Understanding and Living with Aspergers

1. Understanding and Living with Aspergers Sarah Hare Specialist Speech and Language Therapist BCUHB East

2. Timetable for today's talk

4. In a nutshell….. Children/young people (YP) with Aspergers: • Find it difficult to tell people how they feel and what they need • Find it difficult to meet other people and with friendships • Find it difficult to understand what people think (empathy)

5. Aspergers Syndrome Info Children/young people with Aspergers might • Think that people always mean what they say (difficulty understanding jokes) • Only talk about their favourite subject • Be very interested in some things (eg trains/the weather/Dr Who) • Not understand how other people feel

6. Aspergers vs Autism Aspergers is similar to Autism. Aspergers usually have • Average IQ/no learning difficulties • Less problems with speaking/language Aspergers may have • other associated difficulties eg dyspraxia, ADHD, mental health problems (anxiety/depression)

7. People with Aspergers may have • A love of routines - to try and make the world less confusing they may have routines/rituals which they insist upon • Special interests – they may develop an intense/obsessive interest in a hobby or collecting • Sensory Issues – they may have sensory difficulties; can occur in one/all of 5 senses (sight, sound, smell, touch, taste)

8. Sensory Issues • Sight – some may not like bright colours/lights, others may like them a lot • Sound – some may not like loud noises, others may like certain noises • Smell – may not like some strong smells, others may like a certain smell • Taste – might like to eat the same food everyday, might like a lot of different foods • Touch – some may not like being touched, others like being touched, some like feeling of weight (eg weighted blankets)

9. Behaviour and Aspergers • The world can sometimes be a bewildering, isolating and frightening place for a child/young person with Aspergers; they may sometimes exhibit inappropriate, difficult or challenging behaviour. • Difficult behaviour in a child or YP with Aspergers is rarely just that and is often caused by their difficulties with communication and social interaction – the ‘challenging’ behaviour can be their way of coping with a difficult/stressful situation. • When looking at behaviour it is important to think about what the root cause or trigger is – this may give us an answer as to how to help change the difficult behaviour.

10. Behaviour and Aspergers cont… Common causes of ‘challenging’ behaviour • Communication • Sensory Issues • Change • Social Situations • Unstructured times An ABC chart or functional analysis of the child or young persons behaviour can help identify causes or triggers (see NAS website)

11. Role of the SLT with children/young people with Aspergers • Speech and Language Therapists (SLTs) help people develop their communication skills. • A SLT can assess a child/young person with Aspergers to determine how best to support and develop their communication skills. • Therapy will be focused on the child/young persons specific communication needs related to the triad of impairment • The SLT may visit the child/young person at home, nursery or school dependent on their age/specific difficulties

12. Role of the SLT with children/young people with Aspergers cont… Therapy may focus on • Language skills • Social skills Therapy may be delivered • By programme (via a support worker/parent) • 1:1 • Small group • Embedded into the curriculum/classroom practice

13. Role of the SLT with children/young people with Aspergers cont… The SLT may also provide • Support/advice/consultation to parents/carers/school staff/other professionals – eg re: behaviour issues. • Training/awareness raising for parents/carers, school staff, other professionals.

14. To refer to SLT in your area… BCUHB SLT East - Wrexham/Flintshire Speech and Language Therapy Service Wrexham Child Health Centre PO Box No. 2073 Wrexham Maelor Hospital WREXHAM LL13 7ZA 01978 727072 or 727073 Helpline 01978 727071 staffed Mon 9-10 and Thurs 3:30-4:30

15. To refer to SLT in your area… BCUHB Central – Conwy and Denbighshire Speech and Language Therapy Dept Royal Alexander Hospital Marine Drive Rhyl LL18 3AS Tel: 01745 443178

16. To refer to SLT in your area BCUHB West – Gwynedd and Y Mon Speech and Language Therapy Dept Bodfan Ysbyty Eryri Caernarfon Gwynedd LL55 2YE 01286 662 759

17. Hints and Tips for living/working with Aspergers • Think and teach visually - many are visual thinkers/learners • Use an area of interest, a fixation or a special talent - to connect with the child, improve attention/listening and academic skills • Be aware of environmental distractions - bright lights/loud sounds/particular textures may interfere with learning – consider their sensory needs • Utilize technology E.g. TV, CDs, computers – many are visual learners. Use of computer and keyboard may help them record their ideas/work more successfully than handwriting • Keep language simple, reinforce with visuals (symbols, photos, pictures)

18. Hints and Tips for living/working with Aspergers cont… • Use physical structure/TEACCH type approach – organise the room, minimise distractions, reduce sensory stimuli. E.g. using barriers to section off or task and finish boxes/baskets. • Use clear short instructions and avoid abstract language (many are very literal), break tasks into clearly defined steps • Be aware of difficulties generalising skills to different areas/locations – will often associate a skill/behaviour with a specific location • Stick to a routine - they need routine to feel secure because of their lack of understanding of the world. Visual timetable useful; prepares children in advance for any changes e.g. visitors/school trips

19. Hints and Tips for living/working with Aspergers cont… • Use repetition to modify behaviour, teach new skills and improve communication - Children with ASD learn and retain information more easily when given that information repeatedly and in a variety of settings • Use modelling to improve social skills - Model what you want them to learn (i.e. appropriate ways of greeting others) in a real life setting if possible • Praise – praise the positive – even if it takes you all day to find the one incidence of them demonstrating good listening! Rewards and praise are very motivating! Rewards need to be concrete, immediate and tangible.

20. Hints and Tips for living/working with Aspergers cont… • Tackle one problem at a time when addressing behaviours, use ABC or functional analysis chart (NAS website). Rate behaviours in order of importance/severity and work on that one until it reaches an acceptable level • A child/young person with Aspergers lack of empathy can be difficult to deal with from a neurotypical point of view. Try and explain how people may feel in different situations eg when watching TV programmes, using real life scenarios as examples (eg brother upset, sister excited, mum cross) • Children/young people with Aspergers generally prefer quiet, calm unstimulating environments, especially when stressed/upset – opportunities for time out in a quiet area can help with many aspects of challenging behaviour.

21. Support for children/young people with Aspergers and their families National Autistic Society • excellent website – www.autism.org.uk • NAS Campaigns – You Need to Know (Mental Health), Great Expectations (SEN/Education) • NAS Autism Services Directory - for NAS local groups and other services that may be of use to children, young people with autism and their parents/carers • Specific info about behaviour: www.autism.org.uk/19044www.autism.org.uk/behaviourfaq • Autism Helpline (NAS) Call 0808 800 4104Lines are open 10am-4pm, Monday to Friday (free from landlines and most mobiles) impartial, confidential information, advice and support to people on the autism spectrum, their families, professionals, researchers and students.

22. Support for children/young people with Aspergers and their families continued…. • Autism Cymru www.awares.org • CAMHS – mental health issues and diagnosis • Physiotherapy – co-ordination difficulties • Occupational Therapy – sensory issues • Association of Voluntary Organisations Wrexham www.avow.org • Dynamic Youth Groups www.dynamicwrexham.com • Talk for Talk – parent support groups for Wrexham, contact Jill McMinn 01978 317655 • North East Wales Carers and Information Service NEWCIS (via www.carers.org – search for your local centre – Flintshire and Denbighshire)

23. Support for children/young people with Aspergers and their families continued…. • Parent Partnership (various locations across North Wales) www.parentpartnership.org.uk/find_your_local_pps/wales.aspx • Daffodils Tel: 01352 751605A support group for disabled children and young people up to 25 years old. Cater for children's special recreational needs and provide for their social integration through sibling involvement and encouraging family friendships. They also run a very wide range of social activities at venues throughout Flintshire. • Gwynedd and Anglesey Asperger/Autism Support GroupTel: 01248 364015Meet monthly at The Committee Room, Ysbyty Gwynedd, Bangor, 7-9pm. Arrange activities for the children such as outings, parties and fun days and also have a library of books and videos on ASD. • Carers outreach service for North West Wales (Gwynedd, Conwy and Anglesey www.carersoutreach.co.uk

24. Further reading/viewing • Temple Grandin film • House Rules, Jodi Picoult (2010) • The Curious Incident of the Dog in the Night Time, Mark Haddon (2003) • NAS website www.autism.org.uk • Autism Cymru website

25. Any questions…….?

26. The End!! Sarah Hare BSc Hons PG Cert Aspergers Syndrome Specialist Speech and Language Therapist (Autism) Tel: 01978 727072 Email: sarah.hare@wales.nhs.uk