Asperger s Syndrome in adults. Part 1: Employment

Transcription

1 Asperger s Syndrome in adults Part 1: Employment

2 Employment Qualities of the Person With Asperger s Syndrome Factual knowledge Accuracy Persistence Attention to detail Perfectionist Thrives on routine and consistency Conscientious Technical ability Sense of social justice Originality in problem solving Creativity in arts and sciences Caring professions

3 Job Interview Rehearse, rehearse, rehearse Where the interview will take place and travel arrangements Stress support just prior to the interview Clothing Probable questions and answers What questions to ask Reading body language for more information or closure

4 Job Interview Seeking clarification and whether the question has been answered Social and conversational conventions at an interview Eye contact and non-verbal communication Portfolio Disclosure? How ASD is an advantage in this particular job Closure

5 Starting the New Job Mentor at work Mentor at home Guidance in the unwritten social rules and personalities Feedback on work performance Memory for instructions Exhaustion at the end of the day Changes in expectations and responsibilities Literature:

6 Maintaining Employment Team work Need for validation and reassurance Changing line manager and expectations Bullying and teasing Honesty and integrity Social occasions such as coffee breaks Dress sense and personal hygiene Personality clash Asking for help Promotion

7 Emotion Management Current levels of depression, anxiety and stress Personal signs of anxiety: Bodily sensations, behaviour and actions, thoughts and medical signs Concept of an emotion thermometer Sports technology to measure how anxious you feel

8 Physical Activity Tools. Quick release of emotional energy Relaxation Tools. Slow release of emotional energy Personal trainer Physical exercise, walk, run, trampoline. Sport (Basket Ball, golf, weight lifting or dancing). Creative destruction (recycling) Running keeps anxiety away Relaxation training. Solitude. Massage. Sleep

9 Inappropriate Tools Violence Being alone too long Taking stress out on someone else Self-injury to focus on another feeling Other people becoming emotional and confrontational Use of alcohol and illegal drugs Different tools at different points on the emotion thermometer. Relaxation tools at low stress levels, physical tools at high stress levels.

10 Characteristics of Depression Associated with Asperger s Syndrome A change in the special interest to a morbid or macabre topic Watching movies with a theme of death and despair An attempt to understand morbid thoughts and deep negative inner emotions Wearing a mask to hide true feelings and the true self in order to be accepted and liked Suppression of feelings due to not being able to control, and being fearful of, powerful negative emotions

11 Characteristics of Depression Associated with Asperger s Syndrome Fewer, if any, friends to alleviate depression by compassion, reassurance, affection, distraction and enjoyable social experiences Difficulty resonating with, or being infused by the happiness of others Try to resolve depression by solitary, subjective thought or using the special interest as a thought blocker or energizer Concept of self based on the criticisms and rejection of peers rather than compliments and acceptance. The seeds of depression and basis for negative self-belief

12 Toolbox Physical exercise: Experience has confirmed the great value of regular physical exercise in alleviating depression and anxiety Pleasurable activities: To discover or rediscover activities that are pleasurable to encourage positive thinking and optimism Cognitive restructuring: To see thoughts and beliefs as hypotheses and to seek evidence to affirm or disprove some automatic assumptions To recognise that a positive change in thinking, feeling and responding is achievable

13 Toolbox Social support: Encouraging social inclusion and success within the abilities and capacity of the person completing the programme Relaxation activities: To alleviate anxiety and stress to achieve a relaxed state of mind that can initially appear elusive but is attainable Self-awareness and mindfulness: To recognise bodily sensations, thoughts, feelings, values and personality characteristics Meditation for self-awareness, which is now an established psychotherapeutic technique for depression Medication: To increase feelings of well-being and happiness and to treat a severe depression

14 Energy Bank Account: Withdrawals Socializing Change Making a mistake Sensory sensitivity Daily living skills Coping with anxiety Over analysing social performance Sensitivity to other people s moods Being teased or excluded Crowds Government agencies Body shape Perceived injustice Certain people

15 Energy Bank Account: Deposits Solitude Special interest Physical activity Animals and nature Computer games Meditation Caring for others Nutrition Sleep Reading Harry Potter books Mental health vacation day Information on the Internet Being with pets Certain people

16 Being Bullied, Teased, Rejected or Humiliated Echoes from the school years After an incident, recording details Seeking verification and guidance An opportunity to ;de-brief at work or at home Creating and rehearsing an assertive future response Thoughts that can encourage remaining calm during the incident Knowing the employers relevant policies and procedures

17 Adaptive Thinking Maladaptive Self-blame* Catastrophizing* Blaming others* Ruminations* Adaptive Positive refocussing Positive reappraisal (optimism) Refocus on planning (flexible thinking) Putting it in perspective Self-soothing * characteristic of ASD

18 Cognitive Talents Cognitive Difficulties Long term memory for facts and information Being an expert in an area of special interest Originality in problem solving Visual memory A craftsman in areas such as woodwork Repairing things Playing computer games such as A talent in the arts such as Creative writing Playing an instrument Knowing and organizing what will be needed for the task Auditory memory for instructions Distracted by details Switching attention Completing the activity in the correct sequence Using ne strategies Time management and prioritising Having higher standards than required

19 Asperger s Syndrome in adults Part 2: Relationships

20 The Dating Game: Session 1 What are you main sources of information on dating and intimacy? (Films and television) Starting a conversation (compliments) What would you like to achieve from the group?

21 The Dating Game: Session 2 Interest and Attraction How can you know that someone finds you interesting? Body language to express interest MIND Reading DVD (Fond, affectionate, liking) Leaders have a conversation. Identify the signs of interest in someone Other ways to tell someone is interested in you (sitting close, suggests meeting, compliments etc.) Body language that expresses NOT interested Role play by the leaders Checking your assumptions (a friend, parent or relative)

22 The Dating Game: Session 3 Dating How and when to ask someone out on a date How long known each other, family or friends know the person, what they think of that person Group date or the two of you? Where would you go? (safety) What if the person says no? Asking parents about their dating experiences Who would you ask? Where would you both like to go? What would you talk about? Imagine the situation

23 The Dating Game: Session 4 Personality, Abilities and Appearance What males and females find attractive in a girlfriend or boyfriend What are you attracted to in a girlfriend or boyfriend? Rating from zero to ten Trust, intellectual ability, honesty, fun to be with, able to understand you, physically attractive, self-confidence, weight, sense of humour, age, clothing, hair length and style, listening skills, personality similar to mother or father, likes animals, wants to have sex, personal hygiene, religious beliefs, previous relationship experience etc.

24 The Dating Game: Session 4 Personality, Abilities and Appearance What will someone find attractive about you? Group activity Personality Abilities Appearance

25 The Dating Game: Sessions 5 and 6 What to wear, conversation and touch What would you wear? What would you talk about? How would you act? (body language) The next step Touch (permission, where and how) What touch experiences would you like?

26 The Dating Game: Sessions 7 and 8 Going further, being over, moving on Feeling comfortable or uncomfortable with touch How would you know how much touch and affection to give? The body language and signals and moral and legal codes How much time to spend together and communicating together Gifts

27 The Dating Game: Sessions 7 and 8 Going further, being over, moving on How do you know when the relationship is going well? Signs: Happy to see you, interested in your experiences, thoughts and feelings. Wanting to spend time with you and suggesting opportunities to meet Smiling, laughing and having fun together Compliments Feeling safe and relaxed Free to be your natural self

28 The Dating Game: Sessions 7 and 8 Going further, being over, moving on How do you know when the relationship is NOT going well? Excuses not to see you or ignoring you Not looking pleased to see you Not laughing and having fun together Why is it difficult Coping with rejection Recovery and moving on Optimism for a long lasting relationship

29 The Asperger s Perspective Why are typical people so obsessed with expressing reciprocal love and affection? A hug can be an uncomfortable, constricting squeeze. As a child, learn not to cry because someone will squeeze you. Not comforted by affection to the degree that neurotypicals expect.

30 Session 1: Love and Attraction Five qualities in your partner s personality, abilities and appearance that originally attracted you to him or her Which qualities do you still admire and are there any new qualities? Separate groups: Aspects of Asperger s and NT to understand about each other Project: Compliments What is love?

31 Session 2: The Communication of Thoughts and Emotions Feelings that need to be communicated but are difficult to communicate Barriers to communication Means to communicate Developing a communication system

32 Session 3: Stress and Anxiety Management Sources of stress and anxiety Signs of stress and anxiety Your partner s code of needing help Repairing the effects of stress and anxiety Energy accounting

33 Session 4: Anger Expression and Management Why those with Asperger s syndrome are likely to have issues with anger management Comparison to NT expressions of anger Situations that trigger feelings of anger within the relationship What strategies reduce the level of anger What would you like your partner to do/not do when you feel angry The art of apology and relationship repair

34 Session 5: Love and Affection When was the moment you experienced the greatest depth of love with your partner? Early in the relationship, how did you express love? Do you still do those expressions? The Five Languages of Love questionnaire (words of affirmation, quality time, receiving gifts, acts of service, physical touch) How does your partner express love for you? Are there ways that you would like your partner to express love? Project: Scheduled expressions of love

35 Session 6: Intimacy Verbal Emotional Physical Are your physical intimacy needs for affection fulfilled? Are your sex needs currently fulfilled? What may inhibit that fulfillment? Strategies to encourage intimacy

36 Session 7: Working as a Team Areas of expertise Project management House chores How your partner can be supportive in each of these

37 Session 8: The Future Middle age family and relationship issues Teenagers, empty nest, promotion, redundancy and retirement Life time profile of ASD The elderly years

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39 Managing Challenging Behaviour in Children with Autism

40 1: Social Understanding The Continuum of Autism - Aloof Greatest confusion in understanding and relating to people, severest autism People are perceived as intrusive, aversive and best avoided. Child or adult learns strategies to avoid social interaction, including finding a solitary sanctuary, non-compliance and being unpleasant (hitting)

41 1: Social Understanding Passive Approach others for assistance such as opening the door to the garden Passively accept social interaction Prefer to be alone but will tolerate group activities for a short while The person finds something more interesting than socializing

42 2: Communication The mannerisms have a message Communication of thoughts and emotions

43 Frustration: Problems With Comprehension Verbal complexity and length of utterance Clear, simple instructions Demonstration Match the length of utterance to the child s level of comprehension and memory One instruction at a time Processing time Value of alternative and augmentative communication(gestures and pictures)

44 3: Sensory Sensitivity. Acute auditory sensitivity to specific sounds (Hyperacusis) Sudden or sharp noises, ( dog barking, coughing, click of a pen top) Small electric motors or a specific pitch

45 Tactile Defensiveness Acute sensitivity to specific tactile experiences Sensitivity to touch and texture on particular parts of the body (scalp, upper arms, palms of hands and soles of feet) Gestures of affection perceived as too intense a sensation Aversion to certain fabrics Strategies: deep pressure, sensory integration therapy

46 A World Of Terrifying Sensory Experiences Hyper-vigilant and shell shocked Need a coping or escape mechanism Self hypnosis, being mesmerized by a repetitive action or sensation

47 Meltdown versus Tantrum From Anxiety to Meltdown by Deborah Lipsky Meltdown Overwhelmed by social, cognitive, linguistic and sensory experiences Catastrophic reaction Involuntary response Escape Solitude, reassurance Slow to recover Tantrum Response to frustration Emotional blackmail Instant recovery Non-negotiable Assertive and calm

48 4: Anxiety Anxiety about rules being broken Concept of the Intolerance of Uncertainty Difficulty with creating an internal representation of a new plan Anxious when required to do something for which they have no plan Autobiographical memory: Unable to recall past episodes where they have been in similar situations Coping with Anxiety: Controlling your experiences Routines and rituals Thought blocker

49 5: Preparation for Change Explanation, preparation and reassurance Social Stories Compulsion for completion Change of routine Change of staff (staff attitude and training) Transfer to new accommodation or day services

50 6: Developmental level Exploration Through Sensation The person s developmental level in exploratory play Exploring the world through taste, touch, aroma, sound, colour and perspective Prior stage to constructive and imaginative play Introduce a wide range of sensory experiences Sensory integration therapy Can be used as a reward If the action is dangerous or socially inappropriate, find an acceptable substitute

51 7:Learning Profile Cognitive Flexibility: One Track Mind Problem Solving and Frustration Coping With Mistakes

52 8: Movement Disturbance Apraxia and Dyspraxia Planning the movement Problems with starting, stopping, continuing, combining and switching motor actions Some actions are to help start or switch motor actions Touch to initiate and rhythm to coordinate movements Advice from an Occupational Therapist and Music Therapist Rhythm