As many readers may be aware, the DSM-5 (Diagnostic and Statistical Manual) was introduced in May 2013, which put Asperger’s syndrome and pervasive developmental disorder not otherwise specified (PDD-NOS) under the umbrella of ASD (Autism Spectrum Disorder). For some, this revision was great; others, not so much. Individuals with Asperger’s syndrome may now not qualify for certain therapy methods, as they may be seen as too high-functioning. Dr. Alisa G. Woods, speaker at ICare4Autism’s latest autism conference and member of ICare4Autism’s Advisory Committee, assembled a review on the different areas of struggle for people with Asperger’s syndrome, and different methods therapists can use to improve the deficits.
Those diagnosed with Asperger’s syndrome tend to struggle with social skills and communication, while maintaining an intelligence level higher than average. For therapists and professionals in the field, accomplishing these tasks may present difficulty. The following are areas discussed in the recently published article, as well as methods therapists may want to try when treating clients with Asperger’s syndrome.
Individuals with Asperger’s syndrome present the following difficulties: sensory and motor functions, social aspects (awkwardness and anxiety), speech-related aspects (linguistics), restricted interests, and emotionality. The best way to convey what was written in the article is to break down each difficulty separately.
Sensory and motor functions: When compared to people with high functioning autism, those with Asperger’s syndrome tended to be quite clumsy, and struggle with sensory overload (lights being too bright and/or sounds being too loud). When in a therapy session with someone with Asperger’s syndrome, it may be best to ask the individual if they are comfortable in the current environment setting, or if there is something that needs to be altered to become less stressful. Occupational therapists may use Cognitive Orientation for (daily) Occupational Performance (CO-OP), a method that is goal-directed to improve motor skills.
Social aspects: If you have ever spoken to someone with Asperger’s syndrome, you will find that most of the time they have a “typical” vocabulary, but may struggle with communication and understanding your tone of voice. This struggle can lead to awkwardness and social anxiety, because this person simply does not understand your social cues and rules. If the therapist explicitly explains social rules to the individual, he or she may have a better understanding and therefore reduce their anxiety. Four approaches were discussed in the review that therapists may adapt to working with their clients: 1. Socio-dramatic affective-relational intervention (SDARI), a group therapy using improvisation and games to increase social interactions; 2. Video modeling, to improve conversational skills; 3. LEGO therapy and 4. Stop-Observe-Deliberate-Act (SODA), a social-behavioral learning strategy. Both individual and group therapy settings have been proven useful when seeing individuals with Asperger’s syndrome.
Speech: In addition to finding that someone with Asperger’s syndrome may be “socially awkward,” he or she may also use pedantic speech. The conversation may also never leave one specific topic, as many with Asperger’s syndrome tend to focus on one topic for conversation, usually one they are the most knowledgeable on or interested in. The conversation may also seem very formal. Forming a routine is something therapists should do to help their clients feel safe, and hopefully veer off from just one topic of conversation. People with Asperger’s syndrome also tend to miss metaphors and similes, and therefore not understand the message being conveyed.
Restricted Interests: The authors of the study found that people with Asperger’s tend to have restricted interests and/or hobbies. When working with this population, the therapist can use this special interest to gain the individual’s trust and comfort.
Emotionality: Let’s be clear here: people with Asperger’s syndrome DO have emotions. They have feelings, just as typically developing people do, but have trouble expressing their emotions. Understanding someone else’s emotions is difficult as well; many people with Asperger’s syndrome do not understand the affect their actions may have on others. Depression and anxiety may arise from this struggle, and therapists need to be aware of this, since the individual may not be able to verbally express these feelings.
With the new DSM-5, parents of children with Asperger’s syndrome are nervous their child may not receive the proper therapy and education necessary. The purpose of the paper was to clearly break down each area of concern for someone with Asperger’s syndrome, and to help therapists understand the best methods for improving these deficits.
To read the full article, click here.