Consultant
Asperger's Syndrome was named for a Viennese psychiatrist, Hans Asperger. In 1944
Asperger published a paper in German describing a consistent pattern of abilities
and behaviors that occurred primarily in boys. In the early 1980s Asperger's paper
was translated into English, which resulted in international recognition for his
work in this area (6).
In the 1990s, specific diagnostic criteria for Asperger's Syndrome were included
in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental
Disorders, 4th Edition (DSM-IV, 1994) as well as the International Classification
of Diseases, 10th edition (ICD10) (3) & (15). In general, DSM-IV and ICD10 base their
diagnostic criteria for Asperger's Syndrome on the following:
- Impairment of social interaction
- Impairment of social communication
- Impairment of social imagination, flexible thinking and imaginative play
- Absence of a significant delay in cognitive development
- Absence of general delay in language development (in Wisconsin, the child may still
have an impairment under the state eligibility criteria for speech & language)
Recent research establishes the prevalence of Asperger's Syndrome as approximately
1 in 300, affecting boys to girls with a ratio of 10:1 (6). Children with clinical
(medical) diagnosis of Asperger's Syndrome and who have been identified by schools
as "children with disability" are typically found by the IEP Team conducting the
evaluation to have an impairment in such areas as Autism, Speech/Language, or Other
Health Impaired. Depending on the unique characteristics of the child, other impairment
area listed under state law for special education may also be considered and used.
This link will connect to the Wisconsin Department of Public Instruction for additional
information on these areas: http://www.dpi.state.wi.us/dpi/dlsea/een/program.html.
The general features and characteristics exhibited by children diagnosed with Asperger's
Syndrome are similar to the general features and characteristics exhibited by children
who have been clinically diagnosed with Autism and are described as having "high
functioning autism". For educational purposes, the remainder of this paper focuses
on the child with Asperger's Syndrome who has been identified by the IEP Team as
being a child with a disability. Much of the following information is also relevant
for consideration in working with children identified as having autism and who are
described as having "high functioning autism".
Each person who comes in contact with a child diagnosed with Asperger's Syndrome
(either school staff or peers) should receive training on the unique characteristics
and educational needs of such children. Due to confidentiality issues this should
always be discussed first with the parents of the child with Asperger's Syndrome.
Their written consent should be obtained prior to providing peer training.
Educational Staff Training should include the following two components:
- General training of the entire school staff: Prior to working with children with
Asperger's Syndrome, it is critical to understand the unique features and characteristics
associated with this developmental disability. Staff should be informed that children
with Asperger's Syndrome have a developmental disability, which causes them to respond
and behave in a way which is different from other students. Most importantly, the
responses/behaviors exhibited by these children should not be misinterpreted as purposeful
and manipulative behaviors (4).
- Child specific training for educational staff who will be working directly with the
child: Educational staff who will be working directly with a child with Asperger's
Syndrome should understand his individual strengths and needs prior to actually working
with the child. A team of persons familiar with the child and his disability should
provide this training. The team may include previous teacher(s), speech/language
pathologist, occupational therapist, teacher aide and most importantly, the child's
parents.
The peers/classmates of the child with Asperger's Syndrome should be told about the
unique learning and behavioral mannerisms associated with Asperger's Syndrome. It
is important to note that parent permission must always be given prior to such peers'
training. A successful protocol for training peers at the kindergarten to approximately
second grade level was developed by Division TEACCH and is available at their web
site http://www.unc.edu/depts/teacch/. Another peer training protocol designed for
children between the ages of 8-18 is Carol Gray's "Sixth Sense" (10).
Characteristics and Learning Styles: General
The following characteristics and learning styles associated with Asperger's Syndrome
are important to consider, particularly their impact on learning, and in planning
an appropriate educational program for the child (7). Children with Asperger's Syndrome
exhibit difficulty in appropriately processing in-coming information. Their brain's
ability to take in, store, and use information is significantly different than neuro-typically
developing children. This results in a somewhat unusual perspective of the world
(7). Therefore teaching strategies for children with Asperger's Syndrome will be
different than strategies used for neuro-typically developing children.
Children with Asperger's Syndrome typically exhibit strengths in their visual processing
skills, with significant weaknesses in their ability to process information auditorilly.
Therefore use of visual methods of teaching, as well as visual support strategies,
should always be incorporated to help the child with Asperger's Syndrome better understand
his environment.
The remainder of this article describes ten primary characteristics of children with
Asperger's Syndrome and intervention strategies for each.
Social Relation Difficulties
Characteristics: Children with Asperger's Syndrome tend to exhibit a lack of effectiveness
in social interactions rather than a lack of social interactions. They tend to have
difficulty knowing how to 'make connections' socially (4). Social situations are
easily misread by children with Asperger's Syndrome and as a result, their interactions
and responses are often interpreted by others as being odd (4).
Children with Asperger's Syndrome can exhibit low self-esteem and possible depression,
particularly when they reach adolescence, due to their painful awareness of the social
differences that exist between them and their peers (12). They have a desire to "fit
in" socially, yet have no idea how to do this. Children with Asperger's syndrome
can be significantly impacted by the following characteristics of social relations:
- Social Reciprocity: Children with Asperger's Syndrome can exhibit an imbalance in
reciprocal social relations (i.e., the "give and take" in social relationships),
which can be exhibited in several ways:
- The child can exhibit the need to take control and direct social situations according
to his own limited social rules and social understanding. Although the child may
be able to initiate interactions with others, these interactions are typically considered
to be "on his own terms". These interactions appear to be very egocentric in that
they relate primarily to the child's specific wants, needs, desires and interests
and do not constitute a truly interactive, give-and-take social relation with another
person.
- The child can appear very quiet, withdrawn and even unresponsive. He exhibits limited
social drive. It can be extremely difficult for the social participant to engage
the child in a social relation. (e.g., A child with Asperger's Syndrome was having
a birthday party at her home. When the other children arrived, she stayed in the
living room with them for a short while. She then said, "good-night", and stayed
in her room for the rest of the party.).
- Recognizing and interpreting various social situations: Typically developing children
are able to recognize and interpret the social nuances of various social situations
without being specifically taught. Their intact processing systems allow for this
to occur. However children with Asperger's Syndrome typically have great difficulty
recognizing, understanding and thus applying appropriate social skills to various
social situations. Their unique processing/learning systems do not readily allow
for accurate recognition and interpretation of this seemingly abstract information
(14).
- Social rules: Children with Asperger's Syndrome typically do not learn social rules,
either by observing others or through frequent verbal reminders. These children do
not appear to be intentionally ignoring and/or breaking these rules. Instead, they
have a difficult time accurately perceiving social environments and thus, they do
not understand that a particular social rule is to be applied in a specific social
context.
Example: A teacher frequently reminds a child with Asperger's Syndrome, prior to
going out for recess, that he cannot push other children. The child repeats this
rule prior to going out to recess. However, when the child goes onto the playground
at recess, he pushes several children.
Friendship skills: Children with Asperger's Syndrome tend to exhibit limited knowledge
of the concept of friendship.
Example: When a teenager with Asperger's Syndrome was asked if he had any friends
he responded that friendship was an area where he had some problems. He was able
to name two peers whom he considered "friends"; however, he did not know the last
name of one of the students. He proceeded to physically describe the student to see
if the listener knew the student's last name. When asked why these students were
his friends, he said because he saw them in the hallway during passing period, and
that he also saw one of the students at a weekly church youth group meeting. When
asked if he and his "friends" went to each others' houses, talked on the phone, etc.,
the teen with Asperger's Syndrome said no, that he just saw them at different places).
Children with Asperger's Syndrome also do not appear to attend to or respond to peer
pressure. They may have definite preferences for clothing due to comfort level, in
relation to sensory sensitivities without regard or concern for popular styles as
worn by peers.
Example: Some children prefer no ridges on the collar, no buttons down the front
of a shirt, no blue jeans - only elastic waist pants, no long/short sleeves or long/short
pants, etc.
- Understanding and expressing varied emotional states: Children with Asperger's Syndrome
may have difficulty identifying (labeling and understanding) varied emotional states,
both in themselves and in others. In addition, regulation of emotional states can
be extremely difficult.
Example: When experiencing great distress, a child with Asperger's Syndrome continually
asks others for monitoring of his emotional states, "Am I under control yet?", He
has limited awareness of when he is calm, versus extremely upset. Another example
would be laughing, seemingly inappropriately, when others are hurt, embarrassed,
etc. One child with Asperger's Syndrome physically manipulates his face when requested
to exhibit various emotional states.
Social Relation--Intervention Strategies:
The child with Asperger's will need to be directly taught various social skills (recognition,
comprehension and application) in one-to-one and/or small group settings. Social
skills training will also be needed to generalize previously learned social skills
from highly structured supportive contexts to less structured settings and, eventually,
real-life situations. It is important to emphasize that children with Asperger's
Syndrome will not learn social relations by watching other people, or by participating
in various social situations. They tend to have great difficulty even recognizing
the essential information of a social situation, let alone processing / interpreting
it appropriately.
- Tools for teaching social skills:
The use of Social Stories (9) and social scripts can provide the child with visual
information and strategies that will improve his understanding of various social
situations. (See the previous article on "Assistive Technology" for an explanation
on social stories.) In addition, the Social Stories/scripts can teach the child appropriate
behaviors to exhibit when he is engaged in varied social situations. The repetitious
"reading" of the Social Story/script makes this strategy effective for the child
with Asperger's Syndrome. A 3-ring binder of Social Stories/scripts kept both at
home and school, for the child to read at his leisure, has proven very successful
for many students with Asperger's Syndrome
- Role-playing various social situations can be an effective tool for teaching a child
appropriate social responses.
- Video-taping/audio-taping both appropriate and inappropriate social behaviors can
assist the child in learning to identify and respond appropriately to various social
situations.
- "Lunch/recess club" is a structured lunch/recess time with specific peers to focus
on target social skills for the child with Asperger's Syndrome. This strategy can
assist in generalizing social skills previously learned in a structured setting.
- Comic Strip Conversations (8) can be used to visually clarify social interactions
and emotional relations (see sample ComicStrip conversations photo).
- Peer partners/buddies: Specific peer(s) can be chosen to accompany and possibly assist
the child with Asperger's Syndrome during less structured social situations and when
experiencing social difficulties (e.g., out of class transitions, recess, lunch,
etc.). This peer support network should initially be established in a small group
setting.
- Individualized visual social "rule" cards can be taped to the child's desk as a visual
reminder regarding appropriate social behaviors to exhibit. Portable "rule" cards
can be used for environments other than the classroom. The rules can be written on
index cards, laminated, and then given to the child to carry along as visual reminders
of the social "rules" for any particular context.
Social Communication Difficulties
Characteristics: The child with Asperger's Syndrome typically exhibits highly articulate
and verbose expressive language skills with large vocabularies, particularly regarding
specific topics (high interest areas). However, his convincing language skills can
easily be misinterpreted as advanced communication skills. In turn this can result
in a mislabeling of the child's actions as purposeful or manipulative, rather than
behavior that is due to the child's significant difficulty in understanding and using
appropriate social communication skills. Children with Asperger's Syndrome often
lack social communication skills to sustain even minimal social communicative interactions
in any of the following areas:
- Conversational discourse skills: Children with Asperger's Syndrome can generally
engage in routine social interactions such as greetings. However, they may exhibit
significant difficulty engaging in extended interactions, or "two-way" relationships
(12). They can have difficulty initiating and maintaining appropriate conversations,
engaging in conversational turn-taking, and changing topics in an appropriate manner.
Their language can be extremely egocentric in that they tend to talk at people, instead
of to them, exhibiting seemingly one-sided conversations (2). Incessant question
asking can also be prevalent, as well as difficulty in repairing conversational breakdowns.
- Understanding and using non-verbal social communication (discourse) skills: Children
with Asperger's Syndrome can have significant difficulty interpreting non-verbal
social communication skills used to regulate social interactions (e.g., tone of voice,
facial expressions, body postures, gestures, personal space, vocal volume, use of
eye contact to "read" faces, etc.). For example, they may not understand that a raised
vocal volume can convey an emotional state such as anger (e.g., A student with Asperger's
Syndrome stated, "Why are you talking louder? I can hear you" when his mother raised
her voice to communicate anger). These children may also have difficulty interpreting
non-verbal cues, which the listener might be giving to communicate that a conversational
breakdown has occurred (e.g., facial expressions to indicate not understanding the
message, boredom, etc.). Some children with Asperger's Syndrome can exhibit conversational
speech with a somewhat flat affect: limited vocal change regarding vocal tone, volume,
pitch, stress and rhythm, particularly to indicate emotion and/or emphasize key words.
- Narrative discourse skills: Children with Asperger's Syndrome can exhibit difficulty
with their narrative discourse skills, including relating past events, or retelling
movies, stories, and T.V. shows in a cohesive and sequential manner. They may leave
out important pieces of relational information, as well as referents, and may use
many revisions, pauses and/or repetitions.
Example: A child with Asperger's Syndrome was relating his weekend to the class.
The child with Asperger's Syndrome related: "Back through time, uhm, uhm, at my Grandma's,
uh, it was (pause) back through time. I was, I was, I (pause) I uh, a long time ago.
I was at my Grandma's."
Social Communication - target skills and strategies for intervention:
The following social communication skills (pragmatic language skills) may be focused
on for direct instruction, depending upon the child's individualized needs:
- Initiation of appropriate social interactions for various situations through appropriate
verbal utterances, rather than actions or behaviors (e.g., On the playground, the
child with Asperger's Syndrome should use the words "Wanna play chase?" to ask a
peer to play tag, rather than going up to the peer and shoving them);
- Topic initiation of varied topics - not only topics related to high interest areas;
- Topic maintenance, particularly for topics initiated by others.
- Conversational turn-taking across 3-4 turns (reciprocal communication skills);
- Asking questions of others related to topics initiated by others;
- Calling attention to communicative utterances. The child directs his communication
to someone by first calling the other person's attention to himself;
- Comprehension and use of nonverbal social communication skills: tone of voice, personal
space, vocal volume, body orientation, facial expressions, etc.;
- Narrative discourse skills: relating past events, retelling stories sequentially
and cohesively by including important pieces of relational information as well as
referents;
- Seeking assistance appropriately (e.g., raising his hand for help in the classroom).
Tools for teaching social communication skills: All of the tools listed previously
for teaching social skills can also be used to teach social communication skills,
with the addition of the following:
- Visual support strategies can be used to teach conversational discourse skills such
as turn-taking, topic initiation, topic maintenance, etc. For example, a visual "my
turn" card can be used to physically pass back and forth between conversational partners,
to visually indicate who's turn it is in the conversation.