Asperger syndrome in the early years: issues and challenges
description
Transcript of Asperger syndrome in the early years: issues and challenges
![Page 1: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/1.jpg)
Asperger syndrome in the early years:
issues and challengesDr Glenys Jones
University of Birmingham
![Page 2: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/2.jpg)
Two key comments
‘We hold more than half the solution.’(Carol Gray)
‘ Other people are my biggest problem.’ (Wendy Lawson)
So, we can all help a great deal if we modify our communication; our demands; the physical and sensory environment; take their perspective and respect and value their way of being.
![Page 3: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/3.jpg)
Knowledge, practice and provision are improving in relation to:
Diagnostic practice Strategies to support the child and
parents, siblings and grandparents Types of advice/training available
for parents and staff expanding
![Page 4: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/4.jpg)
Diagnostic practice 1 Age at diagnosis is getting earlier
(average age 11 years, Howlin and Moore, 1997), but still work to be done
More people able to recognise AS, as awareness and training develops
Methods for identification by key professionals being developed and refined
Video and CD/DVD resources available
![Page 5: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/5.jpg)
Diagnostic practice 2 Local diagnostic teams for ASDs
increasing (as recommended in National Autism Plan for Children)
Greater efforts to include information from all sources and across settings
Development of keyworker systems to avoid repetition of work and confusion
![Page 6: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/6.jpg)
Some diagnostic issues remain Child often sees many different
professionals (15-20 before the age of 5 years)
Conflicting advice on diagnosis and interventions may be given to parents
May be limited co-ordination and collaboration across professions
![Page 7: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/7.jpg)
Some diagnostic issues remain
AS is an ‘invisible disability’ – so other explanations may be given for the child’s behaviour - parents and/or the child may still be blamed by the school or other family members PRIOR to diagnosis
Some professionals may still hold this view AFTER diagnosis too – often those with little experience of ASDs – training need
![Page 8: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/8.jpg)
Some children with AS are not diagnosed early or at all Some children with AS not diagnosed
until late primary or secondary age (or adulthood), even when evidence of AS in their early years has been clear
There are still many children with AS in mainstream schools without a diagnosis, who would benefit from this
However, identification is rising as awareness increases
![Page 9: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/9.jpg)
Issues at and immediately after diagnosis
Rarely time to speak to professionals for long enough or without the child
May only be the child’s mother who receives information first-hand
Advice to parents on how to help, after diagnosis given, may not come soon enough
(6 weeks recommended target in NAPC) HOWEVER, intervention does not need to
WAIT for diagnosis – we can intervene at an earlier stage
![Page 10: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/10.jpg)
Which intervention? There are now lots of interventions and lots
of books on AS, how do we choose what to do?
‘Read the child, not the book’ – ie recognise the differences between those with AS and determine what each individual child actually needs?
How might these needs be addressed? How will the child react to these strategies? How can we check this out?
![Page 11: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/11.jpg)
Another useful triad
1 what is the child’s view of the intervention?
2 what have others done to help his/her understanding of the intervention?
3 what means has the child to 'tell' us what s/he has experienced?
![Page 12: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/12.jpg)
Ideas on intervention: how can we help?
Understanding of AS continues to develop Key areas for assessment and intervention
continue to be identified. Currently, these include:communication; social and emotional understanding; flexibility; sensory perception; motor skills; self esteem; self construct; and leisure activities
Ideas on strategies to develop each of these continue to be developed
![Page 13: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/13.jpg)
The hidden difficulties in AS
Some children are able to ‘pretend’ to be normal, but this is very effortful – and they need time to ‘be themselves’
High intellectual ability or high levels of skill in some areas, does not mean that they have high levels of skill in other areas
Their abilities may mask their difficulties
![Page 14: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/14.jpg)
The hidden difficulties in AS
Good spoken language hides their problems in processing and understanding
Self help and independence skills (eg dressing; shopping; crossing the road; cooking) are often problematic as these involve rapid information processing; flexible thinking; and social understanding
![Page 15: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/15.jpg)
Areas to assess
Communication – initiated and responses Language – expressive and receptive Social understanding and relationships with
children and adults Flexibility Activities when alone Fine and gross motor skills Sensory responses
![Page 16: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/16.jpg)
Which school? Type of school – m/s; special;
specialist; or home tuition Which school? – key variables are
staff attitudes to difference; flexibility; their willingness to involve parents; respect for ALL children;knowledge of AS
![Page 17: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/17.jpg)
Almost every social encounter has the potential to create confusion
and raise stress levels
Literal understanding Q: ‘Would you like a bag?’ A: ‘I don’t know – what colour is it?’ Q: Is this the queue? Friendships are hard to understand, initiate
and maintain and may be viewed simplistically ‘Is there a Friends R Us store?’ Emotional awareness – we need to increase
awareness and give the child strategies to deal with feelings
![Page 18: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/18.jpg)
Some strategies to develop social and emotional understanding
Creating a friendship pair or group Teaching games that children play Creating a Circle of friends Teaching about emotions using real
situations and photos and videos Social stories and comic strips Individual ‘counselling’
![Page 19: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/19.jpg)
Forms of advice and training for parents
Good practice is that which recognises that ‘one size does not fit all’ – need to offer a range
of options to families and children Growth in the literature; outreach; support at
home; training workshops; Internet; accredited courses
BUT these are not yet available to all families Access issues relating to the ability of
professionals to ‘reach’ some families (eg language; literacy; social class; financial; transport)
![Page 20: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/20.jpg)
Demands of AS on parents Child may appear to ignore or avoid parents Parents hurt by the social isolation/rejection of
their child by other children and parents Some behaviours are very distressing and
extremely stressful to live with Not knowing exactly what/when the child might
find it all too much – ‘walking on eggshells permanently’
Constant support and advocacy needed throughout the day and for life – even when at school – anxious in case there is a problem
![Page 21: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/21.jpg)
Social isolation of the parents
Concerns about safety and difficult experiences in the past can reduce the extent to which families access facilities
Many would welcome ‘another pair of hands.’ – and this may be preferable to giving time to an intervention
![Page 22: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/22.jpg)
Recent national guidance and strategies on ASDs Need to provide a good service for
ALL geographically – good practice can be trapped in services
So, to improve coherence and consistency, there is a need for national guidance
![Page 23: Asperger syndrome in the early years: issues and challenges](https://reader035.fdocuments.net/reader035/viewer/2022081421/56814953550346895db6a4f4/html5/thumbnails/23.jpg)
Recent national guidance National Autism Plan for Children,
2003 DfES Good Practice Guidance, 2002 APPGA (All Party Parliamentary
Group on Autism) Autism Cymru work to develop an All
Wales Strategy for ASDs