ASA's 36th National Conference on Autism Spectrum Disorders (July 13-16, 2005)

• Recorded Presentation

1. Attendees will understand how Asperger Syndrome may affect ability to regulate attention, activity level, affect, and arousal/alertness levels and how to improve functioning in these areas.

2. Attendees will understand how the typical executive functions deficits that students with Asperger Syndrome manifest affect organization, work production, motivation and independent behavior and how to improve function in these areas.

3. Attendees will understand the causes and prevention strategies for meltdown cycles in students with Asperger Syndrome.

4. Attendees will understand how sensory processing deficits may interfere with academic and social functioning and how appropriate diagnosis and planning can vastly improve the classroom experience.

5. Attendees will be able to apply what is learned about underlying neurobiological issues to school and home settings.

Children with Asperger Syndrome often present as academically able students, yet may experience great difficulty succeeding with typical classroom work. At home, homework and time management may present insurmountable barriers to a positive home life. With increasing academic demands, these students may feel more and more overwhelmed, and teachers and parents may view them as resistant, lazy, or impudent. Behavioral outbursts may result and often behavior management techniques are ineffective. These students need to be understood in terms of their underlying neurobiological differences, which are largely invisible, and need specific remediation and support so that they can reach their academic and functional potential.

It is often not the diagnostic symptoms of Asperger Syndrome that create problems in classrooms settings and at home. While social, communicative and repetitive behaviors define the syndrome, it is often the associated characteristics that are more poorly understood and not specifically addressed. These neurobiologic characteristics need just as much support, yet because of their very invisibility, students may be blamed rather than supported. When meltdown behaviors occur, other students may fear or reject the child and school officials may feel compelled to suspend or expel. Understanding how sensory differences, regulatory dysfunction, and executive function deficits impact everyday function can be the key to creating a successful environment for the student with Asperger Syndrome. When the school team and the family cooperate in understanding these differences, rather than developing accusatory stances, meaningful change in how the child is viewed and assisted can occur. By putting in place informed supports that shore up these students' underlying deficits, academic and social success is a much more likely outcome.

Processing problems are common in individuals with Asperger Syndrome. They may occur at any point in the response process from registration to orientation to interpretation to organization to execution. They also can occur in any of the sensory modalities, or when multiple modalities are being bombarded simultaneously. A failure at any point of the sequence may create the impression of inattention, when in fact, the child is quite attentive, but processing too slowly. Prescribing a stimulant is often the ineffective intervention, when changes in modality or rate would be more appropriate, if only the specific problem were recognized.

Individuals with Asperger Syndrome may have problems with regulatory processes in attention, activity level, affect, or arousal/alertness. For example, a dysregulated activity level could result in an inappropriate activity level, sometimes too active, sometimes not active enough. Add to that the limited appreciation a child with Asperger Syndrome might have for the social context of behavior, and the poor ability to regulate becomes a major problem. Children with these kinds of regulatory issues very much need to learn coping and self management strategies. Unless this is recognized as a biologic difference, these important lessons will not be provided.

Executive function difficulties are commonly present in individuals with Asperger Syndrome. Yet, many do not realize the wide scope of behaviors that may be negatively impacted by this type of problem, nor how to support and help individuals who are struggling to perform in a confusing world. Executive functioning deficits may create problems in planning, organizing, managing time, establishing priorities, maintaining motivation, sustaining effort, producing written work, understanding time passage, remembering and executing instructions, and behaving independently. As children grow into adolescence and adulthood, they are expected to take more and more personal responsibility at school and at home. Yet executive functioning is seldom specifically taught. Like social development, it is expected to unfold normally in the developmental process. But, individuals with Asperger Syndrome may need specific instruction and support to gain executive skills or coping mechanisms to manage these deficits.

The subtle deficits that may be part of Asperger Syndrome are often unrecognized and unaddressed. But the stress that may incrementally intensify as demands increase with age can result in tuneouts and meltdowns that may imperil a student's chance to have a mainstream academic placement. An understanding of the causative elements and a cooperative school and family approach to remediation and support can make all the difference between a successful, well adapted student and one whose mental health and life functioning is in jeopardy.

This presentation reviews the neurobiologic issues above and provides practical suggestions for remediation and support at school and at home.