My first thought about the title was that the term Asperger is now outdated but professionals continue to understand that the term typical means the person has significant deficits in social language and that their intelligence is usually average to above average. The first part of my blog post includes the vocabulary and review of terms and deficits that author presents. Much of this will be review for most therapists but I found it helpful to review the terms and see the areas of difficulty highlighted. I could possibly refer back when developing goals. The middle part involves ideas with how to structure group intervention. The last part of the post will be activities suggested. There were A LOT, so I just picked several from each area for each age group, along with the page number if you wanted to look up that particular activity. Many are self explanatory and most involve students being in charge of part of the supplies needed so that there is opportunity to practice asking for supplies, turn taking, problem solving, etc.
The book begins by providing definitions for common terms when working with people with autism. Theory of mind is the understanding of others perspective. The book gives the example of a man walking out of a shop, runs back, comes out slowly searching the ground. If you use theory of mind, you can make an inference that the man has likely lost something. Our students who are working on developing this many be confused as to what is going on.
The next term is epistemic words, which are words that reflect internal knowledge or action. Some examples of words include think, feel, hope (verbs), thoughtful, happy (adjectives), sadly, wishfully (adverbs). The author referred back to the man in the shop example. The author states “actions would seem unusual if lacked ability to understand mental state words.” Therefore, if a child has no understanding of epistemic words, then they will likely have difficulty understanding story plots and character perspectives.
Basically, if you have an underdeveloped theory of mind, you will interpret messages literally. This made me think about the impact it would have on a student for reading, interpreting vocabulary, multiple meaning words, and anything with a figurative or literal meaning. According to the author, effective communication is achieved when speakers and the listener use theory of mind to structure the conversation. Additionally, when you use pragmatic skills, you know to organize information to communicate more effectively.
MY THOUGHTS: After reviewing all of this information (I’ve heard it many times over the years) it reminded me how much difficulties with social skills can impact reading and class discussions. It almost made me feel a little overwhelmed at all the ways the students with Autism need to be explicitly taught things that many of us acquire through observation and experience.
The author then discusses the challenges for children with Asperger (and I feel like it applies to all children with autism). The areas are social competence, executive function, friendship, nonverbal communication, academic achievements, self-management, sensory perceptions and motor skills.
Social competence: ability to accomodate and adapt ongoing social skills by rapidly reading social cues
Executive function: higher cognitive abilities to plan long term, choosing/initiating multi tasking, organizing. Can also be perceiving emotions/recognizing facial expressions. May exhibit difficulty with pretend play and planning as well as stopping a task.
Friendship: follows sequence of development. Start playing next to a child, then with a child along with sharing and turn taking.
Then reciprocity (friends help and support each other to facilitate friendship. THEY MAY NEED ASSISTANCE UNDERSTANDING THIS ASPECT SO PRACTICE GIVING COMPLIMENTS, SHOWING CARE AND COMPASSION AND HELPING OUT WHEN NECESSARY
Nonverbal: facial expressions, sarcasm. May misunderstand jokes or conversations. This can lead to social ridicule or isolation.
Verbal communication: Children diagnosed with what was previously referred to as Asperger typically have normal early language development with syntactic, semantic relatively normal and pragmatics impaired. Difficulties typically with conversational turns, eye contact, initiating and maintaining a topic not of their choosing.
Academic: difficulty with central coherence, combine diverse information to construct higher level meaning and make sense of situations and events.
Self Management: Includes 4 categories and typically need to give direct instruction in these areas
Sensory Perception: difficulty with sensory domains (visual, auditory, gustatory, olfactory, somatosensory, vestibular, proprioceptive) If not effectively perceived, organized and processed, may result in the unusual behaviors we see in kids with AS.
MOTOR: often described as clumsy. They can have difficulty with movement, balance, handwriting, scissor use, rhythm and hand-eye coordination Possible accommodations could be keyboard or pairing a highly desired activity with a motor activity.
Rules must be established. The author mentions that it is very important to include the student with establishing the rules but monitor. The author used the example thatt one student said “no wigs.” The author talked to the student and asked if wigs had ever been a problem. WHen the response was no, they decided that wasn’t a necessary rule.
Themes: allow for consistency session to session and increase redundancy of concepts being addressed. THEY ABSOLUTELY NEED REPETITION AND REDUNDANCY TO FACILITATE THEIR LEARNING.
The author provides some theme examples: trip around the world. Problem solving olympics, science, history, holidays, secret garden, a day at the beach, books to read, community helpers.
Conversational skills: These must be actively incorporated, greetings explicitly targeted (often fail to greet and close during social communicative exchanges. Be sure to take baseline so can target appropriate number of conversational turns. Lunchtime groups are becoming popular.
Problem Solving: In every treatment sessions, all participants needs to be included with role for ultimate end product.
Games: The author suggests repeating the mantra “Sometimes we win, sometimes we lose. It’s just fun to play the game.” Help the students to win and lose graciously to foster friendships.
Role Play: helps view situations from perspective of others. The author suggests the following activities, writing a play (playwright), acting it out (actor), present book reports (book reviewer), etc. You should consider each child’s unique talents and interests.
Reward system: This is something that should be agreed on by group and should be simple. Have them vote and that’s important because the author says that it lets them know they don’t always get what they want and typically majority decides in real world.
Principles of Group Intervention
Participants: grouped according to individual needs, deficits and developmental/age level
And structure session. The author stresses always starting with sharing personal information and all other things can go in any order. They provide the following example order:
- Sharing personal information-monitor share time
- Group problem solving
- Group game playing
- Scripting and role playing
REFLECTING ON OUR SESSIONS, WE MAY NEED TO EITHER CUT OUT A STEP OR 2 OR REDUCE TIME OF EACH STEP.
The author breaks activities down in 3 group
I found that almost every activity could be adapted to increase or decrease complexity. I also found that they could work for almost anyone with some modifications. Within the age groups, they break down the activities for specific skills. I will highlight some I thought were most practical for us to do and the ones most easily adaptable. They were many I did like but could not include because the time it would take to type it all out. If you have groups that would benefit, I highly recommend borrowing the book from the speech office. It’s a quick read and there are so many ideas.
I include the page number so if you want the entire activity with materials listed, you can reference it easily.
Activities that target cooperative skills: indoor fall hike (p.20), plate faces (24), seasons book (25), favorite things collages (26)
Activities that target eye contact: guess who (31), dice talk (32), obstacle course (51)
Activities that target turn taking: farm song and play (43), animal imitation (44)
Activities that target pretend play: zookeeper (53), I am a pet, who am I? (55), what’s for dinner (57), car wash (59)
Activities that target cooperative skills: house collage (69), sponge painting an ocean (71), making trail mix (73)
Activities that target eye contact while speaking and listening: red light, green light (82)
Activities that target using facial expressions to convey feelings: expressions charade (87), track meet (90)
Activities that target turn taking in a group: pumpkin decorating (95–could possibly do a contest for each group so they work as a team), floor puzzles (96), watch the leader (97), Fly, Mr.Bird (99), snack with feeling–texture, taste, etc (106)
Activities that target role play: safety at home (111), community helpers (113)
Activities that target cooperative skills: name the border (117), power tower (118), unusual card game (122), no cook oatmeal cookies (123)
Activities that target eye contact when speaking and listening: partner interview (127), I’ll be your server (129), Name game–alliteration (130), Get off my back (134), Here’s looking at you (135)
Activities that target facial expressions to depict emotions: facial expression collage (137), alphabet expressions (138), what to do it… (143), take a deep breath (146)
Activities that target turn taking: treasure hunting puzzle (147), build a robot (148), magnet play (151
Activities that target topic maintenance: outside invitations (157), story creation (158), spinner talk (160), occupation collage (161)
In summary, I liked that this book was an easy read but gave me a good review of information that is helpful when designing groups and working with student with Asperger. The activities offer a great variety of (mostly) easy activities to gather the supplies and execute well in a group. I like how most were easily adaptable and how they list skills the activity can target. I’ve worked with students with Autism for years but sometimes it still can be a challenge to figure out what to focus on and activities that may facilitate growth with the goals.