When attempting to understand someone who has a different perspective and interpretation of life, it is essential to empathise with their position. We need to step away from the subjectivity of our thoughts, feelings and beliefs and view the situation dispassionately and objectively. When the person involved has Asperger syndrome, staff must comprehend how the 'triad of impairments' present in all autistic spectrum disorders, and how the specific characteristics of Asperger syndrome can manifest in an individual's observed behaviour.
As well as behaviour, the areas of impairment will affect the thought processes that govern behavioural responses to the environment and responses to the demands made by people, and situations arising within this space. I will briefly outline the triad of impairments and the specific characteristics of Asperger syndrome before continuing.
Asperger syndrome is a condition which forms part of the autism spectrum, it is caused by a biological brain dysfunction. In order for there to be a diagnosis of autistic spectrum disorder, there have to be impairments in three main areas:
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Social communication - concrete understanding of language and formal, monologue type use of speech and a distinct difficulty in interpreting non-verbal forms of communication.
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Social interaction - difficulty in relating on a social level to others, inability to read the thoughts and feelings of others; forming relationships is a problem area.
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Social imagination - rigid and inflexible ways of thinking associated with obsessions and stereotyped behaviours and a resistance to change. Alongside this is poor motor co-ordination which may appear as a physical clumsiness.
Characteristics specific to Asperger syndrome
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Language peculiarities - including overly dull speech, speaking in a monotone, hyper-correct use of grammar and vocabulary, semantic pragmatic problems (ie although vocabulary may appear quite advanced, it may be used in inappropriate situations, and may also be quite 'empty' - for example the individual does not always have a thorough comprehension of the words they are using).
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Imposition of rules and routines - obsessional insistence on sameness, that is also imposed on others. Can sometimes lead to phobias and avoidance behaviour.
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Non-verbal communication problems - may include blank facial expressions, limited eye contact, lack of understanding of sarcasm or irony (as the Asperger individual takes language very literally, when a tone of voice, or a raised eyebrow can completely change the meaning of seemingly genuine words, they will not interpret these visual, non verbal cues and therefore will miss the intended meaning of the conversation).
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Clumsiness - may include poor gross motor skills, poor co-ordination, ungainly movement, trouble learning certain activities (eg riding a bike), or performing certain tasks (eg balancing on one leg to put on shoes etc).
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Problems with social relationships - there will be problems with making friends in the first instance, and then in maintaining the relationship. This is not a phase the person is going through; there will always be problems interacting with peers. As a child the individual may have preferred the company of adults, or may have sought out younger playmates (whose social skills were less complex and therefore easier to understand).
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An overriding, all pervasive single (and usually odd) interest - this is not just a hobby or a normal fad, it is more far reaching and obsessional in nature.
As mentioned above, people on the autistic spectrum are characteristically extremely rigid in their thinking and related to this is their difficulty to cope with change. It has long been recognised that these individuals can function much more effectively in situations which are clearly mapped out for them. This is reflected in the highly structured educational programs found in specialist establishments, where every moment of the pupil's day is timetabled so the child knows exactly what to expect. Although this example relates to a child in a school environment, this principle will be effective with adults in a range of situations - whether in the home or in a professional setting.
Due to the individual with Asperger's having rigid and inflexible ways of thinking, even a slight change to a normal routine can cause enormous amounts of distress. Unexpected or continual changes of familiar people and environments, may upset the person greatly. If change is inevitable, it is vital that it is implemented as gradually as possible within a clear structure that the individual can anticipate and come to terms with.
It is important to provide as stable an environment as possible for the person with Asperger syndrome, and therefore variations should be kept to a minimum. Consistency and continuity of lifestyle are paramount considerations. Where change is unavoidable, staff and carers need to carefully plan the expected response that the change may bring, bearing the particular individual in mind. Any measures that minimise distress should be implemented.
An example: preparing for an exam
- Tell the student as early as possible the date, time and duration of the exam.
- If possible tell them the location and which staff will be adjudicating (if you can not be specific provide a list of the possible candidates).
- Give them an estimation of how many other people will be sitting the exam.
- Be very specific about what topics and modules are being tested, perhaps provide revision guidelines to ensure they cover all the relevant areas (there can sometimes be a tendency to focus on details rather than the whole picture, the student may need direction to attend to areas which they are not especially interested in).
- If the student seems very anxious about seating arrangements, draw a plan of how the chairs and desks will be arranged.
- If you know in advance the seating plan (eg alphabetical) let them know. Help them to work out the general location of where they will be sitting (this does not need to be that precise - eg 'on the left hand side as you enter the hall, in the back section' should suffice).
- On the day of the exam, give them the opportunity to arrive early so they can become comfortable with the environment (eg one very able student could not write a word until he had run his hands along all the walls of the exam hall).
- Be flexible. If the student has trouble concentrating in large groups of people, let them arrive later than everybody else, or consider annexing them in a side room.
- If they are hypersensitive and become distracted easily by the noise of pens scribbling, chairs creaking etc., think about any aids that may minimise this eg ear plugs.
- Likewise if the student engages in repetitive behaviours - eg muttering, clucking, try to plan in advance for this, as it may irritate other students but will be hard to address on the day.
- Distraction/replacement techniques may help - eg if the student is allowed to chew gum, this may prevent muttering and other verbal habits. It is essential to understand that these behaviours may serve a useful function to the student - they may reassure or relax them, the aim should not be to remove them completely but to adapt them to a more acceptable form or to replace them. It may be useful to role-play the exam situation so any possible problems will be discovered.
- The student may benefit greatly from relaxation techniques which they can practice in the run up to the exams.
- The student may need direct input from the adjudicator. Addressing the whole hall may not be enough - they may need one-to-one instructions to fully realise what they are expected to do.
- The student may need help to decide what questions to answer. The written instructions can sometimes be vague or misleading. Once the student has read through the paper and decided what questions they want to answer, they may need to have the sections renumbered - eg if they can answer questions 2, 3 and 5, it may help if the adjudicator renumbers these questions 1, 2 and 3 with a pen.
Everyday considerations
Teacher as positive role-model
Teachers perform myriad tasks and functions, some overt, some covert. Staff (sometimes inadvertently and perhaps unwittingly) can also dictate the style of communication used within the classroom, accepted levels of behaviour, as well as responses and attitudes to certain students.
Some individuals will always stand out in a class, for a variety of reasons. Students receive labels - sometimes positive, sometimes flattering but sometimes cruel. Labels may be given by other students, but in some cases by the teacher themselves. Whereas a teenager may like and encourage certain labels (eg 'the class joker'), others may become hurt and ostracised by them. A teacher can often set the standards which the rest of the class follow (see the works of Bandura for evidence of modelling). If the teacher sends out the message that it is okay to tease or poke fun at an individual it can become open season.
The positive side of this is that a teacher's own commendable behaviour can often encourage pupils to follow suit. If the teacher can demonstrate compassion, patience and understanding this can become the norm for classmates too. Any incidents of bullying or harassment which the teacher observes, overhears or is told about, must be responded to immediately.
Who should be told about the diagnosis?
Generally people can be very sensitive towards and motivated to help the individual concerned, if they understand what the problem is. If their uninformed perception is that the individual is being bossy, dogmatic, arrogant, rude, etc they will be less generous with their time and help. This brings into discussion whether or not classmates should be told about the Asperger syndrome. There is no right or wrong answer - it is a very personal decision for the individual with Asperger syndrome to make (with the support and guidance of family and friends). They will be advantages and disadvantages whatever decision is made, but it is clearly one that requires careful thought.
What problems may occur within the teaching setting?
Group work
Due to the problems experienced with communication and social understanding, the student with Asperger syndrome may find group work hard. People on the spectrum also have problems empathising with other people - therefore they may not function that well in a team as they do not naturally consider other peoples wishes or needs (eg the desire to win or be successful). A good example of where problems may arise be coursework that is conducted in groups. In these situations the success of all the students in the group depends on everybody 'pulling their weight'. Not only may the student with Asperger's have difficulty motivating themselves (especially if the topic is not something they are particularly interested in) they may also have difficulty understanding other people's anger or frustration if things do go wrong. Certain members of the group, or a member of staff, may have to act as mediator in these situations - to ensure that the student with Asperger's fully understands what everyone else in their group expects them to do, and that any disputes are addressed in a calm and logical manner.
Lack of comprehension
Our speech is littered with metaphors and extended use of language. We use these terms without realising how confusing they would be form someone who takes language very literally. I myself have used 'pulling their weight' in the above paragraph when I could have easily said 'doing their share of the work'. It is important to be really careful about the everyday phrases that are used in the classroom. A student with Asperger's may be baffled and confused by certain terms and their subsequent response may make them appear cheeky, ignorant or simply rude. The student may be embarrassed to actually admit in front of other classmates that they do not understand what has been said. The person with Asperger's may have built up a range of coping mechanisms to deal with this problem - acting the joker, and pretending that their confusion is really a deliberate act may be just one such technique. A way to get around this is for the teacher to act (seemingly inadvertently) as an interpreter - eg:
if during a discussion a student says:
"I wish my group members would get off my back about this coursework"
the teacher can feedback to the class ...
"you sound really angry, you just want people to stop harassing you about the coursework".
This technique can work really well as it is not necessary to single out the student with Asperger's as the one always having the problem.
Lack of empathy (sometimes referred to as a lack of 'Theory of Mind')
This has already been mentioned in a previous section, but I would like to elaborate further. There may be problems in situations requiring empathy (ie putting yourself in someone else's shoes). This may involve the student saying things that cause great distress to another classmate or staff member but not seeing themselves as responsible for the upset or anger the remark has caused. In these situations, the client has to be clearly told what effect their words have had, in clear simple terms, as they may not make the connection alone. This deficit must be largely responsible for the problems experienced in making and maintaining friendships. In the teenage years it becomes more important to find friends that understand where you are coming from. Someone on the spectrum can be aided in these matters but they need friends to be very direct and honest. Too often we expect people to pick up our mood from our tone of voice or choice of words - we want to be questioned further so we can reveal our problems to a sympathetic listener eg:
Tom: "How was college today?"
Sue: "It was okay."
Tom: "You sound really tired, are you really okay?"
Sue: "Well, actually..."
Something in Sue's conversation alerted Tom to the fact that his friend had had a hard day. It could have been her voice, her tonal emphasis on certain words, her facial expression, her posture - there are so many non verbal cues we use to understand people. Someone with Asperger syndrome may have real trouble interpreting the non verbal parts of communication. They may have asked Sue how her day was, but they may have just relied solely on her words and not read any more into the situation. This is why sarcasm can cause problems when it is directed at the individual with Asperger syndrome - the words may be taken genuinely. It may even appear as if the person is being sarcastic back, eg:
Tom: '"Nice shirt." (sarcastic)
Rob: "Thanks." (genuine)
This is probably not the case, sarcasm is quite an advanced use of language and extremely idiosyncratic (user-specific). There is no set of rules to learn for sarcasm - some people wink, others raise an eyebrow, some emphasis particular syllables when they are being sarcastic. This makes it very hard for someone on the spectrum to learn the rules of sarcasm which in turn would allow them to recognise and respond. The person with Asperger's may be able to recognise and use the more basic forms of sarcasm (eg at a 70's party 2 friends - 1 with Asperger's - may hold the above conversation where both people are being sarcastic, but this is an obvious form for specific occasions).
A lack of theory of mind also causes difficulties in differentiating between what the individual with Asperger's knows, and what someone else knows. This may result in misunderstandings - a student may not bother to ask the teacher for an extension for an essay because they may assume the teacher automatically knows that their grandma died over the weekend. Implicit instructions can prevent this - eg if you need extra time on an assignment please inform me.'
Problems with motivation
Students with Asperger syndrome may have a special interest - indeed it may be the course they are doing. Invariably (as with everyone) there will be aspects of a course that they are not so motivated by. Most students can rationalise and understand that they have to apply themselves to the whole curriculum, even if it is something they really dislike. A pupil with Asperger's may be very much focused on the concrete here-and-now eg 'I would rather work more on the statistics of my course component than the essay writing'. This obviously could jeopardise that student's overall success. They may find it hard to be motivated by the future (eg 'if I write the essays required I will get my certificate next year'), and they may need additional supervision and motivation that makes goals more concrete (eg 'if you want to become an engineer, you need to complete all parts of the course - including the essays').
Distress caused by lack of information
People on the spectrum are reassured by detailed information. It enables them to relax as they know what to expect. This is especially so when change to a routine occurs. A student will feel more secure with teacher A's statement, than with teacher B's:
Teacher A
"Next Tuesday afternoon, I will not be taking you for geography as I usually do. I have an appointment that day. Mr Stokes will be taking your geography class instead. I will set some work in advance for you to complete. I will be back on Wednesday morning and lessons will continue as normal."
Teacher B
"I won't be in one afternoon next week. Someone else will stand in."
Obviously Teacher A has spent more time briefing her class. However in the long run she may have cut down on her work as a student on the spectrum who is not satisfied by the information provided may well approach her and ask a long list of questions before they are sufficiently reassured. A more negative response may be that the student with Asperger's shows their distress through their behaviour (they may show an increase in coping mechanisms - i.e. ritualistic behaviours, they may panic, play truant, question other students incessantly etc.) - this can easily be minimised/prevented if enough information is given in the first instance. For students that are particularly worried by these kinds of situations, it may comfort them if a timetable is drawn up for that week that shows any changes - it may reassure the student to see visually that although one lesson has changed, the rest of the week will run as expected. This strategy may also reduce the number of questions asked, as the student has something they can consult whenever they feel worried.
Social chameleons
People with Asperger's can become very good at blending in, in familiar situations with predictable events. In these situations it may be very hard to pick out someone on the spectrum. It is only when things go wrong or unexpected events occur that others may realise. Hopefully with the right amount of support and understanding from the beginning of a course, difficulties can be anticipated and kept to a minimum.
A final note
Up until now I have focused upon the difficulties that may arise with the student with Asperger syndrome. I would hate to present an unbalanced picture. Your student with Asperger syndrome will be completely unique.
The impression you may have gained from this article is that an individual with Asperger's is a walking syndrome - this could not be further from the truth. No two people are ever affected by autism spectrum disorders in quite the same way, the manifestations of the main triad and the specific characteristics can vary enormously. The personality of the student will also play a huge role in the way they are - the Asperger syndrome is only a part of what makes up the whole. Your student may be incredibly gifted, have amazing attention to detail, encyclopaedic knowledge of special interests, faultless punctuality and - perhaps most importantly - they can offer you the priceless opportunity to view the world from their particular perspective.