Tom – A Child With Asperger’s Syndrome
By. YouNa Seo 300724694
Case Study: Scenario
What is the Special Needs?
Tom is a child with Asperger’s Syndrome
He is 8 years old and has difficulty in social situations and impulse control
What are challenges the family faces?
Single Mother, works full time
Worried about July and August
Needs to find an affordable summer program
Would like Tom to be involved with other children and spend time actively outdoors
Asperger’s Syndrome: What is it?
A higher functioning form of Autism Spectrum Disorder (ASD)
A neurobiological developmental disorder that impairs social interactions, and restricts interests and activities but little or no impairment in language, cognitive, self-help skills or adaptive behavior
Can only be determined based on social interactions
Cause is unknown but leading theory points to genetic causes: tends to run in families, more common in males than females
No known prevention
Asperger’s Syndrome: Symptoms
• Difficulty with social interactions
• Obsessive interests
• Routine/Repetitive behaviors
• Odd Speech/Communication Style
• Hypersensitivity to lights, sound, smells
• Other Possible Symptoms
Asperger’s Syndrome: SymptomsDifficulty with social interactions
• Prefer to play alone
• Difficulty making friends
• Lack innate drive for social engagement
• Limited or inappropriate social interactions
• Does not understand social/emotional and nonverbal cues (may stare, not make eye contact)
• Lack ability to take perspective of another person (empathy): Cannot understand what another person is thinking/feeling
• Cannot predict what another person is likely to do
• Lack instincts and skills to express thoughts and feelings
Asperger’s Syndrome: Symptoms
Obsessive interests
• Unusually strong, narrow interests - only interested in specific topics
• Focus on one topic - contributes to social isolation
• Can focus for a very long time (on interested topics)
Asperger’s Syndrome: Symptoms
Routine/Repetitive Behaviours
Repetitive routines provide security
Stresses when routine suddenly changes
Does certain things in an inflexible, repetitive way
Repetitive speech
Asperger’s Syndrome: Symptoms
Odd Speech/Communication Style
Speech may lack tone, pitch, and accent (like a “robot”)
Average to above average verbal skills
Formal style of speaking advanced for age (like a professor)
Repetitive speech
Tends to discuss self than others
Inability to understand nonliteral phrases
One sided: lack of reciprocal conversations
Asperger’s Syndrome: Symptoms
Hypersensitive to lights, sounds, smells
Can be hypersensitive to or bothered by lights, sounds/noises, smells, strong tastes or textures
Asperger’s Syndrome: Symptoms
Other Possible Symptoms
May be clumsy; may lack coordination
Unusual facial expressions, body postures, gestures
Poor handwriting or trouble with other motor skills (i.e. riding a bike)
May show aggression
Asperger’s Syndrome: ImplicationsImplications for the child and the family:
Affects the way child develops and understands the world
No clinically significant delay in language and cognitive abilities
Has average to above average intelligence
Without diagnosis, support, and intervention, the diagnosed child and families can struggle to understand and deal with the child’s puzzling traits
Through support, treatment, and medication, may help with concentration, aggression, depression, and learn how to react to social cues
Explaining Asperger’s Syndrome
It can be difficult to explain AS to a child
A tool that ECEs can use to explain AS to children is by using a video that demonstrates AS in terms that children can understand:
http://www.youtube.com/watch?v=s9eATBV-_lg
Meeting the Needs of a Child with AS in a Childcare/School Setting
Role of the Teacher:
Get to know the child individually, the child’s interests and favorite toys or activities
Teach or engage in a group/class activity related to a topic of interest to enhance attention and build a common ground/interest among children
Be consistent and provide love and security!
Have realistic and achievable expectations and goals
Communicate and guide the child through modeling
Meeting the Needs of a Child with AS in a Childcare/School SettingPhysical Adaptations:
To address possible hypersensitivity:
Avoid seating child directly under a bright light
Avoid spraying strong scented air-fresheners or perfume in the classroom
Avoid shouting and place a large visible “No Shouting” sign with picture for others to see
Provide fidgeting kits to increase attention
For poor handwriting or motor control, can provide devices such as adjustable touch screen styluses
Address or remove any other barriers to learning/inclusion
Environment should be predictable yet flexible
No Shouting
Meeting the Needs of a Child with AS in a Childcare/School SettingTeaching Strategies:
Use visual communication and cues such as pictures to capture attention, communicate, explain a schedule, process, etc.
A child with AS who is shy to speak out in front of a group can point to a picture to make a choice and communicate
Pictures with labels can be used to demonstrate and explain a social process such as sharing or trading a toy
Pictures with different facial expressions, gestures and labels can be used to teach the child such non-verbal expressions
Guide the child with physical, modeling and demonstrations, gestural, visual, positional prompts, verbal as needed
Use most to least prompts to teach a new skill, then least to most prompts once a skill is learned
Use fading to gradually reduce the amount of force and extend the time between instruction and support
Modeling /demonstration may be most appropriate as a child with AS has difficulty understanding non-verbal gestures and non-literal expressions
Meeting the Needs of a Child with AS in a Childcare/School SettingTeaching Strategies:
Provide a routine but flexible schedule to enhance sense of security for the child with AS but to also allow flexibility for other children
Begin with teaching useful skills such as recognizing different facial expressions and gestures and once the child succeeds, move onto more difficult tasks involving others such as playing games with other children
Reinforce positive behavior and skill acquisition with social praise (i.e. good job, high five), attention, and tangible rewards such as toys or activities
Utilize technology and tools such as Picture Exchange Communication System (PECS)
Meeting the Needs of a Child with AS in a Childcare/School SettingOther Children
To help the child develop social, group and teamwork skills while creating an inclusive environment for all children, the class can engage in activities such as:
Bowling
Child can learn by observing the behavior of other children
Teacher can model by tapping chest, stating “my turn” before throwing the ball and repeat for the child’s turn stating “your turn”
Drama/Acting/Role-playing
Have all necessary props to make the play as realistic as possible.
Make the children change roles or change roles with the child
Games
State and model rules of the game to help facilitate play with another child
Provide the level of prompt needed from least/weakest to most/strongest
Meeting the Needs of a Child with AS in a Childcare/School SettingAddressing Problem Behaviors: Impulsive/Explosive Behaviors:
Once problem behavior is identified, use a functional assessment tool (i.e. Functional Assessment Interview by O’Neill) to record observations at childcare/school and gather information from parents
Identify what happens before the behavior, the setting and time behavior occurs, and what happens after (Find out the triggers: why, what, and where behavior occurs)
Plan for change based on observations and analysis. Make the behavior irrelevant, inefficient, and ineffective
Make behavior irrelevant by changing/adapting the environment: prevent/control things in the environment that lead to the behavior (i.e. if another child makes fun of Tom then discipline and teach this child not to do so. If bright lights or some smell is bothering Tom then remove this from the environment or move Tom away from it)
Make behavior inefficient by eliminating need for behavior (i.e. teach specific adaptive, educational and social behaviors such as how to control their impulse or an alternative behavior that is more appropriate i.e. express their frustration calmly through conversation)
Meeting the Needs of a Child with AS in a Childcare/School SettingAddressing Problem Behaviors: Impulsive/Explosive Behaviors:
Finally to make a behavior ineffective, prevent the child from fully engaging in or unleashing the problem behavior by responding immediately as soon as the child tries to engage in the problem behavior
(i.e. if Tom tries to be aggressive to another child, remove this other child from sight or away from Tom, remind Tom of the rules or what to do to manage this impulsive/aggressive behavior such as expressing himself verbally instead of through physical aggression)
Change the behavior in every environment the child is in (i.e. at home and anywhere outside the childcare or school)
Meeting the Needs of a Child with AS in a Childcare/School SettingAddressing Problem Behaviors: Impulsive/Explosive Behaviors:
In Summary, to help the child learn to control impulsive or explosive behaviors, we must teach them:
How to think in frustration
Consequences and rewards
How to calm down
How to reduce frustration
Read related books
Develop and engage in fun activities to practice calming down and thinking in a frustrating situation
Provide negative and positive reinforcement (consequences and rewards) during practice and after every impulsive/explosive behavior or attempts to control behavior and calm down
Involve and train with parents and other children
Meeting the Needs of a Child with AS in a Childcare/School SettingFamilies:
Work with families to develop a thorough and complete understanding of the child and the child’s needs
Educate families on strategies used at the school/childcare center to deal with the child’s problem behavior and suggest corresponding strategies to use at home to ensure consistency
Help create and implement Individual Program Plans (IPP) and Individual Educational Plans (IEP) including thoughts, ideas, observations, strategies, solutions
Consult resource consultants, specialists, coworkers
Set realistic expectations and goals
Refer the family and child to appropriate support and services
Understand or provide what is needed to access services (forms, etc.)
Agencies
Summary of Agencies:
Asperger’s Society of Ontario (ASO)
Kerry’s place
Geneva Centre for Autism
Autism Ontario
Agency:Asperger’s Society of Ontario (ASO)
*A good agency to refer to when looking for resources in your area (in Ontario)
A not-for-profit organization; only agency in Ontario solely devoted to serving Asperger Syndrome patients and families
Free Services:
Information and funding guide for camps: http://www.aspergers.ca/2013/02/summer-camp-resources/
ASO Searchable Resource Database (an online searchable resource directory)
Allows you to find resources in your area by postal code or address (can filter for different fields)
Asperger’s Syndrome info Line
Program specialist responds via phone or e-mail for information and guidance on resources and services available throughout the province (responds within 24 hrs)
416 651 4037; [email protected]
http://www.aspergers.ca/
Agency:Kerry’s Place*A good agency to refer to when looking for resources in your area (in Ontario)
A non-profit Ontario corporation: “Canada’s largest service provider for children, youth and adults with ASD [serving] more than 7000 people with an ASD and their families each year”
Regions Served: Peel/Halton, Dufferin, Durham, York/Simcoe, Toronto, and Hastings
Services:
Parent Support Groups
Provides parents of children with Asperger Syndrome to get together and share experiences
Free of Charge
Other Support Groups
Provides workshops, social groups, family and sibling support groups for children with ASDs
Camps
Agency:Kerry’s Place
Resource Centres & Online Autism Services Resource Library
Various regiona Resource Centres in Ontario lends materials such as books, journals, DVDs, on a wide range of topics related to Asperger’s syndrome, education, planning, communication strategies, recreation and leisure, etc.
Must provide photo identification and proof of address to borrow materials & sign a Terms and Conditions for the first time
E-mail address required for online registration
Free of Charge
Toronto Resource Centre: 376 Rusholme Rd, Toronto, ON M6K 3J1; 416-534-1644
http://www.kerrysplace.org/
Agency:Kerry’s PlaceExcel table containing list of camps available for children with Asperger’s syndrome in Ontario with corresponding columns highlighted in green:(double click to open file)
Main point of contact for Toronto:
Meggie Stewart, Autism ConsultantKerry’s Place Autism Services, Toronto Region12A-219 Dufferin StreetToronto, ON M6K 3J1416.537.2000 ext. [email protected]
Agency:Geneva Centre for Autism*An international leader in the development and delivery of clinical intervention services and training. Offers a wide range of clinical services determined individually for each person with ASD helping those with ASD build skills to realize their full potential.
Services:Asperger specific workshops, groups, consultations
Services for Parents-Caregivers:
provides ongoing support to help families navigate services, connect to resources, facilitate groups and workshops, provide support and advocacy
Toronto Partnership for Autism Services
Intensive Behavioral Intervention (IBI)
Parent Education and Support Services
Transition Services
Behavior Communication Services
Behavior management, communication, and life skills development for preschool, school age children
Parent education, consultation and coaching, and skill building group service
Agency:Geneva Centre for Autism
Services:
Asperger’s Respite GroupsA variety of evening and weekend out-of-home programs that provide participants the opportunity to develop social and life skills in a structured environment.
Cost $360, Ratio: 1:3
Age range: 6-18 years old
Summer Camps $500-600/week, 1:3 Ratio, 4-13 or 2-18 years old
Social skills building groups and other fee-based services
Main point of contact for Toronto:
Nicole Thompson / Administrative Assistant for Respite ProgramsGeneva Centre for Autism112 Merton Street Toronto, Ontario, M4S-2Z8T: (416) 322-7877 ext:325 | F: [email protected]/
Agency:Autism Ontario
Membership-based organization of parents, other family members, and professionals committed to helping those affected by ASD.
Services:Arts, camps, legal services, resources, treatment centers & services, where to get a diagnosis
Subsidizes cost for attending workshops and seminars and summer camps
Holds “family fun” events
CALYPSO – specialized online resource designed to help parents find the right camp program for their child or youth with ASD
Potential Programme:
Supports families of children with ASD through the support of highly skilled clinicians
http://www.autismontario.com/
Agency:Autism OntarioMain point of contact for Toronto:
Sarah Duhaime, MSW, RSWFamily Support CoordinatorAutism Ontario – Toronto1032 Pape AvenueP.O. Box 60007Toronto, ON M4K 3Z3416-246-9592 ext 236 Or 1-800-472-7789 ext [email protected]
References
http://www.aspergers.ca/
http://www.healthlinkbc.ca/kb/content/mini/zq1008.html
http://www.cangrands.com/healthpdd.htm
http://www.autismspeaks.org/what-autism/asperger-syndrome
https://www.stronginstitute.com/blog/case-study-8-year-old-male-with-aspergers-syndrome.html
connectability.ca
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