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Principal Leadership Magazine, Vol. 5, Number 3, November 2004

Counseling 101 Column

Asperger Syndrome: A Guide for Secondary School Principals

By Gena P. Barnhill

Gena P. Barnhill (gpbarnhill@yahoo.com) is a special education coordinator and autism consultant for the North Kansas City (MO) School District and the parent of an adult son with Asperger Syndrome. She is the author of Right Address ...Wrong Planet: Children with Asperger Syndrome Becoming Adults. Counseling 101 is provided by The National Association of School Psychologists, www.nasponline.org.

Asperger Syndrome (AS) is a developmental disability characterized by a lack of social skills; a limited ability to have a reciprocal conversation; and restrictive or repetitive patterns of behavior that can include rituals, routines, and an intense interest in a single subject.  AS is not an emotional disturbance, it is not caused by bad parenting (researchers believe that biological and genetic factors are involved), and it is often considered to be on the high-functioning end of the autism spectrum.

Although Hans Asperger, an Austrian physician, first identified the disorder in 1944, it wasn’t until 1994 that the American Psychological Association recognized AS as a pervasive developmental disorder. Though AS is still considered a low-incidence disability—with a prevalence rate of approximately 0.5%—educators are now realizing that AS is not rare. As more families request appropriate educational services to meet their children’s needs, educators desperately need information about classroom interventions that can assist students with AS.

Most students with AS attend regular education classes, function well in many areas, and benefit tremendously from the opportunity to learn and practice skills to compensate for the areas in which they have deficits. However, because of this higher level of functioning—combined with the many nuances of AS—untrained teachers may fail to recognize AS as a true disorder and may view students with AS as being simply troublesome or odd.

Principals can help by becoming well-informed about AS and providing staff members with training. Often administrators come in contact with a student who has AS after the student has been referred for a disciplinary problem or when a parent calls to request additional support services. A clear understanding of the condition is necessary to accurately interpret a student’s behavior and effectively intervene.

Diagnosing Asperger Syndrome Many individuals with AS remain undiagnosed well into adulthood and may only receive a diagnosis of AS after they make a suicide attempt or become involved in the criminal justice system because of an offense related to their special interest, sensory sensitivity, or strict moral code. Frequently, individuals with AS have received multiple diagnoses prior to the diagnosis of AS. Characteristics of Asperger Syndrome Individuals with AS often exhibit communication difficulties in the areas of pragmatics, which includes difficulty with requesting; criticizing; asking; discussing opinions; speculating; negotiating; understanding others; and expressing complex thoughts, feelings, and emotions. Attwood (2003) describes AS as the “pursuit of knowledge, truth, and perfection." For individuals with AS, the expression of truth is more important than feelings. Further, Attwood states that these individuals often have “a one-track mind, but are the last to know they are on the wrong track." Individuals with AS experience difficulties with executive functioning abilities such as planning, organization, goal selection, flexibility, and self-regulation. Attwood (1998) reports that children with AS seem to provoke the maternal instinct in some peers and the predatory instinct in others. Strengths typically associated with AS include excellent rote memory skills, good grammar and vocabulary skills, interest in the social world, and an ability to focus energy and commitment in an area of interest. Students with AS often show a surprising sensitivity to the personality of the teacher. However difficult they are even under optimal conditions, they can be guided and taught “by people who show kindness to them and, yes, humor” (Asperger, 1991). Individuals with AS generally do not choose to have meltdowns and be noncompliant. Their development of the skills that are necessary to be flexible and tolerate frustration may be delayed in these individuals. Reports indicate that there is a greater risk of depression for individuals with AS.  Tantum (1991) states that up to 15% of adults with AS have experienced a period of depression, and Wolff (1995) reports that adults with AS are more likely to be at risk of suicide.

Implications for Adolescents

Several characteristics of AS seem to have their greatest impact during the adolescent and young adult years when successful social relationships are the key to most achievements (Tantam, 1991). Studies have shown that adolescents and adults with AS frequently experience depression (Ghaziuddin, Weidmer-Mikhail, & Ghaziuddin, 1998) and are more likely to be at risk of suicide (Wolff, 1995). AS is typically diagnosed later than autism, often not until the student is in middle level or high school. By this time, students with AS may feel so discouraged from academic or social failures that they have low self-esteem and a sense of learned helplessness. Their delayed emotional maturity, which is particularly apparent in the difficulties they have in conforming to the behavioral expectations of their peers, is more apparent during the secondary school years and sets them up to be victimized or ostracized. This can be particularly painful in the middle level years because behaving like their peers is the “rule of law” among middle level students.

Difficulties with executive functioning skills become a greater problem in high school because long-term projects are assigned and students with AS have difficulty breaking these tasks down into manageable parts. Further, the academic content in high school becomes more abstract and difficult for them to understand. Although some students with AS may be encouraged to participate in academic quiz bowls because of their excellent rote memory skills, these strong rote memory skills can lead to the false assumption that these students can remember relevant information at any time. This is not true; students with AS sometimes cannot retrieve information unless a specific word or prompt is used.

Theory-of-Mind

Individuals with AS have varying degrees of difficulty inferring the thoughts or beliefs of others, a concept that is referred to as theory-of-mind. Typically by the age of four, children begin to understand that other people have unique thoughts, intentions, and desires. Although some children with AS have developed a theory-of-mind, they often cannot apply those skills when they converse with others. This may cause them to appear rude or manipulative because they do not understand the thoughts of others. As a consequence, many students with AS are bullied and taken advantage of by others who prey on their naiveté. It is believed that theory-of-mind deficits lead to a number of related difficulties, including an inability to explain behavior, understand emotions, predict the behavior or emotional state of others, understand the perspective of others, infer the intentions of others (e.g., interpret being used by others as friendship), understand how behavior affects how others think or feel, apply social conventions (e.g., turn taking and politeness), and differentiate fact from fiction.

Strategies. Using direct instruction about how to understand the thoughts of others and teaching problem-solving strategies—such as Last One Picked...First One Picked On (Lavoie, 1994)—are suggested to remediate the theory-of-mind deficits of students with AS. Comic Strip Conversations (Gray, 1994) is another intervention strategy that has been used effectively in schools. It should be remembered that it is not helpful to ask these students why they behave the way they do. Instead, invite them to examine the cause and effect of their behavior.

Social Skills

Because they lack appropriate social skills and do not understand many of the unwritten rules of communication and social behavior, students with AS often have difficulty developing or maintaining friendships and may face challenges because of their difficulty learning conventional social and work-related behaviors.

Strategies. Educators can provide social support to students with AS and encourage skill development through the following activities:

• Providing supervised activities at school that protect them from being bullied and teased. 
• Providing opportunities for direct social-skill instruction that focuses on such areas as reading, responding to social cues, making friends, and dealing with frustrations. 
• Using visual reminders to prompt social skills. This can be done informally or through such visual scripts as Power Cards: Using Special Interests to Motivate Children and Youth with Asperger Syndrome and Autism (Gagnon, 2001) or The New Social Story Book: Illustrated edition (Gray, 2000). Teach and practice the strategies to understand the thoughts of others by using Comic Strip Conversations (Gray, 1994).
• Allowing the student to have some time alone during the school day to relax; educators should realize that the student may have had more than enough social contact at school and may need some time alone.

Verbal and Nonverbal Communication Skills

Individuals with AS appear to have strong verbal skills and some even speak in a sophisticated manner. However, they have difficulty using language for social purposes, particularly when it comes to beginning and maintaining conversations. They use language more as a means to a specific concrete end than for socializing. They may speak endlessly about their particular interest and be completely unaware that others are bored and not joining the conversation. Sometimes the conversations of individuals with AS do not seem to hang together or they use words in an odd or repetitive manner. Individuals with AS also have difficulty understanding that certain words have multiple meanings, which can cause them to take comments literally and misunderstand jokes. They may mistake indirect and polite commands used in school—such as, “Can you take out your notebook?”—as real questions.

Students with AS also display problems in social behavior that reflect their difficulties with nonverbal communication. For example, they may have limited facial expressions, awkward body language, or a peculiar eye gaze. Because they have difficulty interpreting and reading the body language of others, they may violate rules of personal space and stand too close to others.

Strategies. Teachers can use the following strategies to help students with AS develop, use, and understand social communication skills:

• Be brief and explain things simply
• Be concrete and specific when making requests
• Get the student’s attention before giving instructions
• Allow time for the student to process verbal information
• Check for understanding; the student could just be parroting what he or she has heard
• Provide training on nonverbal communication skills: tone of voice, facial expressions, body language, and personal space
• Provide direct instruction in multiple meaning words and idioms
• Provide training on how to begin, maintain, and end conversations.

Behavior and Mental Health

Students with AS have a restricted range of interests that can take unusual or eccentric forms. For example, some may be interested in unusual things, such as washing machines, bus timetables, or subway maps. Although their obsessive interests may be similar to the interests of other students, they are unlike other students because their restricted interest is the only activity in which they participate. Their rigidity is often exhibited as an insistence on a specific order of events, a compulsion to complete what was started, an insistence on rules, a difficulty with transitions, or a fear that is based on a single experience. They do not seem to recognize that there are times when rules can be renegotiated, bent, or broken. Because they may have difficulty predicting the future, insisting that things happen in a certain order can be comforting to them.

Many students with AS have additional psychiatric diagnoses, such as attention deficit hyperactivity disorder (ADHD) when they are children and depression or anxiety when they are adolescents and young adults. Even though students with AS often lack the emotional resources to cope with the demands of the classroom, they do not always demonstrate stress through their tone of voice or body posture (Ghaziuddin, Weidmer-Mikhail, & Ghaziuddin, 1998). Therefore, their inner turmoil may escalate to a point of crisis before others recognize their discomfort.

Educators should be aware that changes in behavior—such as greater levels of disorganization, inattentiveness, and isolation—may be indicative of anxiety or depression. Because these students typically have difficulty identifying their own emotions, they may not be able to acknowledge that they are sad or depressed. Educators need to be aware of the signs of agitation to initiate interventions to avert an emotional or neurological crisis.

Strategies. Educators can use the following strategies to help students with AS cope more effectively with their daily social environment:

• Provide a predictable and safe environment that avoids things that could trigger rage or a meltdown in students. Because a student or group of students can be a trigger for this behavior, it may be wise to limit interaction.
• Set up consistent routines with clear expectations throughout the day. Warn the student of upcoming transitions and try to avoid surprises.
• Limit opportunities for obsessive talk about special interests by providing a specific time of day for this behavior. Use the student’s fixations as a method to broaden his or her repertoire of interests.
• Teach an appropriate replacement behavior when extinguishing an inappropriate behavior. For example, teach the student to engage in such appropriate waiting behavior as counting slowly to 10 rather than screaming to gain the teacher’s attention.
• Use humor to diffuse tension.
• Teach anger-control skills.
• Teach cause-and-effect concepts.
• Create a safe place for a student to go when he or she feels a need to regain control. Similarly, consider safe escapes—for example, sending a student on a simple errand—that remove the student from difficult situations in a nonpunitive manner.

Academic Skills

Students with AS generally have average to above-average intelligence and frequently have good rote memory skills. However, they may lack higher-level thinking and comprehension skills and have poor problem-solving skills. Because many can decode words well, their impressive vocabularies may give a false impression that they understand everything they say or read.

Strategies. Educators can support academic progress in students with AS by using the following strategies:

• Capitalize on their exceptional memory skills by providing them with opportunities to demonstrate their factual knowledge in class  
• Provide visual schedules so they know what is happening throughout the school day
• Link their obsessive interest in a single subject to another subject that is being studied in class
• Shorten or modify their written assignments and consider allowing them to use a word processor or computer.

Summary

Although students with AS exhibit difficulties with social skills, communication skills, and repetitive behaviors, each student is unique and the different strengths and weaknesses of each student must be considered. Principals can assist these students by ensuring that all staff members are trained to recognize the characteristics —and the best-practice interventions— of AS. By understanding how theory-of-mind deficits affect their daily functioning, staff members will know that these students are not purposely misbehaving. Open and honest communication with these student’s families is also needed. By supporting their academic and social success in school, educators help students with AS develop the necessary skills to function successfully in the workplace and community as adults. PL

References

Asperger, H. (1991). Autistic psychopathy in childhood. In U. Frith (Ed. & Trans.), Autism and Asperger Syndrome (pp. 37–92). Cambridge, UK: Cambridge University Press. (Original work published in 1944).

Attwood, T. (1998). Asperger’s Syndrome: A guide for parents and professionals. London: Jessica Kingsley.

Gagnon, E. (2001). Power cards: Using special interests to motivate children and youth with Asperger Syndrome and autism. Shawnee Mission, KS: Autism Asperger Publishing.

Gray, C. (1994). Comic strip conversations. Arlington, TX: Future Horizons.

Gray, C. (2000). The new social story book: Illustrated edition. Arlington, TX: Future Horizons.

Lavoie, R. (Host). (1994). Learning disabilities: Last one picked, first one picked on [Videotape]. (Available from Public Broadcasting Service, http://teacher.shop.pbs.org)

Ghaziuddin, M., Weidmer-Mikhail, E. & Ghaziuddin, N. (1998). Comorbidity of Asperger Syndrome: A preliminary report. Journal of Intellectual Disability Research, 42, 279–283.

Tantam, D. (1991). Asperger syndrome in adulthood. In U. Frith (Ed.), Autism and Asperger Syndrome (pp. 147–183). Cambridge, UK: Cambridge University Press.

Twatchman-Cullen, D. & and DeLorenzo, D. (2000). How to be a para pro: A comprehensive training manual for paraprofessionals. Higganum, CT: Starfish Specialty Press

Wolff, S. (1995). Loners: The life path of unusual children. New York: Routledge.

Resources

Asperger Syndrome and adolescence: Practical solutions for school success. 2001. B. S. Myles & D. Adreon. Shawnee Mission, KS: Autism Asperger Publishing.

More Advanced Individuals with Autism, Asperger Syndrome, and Pervasive Developmental Disorders (MAAP), www.maapservices.org.

Right Address...Wrong Planet: Children with Asperger Syndrome Becoming Adults. G. Barnhill. 2002. Shawnee Mission, KS: Autism Asperger Publishing.

This article was adapted from a handout published in Helping Children at Home and School II: Handouts for Families and Educators (NASP, 2004). “Counseling 101” articles and related HCHS II handouts can be downloaded from www.naspcenter.org/principals.