Interventions for Asperger’s Specific Behavioral

Karen Clevenger

SST Members

Michelle Pethtel

Ngoc-Han Nguyen

Ron Hughes

Alliant International University

• The purpose of this case study to familiarize ourselves with different assessment strategies used to identify learning problems and intervention strategies associated with Asperger Syndrome.

Abstract

• The current case this SST meeting will be focusing on is based on a student named Conner, who is currently 5 years, 10 months of age, and is of Caucasian/Native American descendent. He is currently receiving special educational services, including a one-to-one aid at school since January 2001. according to his mother, Conner has been previously diagnosed with Asperger’s Syndrome, behavior problems, and severe speech and language deficits.

Conner

Strengths• Conner possesses a mastery of expressive

language skills, strong visual learner, preference for factual information, and a strong self-identity (as reported by parental self-rating scale).

Weakness• In our case study, Connor exhibits communication

and social difficulties, attention difficulties, and sensory processing differences.

• Behavior Problems

Strengths / Weakness

• Asperger Syndrome is a developmental disorder falling within the autistic spectrum affecting two-way social interaction, verbal and non-verbal communication and a reluctance to accept change, inflexibility of thought and to have all absorbing narrow areas of interest and is also neurologically based.

What is Aspergers?

• Social Interaction • Communication • Repetitive Routines, Rituals, and Inflexibility • Narrow Interests and Preoccupations

General Characteristics

• Cannot read social cues and therefore does not give the right social and emotional responses.

• Lack the desire to share information and experiences with others.

• Lack of social response can lead to behavioral problems. • They are often alone and are noticeably different among

peers. • They often focus on small details and fail to see overall

picture of what is happening in a situation.

Social Interaction

• Spoken language is not entirely understood, so it should be kept simple for them to understand.

• Learning to speak in some cases may be delayed. • The AS child may speak too loud for a situation, overly

formal or use of monotone. • Some may talk continuously on a topic of interest. • They tend to give information rather than hold normal

conversations. • Body language and facial expressions may appear very

stiff when the child is communicating.

Communication

• AS children impose rigid routines on themselves and those around them.

• Routines change from time to time and as they get older they become easier to reason with.

• The rigid routine can inflict upon the child’s imagination and creativity.

• They have high memory skills and learn information quickly without understanding.

Repetitive Routines, Rituals , and Inflexibility

• Preoccupation or obsession with a range of topics is a key aspect. • Preoccupations, usually in intellectual areas, change over time. • The individual will want to learn everything about a particular

subject and tends to dwell on it in conversations and free play. • Some specific areas of interest include: • focus on maps • weather and astronomy • various types of machinery • aspects of cars, trains, planes, or rockets

Narrow interests and preoccupations

Differences between Asperger Syndrome and Autism

• outcome is usually more positive • social and communication deficits are less severe • circumscribed interests are more prominent • verbal I.Q. is usually higher than performance I.Q.

(in autism the case is reversed) • clumsiness is more frequently seen • family history is more frequently positive • neurological disorders are less common • The A.S. child has specific interest in objects, where

the autistic child is interested in only parts of objects.

Previous Assessment

1.)    Wechsler Preschool and Primary Scale of Intelligence-Revised

2.)    Woodcock-Johnson Psychoeducational Battery-III/Achievement

3.)    Adaptive Behavior Evaluation Scales-Revised (School Version)

4.)    Conners Behavior Rating Scale (Teacher and Parent)

5.)    Childhood Autism Rating Scale

6.)    Bender-Gestalt Visual Motor Test

7.)    Developmental Test of Visual-Motor Integration

8.)    Observation of Social/Communication and Motor Skills

Teacher Interview

Assessment Results

Cognitive Functioning• Verbal 84 performance 89 full 89Academic• borderline to averageAdaptive behavior• far below average to averageSocial and emotional• significant clinical concernsLanguage / communication skills• averagePsychomotor skills• no difficulty demonstrated

• 1.)    Weschler Intelligence Scale for Children (4th edition)• 2.)    Vineland Adaptive Behavior Rating Scale • 3.)    Conners Teacher Rating Scale- Revised• 4.)    Conners Parent Rating Scale- Revised• 5.)    Asperger Syndrome Diagnostic Scale• 6.)    Autism Diagnostic Observation Schedule• The results gained from these additional assessment instruments, can

provide a better and more accurate understanding of Connor’s needs.

Additional Assessment

Treatment

• Psychosocial Interventions • behavior modification • educational interventions

Treatment Continued

The 1st Approach: Social skill training

•Conner needs small group discussion and interaction.

•Conner will also learn how to monitor voice and become more socially aware of his different surroundings.

•Family should also consider attending church-group meetings, activities, and clubs where Conner can start to develop relationships. This has proved to be socially therapeutic

Treatment Continued

•The 2nd Approach: Behavior Modification

•Individual and group therapy should be used to help Conner develop ways to handle obsessive or ritualistic behaviors.

•Conner should be taught to be socially aware of others around him and how his actions can directly affect other people.

Treatment Continued

•The 3rd Approach: Educational Interventions

•SSA (Special Support Assistants), Connor should meet with a support group that meets once a week at his school. A group leader helps children to learn specific strategies of how to cope in the educational setting.

•Teacher should encourage child to get involved in group activities.

•Teacher and parent should maintain strong contact regarding the progress of the child in the classroom setting.

•Teacher or aid should help the AS student with organization skills.

Recommendation

. Our behavioral interventions/recommendations will be based on providing Connor with visual stimuli with the use of repetition in the presence of structure. Therefore, we will need to teach Conner how to notice, attend, and imitate positive and appropriate behavior

Recommendation

Initiating play with same aged peers

Engaging in cooperative play with a same aged peer

Demonstrating imaginary play skills

Demonstrating representational play

Functional Communication System

Self-initiating play with peers

Expansion of play activities

RecommendationPicture identification of feelings

Preferred friend/mentor

Initiation of play with a same aged friend

Communicative exchange with a same aged friend

Friendship/mentor system builds friendship/support

Continue pragmatics that would increase his communication that was previously assessed a below average level

Requires a sensory release time during his school day to maximize Connor’s learning potential

 

Individual Daily Behavior Chart Using your H.E.A.D. when you are involved in a Conversation T.G.I.F. Asking someone to play Joining others in play

Sharing Taking Turns Recognizing feelings (Building awareness of feelings) Feelings thermometer Keeping calm• Promoting peer acceptance through sensitivity training and

incentive programs

Intervention

Current assessments indicate that Conner currently meets the criteria necessary to continue special educational programs per Title 5, 3030 as a student with Asperger’s Syndrome; which adversely affects his educational performance. However, it was also recommended that the IEP team determine the most appropriate and least restrictive educational environment.

Conclusion

Closing Statement

•It is important to keep in mind that the child diagnosed with Asperger syndrome is very unique in his own individual talents and abilities. However, this child needs a stable environment of support from the educational field, family, and treatment facilitators to learn how to function as an acceptable individual in the culture surrounding him.

Conner a year later