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An aspect of the Center for
Children
and Families
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Topic:
Pervasive
Developmental Disorder: Asperger Syndrome
Researched and
written by: Sara Bell
I attest that the following
report is a product of my own original work.
Summary
Full
Report
Related Websites
References
Summary
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Asperger Syndrome is a subcategory of
Pervasive
Developmental Disorder (PDD). Currently,
for every ten thousand children, Asperger Syndrome is found in twenty
to
twenty-five of them. With new research
being conducted, the familiarity with this disorder is increasing. Thus, educators are learning more and more
about ways to help children with Asperger Syndrome be successful.
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Overview/definition
of Asperger Syndrome
<>
In early
1944, Viennese pediatrician Hans Asperger categorized Asperger Syndrome
as an
autistic spectrum disorder or a Pervasive Developmental Disorder (PDD)
(Fine,
2004). It was not until 1994, that PDD
included five subcategories: Autistic Disorder, Childhood
Disintegrative
Disorder, Rett Disorder, Asperger Disorder, and Pervasive Developmental
Disorder Not Otherwise Specified (Tsai, 2000).
These subcategories were proposed in the fourth
edition of the
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), hence
making
this disorder fairly new.
Asperger Syndrome is
categorized by impairments in communicative speech, obsessive
temperamental
behavior, and social behavior (Fine, 2004).
According to Turnbull, Turnbull, Shank, and Smith
(2004), an Asperger
Syndrome individual has fewer delays in intellectual performance and
speech development
but has significant setbacks in the areas of emotional and social
functioning. DSM-IV defines Asperger
Syndrome by the following criteria (Henderson,
2001):>
A.
Qualitative impairment in social interaction, as manifested by at least
two of
the following:
1.
marked
impairments in the use of multiple
nonverbal behaviors such as eye-to-eye gaze, facial expression, body
postures,
and gestures to regulate social interaction
2.
failure
to develop peer relationships
appropriate to developmental level
3.
a lack of
spontaneously seeking to share
enjoyment, interests, or achievements with other people (e.g. by a lack
of
showing, bringing, or pointing out objects of interest to other people)
4.
lack of social
or emotional reciprocity
B. Restricted, repetitive and
stereotyped patterns
of behavior, interests, and activities, as
manifested by at least one of the
following:
1.
encompassing
preoccupation with one or more
stereotyped and restricted patterns of interest that is abnormal either
in
intensity or focus
2.
apparently
inflexible adherence to specific,
nonfunctional routines or rituals
3.
stereotyped
and repetitive motor mannerisms
(e.g., hand or finger flapping or twisting, or complex whole-body
movements)
4.
persistent
preoccupation with parts of
objects
C. The disturbance causes clinically significant impairment
in social,
occupational, or other important areas of functioning
D. There is
no clinically significant general delay in language (e.g., single words
used by
age 2 years, communicative phrases used by age 3 years)
E. There is
no clinically significant delay in cognitive development or in the
development
of age-appropriate self-help skills, adaptive behavior (other than
social
interaction), and curiosity about the environment in childhood
F. Criteria
are not met for another specific Pervasive Developmental Disorder or
Schizophrenia
Diagnosis of Asperger
Syndrome tends to occur later
in life as opposed to an Autism diagnosis (Henderson, 2001).
This trend could be due to the innovativeness
of the disorder. Persons diagnosed with
Asperger Syndrome tend to have a combination of diagnoses and/or
misdiagnoses (Henderson,
2001). This could be due to the fact that
the
disorder is fairly new, and not enough research has been conducted. According to Twachtman-Cullen (1997), as
cited in Henderson
(2001), the most common co-occurrence and/or misdiagnosed disorders
include:
Attention Deficit/Hyperactivity Disorder, Oppositional/Defiant Disorder
(ODD),
Conduct Disorder (CD), Schizoid or Schizotypal sensory integration
disorder,
Tourette Syndrome, Obsessive Compulsive Disorder (OCD), and Personality
Disorder.
There
is still some
controversy about the causes of Asperger Syndrome, however, many
believe the
disorder is due to genetics, while others causes are unknown. According to Fine (2004), genetic
correlations show that one parent, most often the father of the child
with
Asperger Syndrome, displays qualities of the disorder, or at least,
tentativeness, constricted interests, and temperamental traits.
Prevalence
Out of every 10,000
children, Asperger Syndrome is
found in between 20 to 25 children, while Autism is only found in 4 out
of
10,000 children, thus making Asperger Syndrome more common than autism
(Fine,
2004). Asperger Syndrome is diagnosed
more frequently in males than females by a 4:1 margin (Fine, 2004). Prevalence of this syndrome seems to be
increasing due to the enhancement of research being conducted. Although Asperger Syndrome is becoming more
recognized by society, many individuals in their school years are still
not
being diagnosed (Barnhill, 2001). With
the issue of cultural based statistics, there seems to be no research
yet
conducted.
Characteristics of
Asperger Syndrome
<>
Asperger Syndrome consists of many characteristics
that differentiate it
from other disorders. A person with
Asperger Syndrome tends to show a deficiency in developmentally
opposite social
skills (Adreon & Stella, 2001). It
is hard for an Asperger Syndrome child to have friends and carry on
conversations because they do not understand how to translate
non-verbal
cues. Children with Asperger Syndrome
have difficulty interpreting facial expressions, eye contact, and
gestures (Adreon
& Stella, 2001). Their conversations
have a tendency to revolve around themselves and their voices are
liable to
sound emotionless and flat (Edelson, 1995).
There are many
symptoms that a
child with Asperger Syndrome has in the area of cognition.
Persons with Asperger Syndrome tend to be
very intelligent and have a higher verbal IQ performance (Fine, 2004). Many children with Asperger Syndrome have
problems changing focus and cannot handle change (Adreon & Stella,
2001). Often, children with Asperger
Syndrome are
obsessive with topics such as music, patterns, and weather (Edelson,
1995). Attentional problems also exist
since they have trouble dealing with two tasks at a time or switching
between
the two tasks (Henderson,
2001). Children with Asperger Syndrome
may also display lack of common sense and trouble with concrete
thinking
(Edelson, 1995). Dyslexia, writing and
math problems may also be concerns (Edelson, 1995). >
Behavioral
problems are also seen in
those children with Asperger Syndrome.
Somewhere between 50 and 90% of children with
Asperger Syndrome
experience problems with motor coordination (Barnhill, 2001). They seem to be socially aware but exhibit
improper reciprocal interactions (Edelson, 1995). Additionally,
children with Asperger Syndrome
have trouble coping with frustration, leading to emotional outbreaks
(Cohen,
2002).
Classroom issues
Students
with Asperger Syndrome have difficulties adjusting to different
environments
(Adreon & Stella, 2001). Many
problems that students with Asperger Syndrome have in the classroom are
the
outcome of unanticipated alterations.
Changes that affect schedule, seating, activities,
and teachers, may
result in distress for the child. Having
to travel to different classrooms throughout the day, a factor in
middle and
high school, may affect the child greatly, mostly causing anxiety
(Adreon &
Stella, 2001). Children with Asperger
Syndrome are often teased, bullied, and excluded (Adreon & Stella,
2001). Classmates see a child with
Asperger Syndrome
as being different. Classmates of a
child with Asperger Syndrome often perceive the child as rude,
immature, and
irritating (Safran, Safran & Ellis, 2003).
A child with Asperger Syndrome often feels left out,
maltreated, and
misread (Adreon & Stella, 2001). As
an outcome of all of these problems, a child with Asperger Syndrome may
respond
with verbal outbursts, self-inflicted physical injury, and tantrums
(Fine,
2004).
Treatment issues as
they relate to the classroom
<>
The
Individuals with Disabilities Education Act (IDEA) of 1997 has many
provisions
which help children with Asperger Syndrome get the best education
possible
(Fine, 2004). This act requires that
every child with a disability has a right to an Individualized
Education
Program (IEP). This IEP is developed in
collaboration with faculty, the child’s parents, as well as the child
once they
reach the age of fourteen. In order to
assure equal success, the plan consists of strategies and special
accommodations which may help the child (Fine, 2004).
Another law that has been implemented is the
No Child Left Behind Act. This law requires that every child, no matter
their
disability, must have equal rights of education and have the
opportunity to be
educated in the general education classroom.
By law, schools must provide training for teachers
and other faculty to
ensure that they are teaching in the interest of all students (Fine,
2004). Due to these laws, it is very
important for teachers to understand children with Asperger Syndrome in
order
to assure they receive equal educational opportunities in the least
restrictive
environment.
>
<>There are many things that teachers
need to consider and understand before having a child with Asperger
Syndrome in
their classroom. A teacher must
carefully construct a seating arrangement where the student will not be
near
potential “bullies” (Safran, 2002).
Seating a child with Asperger Syndrome near a
non-judgmental,
understanding, and kind classmate is a good idea (Safran, 2002). This student could also serve as the child’s
“peer buddy” who could be a communal translator for the child (Safran,
2002). Another strategy that could be
used to promote constructive social interactions between the child with
Asperger Syndrome and other classmates is “circle of friends” (Safran,
Safran
& Ellis, 2003). “Circle of friends”
entails a few peers assigned to interact with the child with Asperger
Syndrome,
which would provide social support for the student, and a type of role
model
for other classmates to see (Safran, et al., 2003).
When group work is needed, the teacher should
not allow students to pick their groups; this causes anxiety for the
child with
Asperger Syndrome (Fine, 2004). Instead,
the teacher should carefully select group members to be paired with the
child
and advocate specific tasks for each member in order to ensure that the
child
feels of equal importance (Safran, et al., 2003).
Changes
in schedule, assignments, and other
activities must be made well in advanced in order to give a child with
Asperger
Syndrome advanced notice to help the child adjust ahead of time (Gagnon
&
Robbins, 2001). The teacher should try
to use as many visuals as possible. This
helps the student with Asperger Syndrome keep tract of the schedule and
be
organized. Providing the child with
pre-highlighted notes will help the student distinguish key information. The teacher should help the student be
organized and decrease the chances of anxiety by sustaining an
assignment book
(Safran, et al., 2003). Priming is a
technique that can be used to help familiarize a student with Asperger
Syndrome, by means of future academic material (Fine, 2004). This technique when utilized can assist in
the reduction of pressure and apprehension for the child.
Academic modifications in assignments,
especially in reading and writing, are beneficial.
Due to the inability of a child with Asperger
Syndrome to read “in between the lines”, clear detailed rules and
curriculum
should be presented visually (Safran, et al., 2003). >
<>
Teachers should
encourage all
students to ask questions. This is
especially so for a child with Asperger Syndrome. Specific
and concrete instructions provided
individually to the child with Asperger Syndrome are most helpful. After a question has been asked, allowing the
child to take some time to think about the question will provide a
greater
chance of him or her to respond correctly (Safran, et al., 2003).
Understanding
a child with Asperger Syndrome can help an educator recognize anxiety. Helping the child learn coping skills, such
as self-talk, is helpful in preventing occurrences of anxiety. Allowing a student with Asperger Syndrome to
have a place to go if he gets upset or frustrated will help him know
there is a
place to escape for alone time (Safran, et al., 2003; Gagnon &
Robbins, 2001). >
<>
Due to the
fact that children with Asperger Syndrome are not successful with
social
interaction, may strategies can be used.
A “cartooning” approach is used to help a child plan
social interactions
which they might encounter (Safran, et al., 2003).
The use of drawing simple comic strips helps
the child visualize a scenario and understand the social situation as
well as
appropriate interactions for the circumstances (Fine, 2004). Another strategy that can be used is called
Situation, Options, Consequences, Choices, Strategies, Simulation
(Safran, et
al., 2003). In this approach, the
teacher helps the child understand the situation, brainstorm options,
consider
consequences for each option, choose the most desirable option, develop
a plan
of action, and practice the plan of action (Fine, 2004).
Children with Asperger Syndrome tend to
isolate themselves as much as possible (Fine, 2004).
In order to help prevent isolation, teachers
need to be aware of behavior intervention approaches to help a child
with
Asperger Syndrome. Motivational and
positive reinforcers should be implemented to reinforce positive
behavior. Applied Behavior Analysis
(A.B.A), is one
approach that can be used; however, it requires a lot of commitment
(Ruberman,
2002). This program is used to teach a
child with Asperger Syndrome cognitive tasks by utilizing a thorough
reward
system (Ruberman, 2002). Another
strategy that is very popular is the ABC’s of behavior management. This strategy is used when a negative behavior
occurs. The “A” stands for antecedent,
meaning what transpired prior to the negative behavior, “B” represents
the
appropriate behavior expected, while “C” stands for the consequence
after the
negative behavior (Fine, 2004). >
Conclusion
The
understanding of Asperger
Syndrome seems to be increasing. As new
research is conducted, there is greater understanding of the disorder. It is very important for professionals to
keep up with research to better understand the diagnosis and treatment. With the help of new research, professionals
can better diagnose disorders. It is
important for people to be diagnosed at the earliest age possible in
order to
help treat them as soon as possible.
Educators need to be constantly trained about new
research and treatments
in order to help children with Asperger Syndrome be successful in
school.
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References
<>References >
Adreon, D., &
Stella, J. (2001). Transition
to middle and high school:
Increasing the success
of students
with Asperger Syndrome. Intervention
in School & Clinic, 36 (5), 1-8.
Retrieved September 5, 2004, from Academic Search Premier
database.
Barnhill, G.
P. (2001). What
is Asperger Syndrome?. Intervention in
School & Clinic, 36
(5), 1-9. Retrieved September 5, 2004,
from Academic Search Premier database.
Cohen, L. (2002).
Asperger’s Syndrome: An introduction for educators. Retrieved November 9, 2004, from Excelligence
Learning Corporation Web site: http://www.earlychildhood.com/Articles/index.cfm?A=252&FuseAction=Article.
Edelson, S. (1995).
Asperger’s Syndrome. Retrieved
November 9, 2004, from Center for the Study of Autism Web site: http://www.autism.org/asperger.html.
Fine, L.
(2004).
Understanding students with Asperger’s Syndrome. Phi Delta Kappa Educational Foundation, (520),
1-11. Retrieved September 5, 2004, from
FirstSearch database.
Gagnon, E., &
Robbins, L. (2001). 20
ways to ensure success for the child with
Asperger Syndrome. Intervention in
School & Clinic, 36 (5), 306-307.
Retrieved September 5, 2004, from FirstSearch database.
Henderson, L. M.
(2001).
Asperger’s Syndrome in gifted individuals.
Gifted Child Today Magazine, 24 (3),
1-11. Retrieved September 5, 2004, from
MasterFILE Premier database.
Ruberman, L. (2002).
Psychotherapy of children with Pervasive Developmental
Disorders. American Journal of
Psychotherapy, 56 (2),
1-9. Retrieved September 5, 2004, from
Academic Search Premier database.
Safran, J.
S. (2002). Supporting
students with Asperger’s Syndrome
in general education. Teaching
Exceptional Children, 34 (5), 1-8.
Retrieved September 5, 2004, from FirstSearch database.
Safran, S. P.,
Safran, J. S., & Ellis, K.
(2003). Intervention ABC’s
for
children with Asperger Syndrome. Topics
In Language Disorders, 23 (2), 154-165.
Retrieved September 5, 2004, from EBSCO HOST database.
This website is a
service learning project by the students of "Psychology of the
Exceptional Child" at Frostburg State University. Manager of web
page and project:
Dr. Megan E. Bradley |