Edited By Jill Goodman and Stephanie Loo
If you have just found out – or if you suspect – that you or someone in your care has Asperger’s Syndrome (AS), you may feel as bewildered as Alice in Wonderland, just after she fell down the rabbit hole! It’s a whole new reality now, and you are probably going to need a guide or two to find your way around this new world. You may feel confused and overwhelmed, as you struggle to absorb a lot of new information, to decide what you need to do, and to figure out where to turn for help. You may find yourself asking: “What kind of help do I need? What is the right combination of service and supports to ensure the best possible future for me, or for my child? And where can I turn to obtain these services? What kinds of people, with what kings of titles and training, can help me most effectively?” Because the good news is, there are a lot of medical and mental health professionals out there - and the bad news is, there are a lot of medical and mental health professionals out there!
To whom should you turn if your kid with AS is driving you or his teachers crazy with his behavior, or if you think you need medication? What are “social pragmatic language” and “sensory integration,” which everyone in the parent support group is talking about? Are these things you or your kid needs- and who can provide those kinds of help? Do you need the services of a psychiatrist, psychologist, neurologist, neurophysiologist, or a psychopharmacologist? A social work, occupational therapist, a developmental or behavioral pediatrician? Yikes! Where do you start?
If you have not already done so, your first priority should be to get an official, properly documented diagnosis. For both adults and children with AS (or other conditions on the autism spectrum), the diagnosis serves as your starting point for securing future treatment, service, and support. For children, the diagnosis is essential for obtaining services from public schools; these services will be outlines in an Individualized Educational Plan (or “IEP”). The AS diagnosis may help adults qualify for important social security benefits, housing, or employment assistance from agencies like Mass Rehab. To obtain a diagnosis, you will probably need to get an evaluation from a neurophysiologist, psychiatrist, psychologist, or…-- but be sure that this professional also has experience with AS. Don’t be shy! If you suspect you or your child has AS, be sure to ask about the professional’s degree of past experience with AS. This professional will administer a range of cognitive and projective tests to determine the diagnosis. The same person will also write up a formal report, which will be an important tool for communicating with the school system or government agencies from which you will be requesting services.
Once you have the diagnosis, you will probably wish to have the support and expertise of one or more professionals who can help with specific issues. AS is a very complex condition; individuals with AS differ widely in their needs—the needs of each “Aspie” (individual with AS) will probably change significantly over time. Most individuals or families whose lives are affected by AS benefit a lot from having one knowledgeable professional who gets to know you or your child well, follows the Aspie’s progress over time, sees the “big picture,” and can help you choose which interventions and therapies will be most helpful in the current situation or stage of development. This person might be a social worker, a psychiatrist, behavioral psychologist, and education consultant. He or she should be someone who knows a lot about AS, and with whom you have a friendly and mutually respectful relationship, so that you can call them with questions or problems as they come up. This person may also be able to serve as an advocate for you or your child, since personnel in school systems and government agencies sometimes respond better to other professionals who “speak their language” or have clout.
Let us introduce you to some professionals who work with people with AS, and who may be helpful to you. We have asked a psychiatrist, a psychologist, a social worker and a neurophysiologist, and member of a developmental team, to describe their role in supporter and serving someone with AS. Others in the same profession may offer different services or take a different approach, but we hope that the essays below will prove helpful, and we thank all our contributors.
This list of professionals that can help the individual with Asperger’s Syndrome and their family is by no means complete. Hopefully this article will serve as a guide indicating where to start looking for an appropriate professional. Individual choices will necessarily be based on logistics, cost, and your personal rapport with the doctor.
Besides those who wrote for us, other therapist may be enlisted to help with specific develop-mental problems, such as a speech and language pathologist for language therapy/social skills training, or an occupational therapist for ameliorating sensory integration and motor/coordination difficulties. (Maybe we can hear from some of these professionals in future issues of the newsletter.) For a child, these services will often be provided through the public school system. (However, you may need to advocate strongly to get them included in the IEP. If the school resists, you may need an educational advocate or, as a last resort, a lawyer experience in special education/Chapter 766 laws, to make sure the student gets all the services he or she needs.).
If the school does not provide service your child needs, you may need to seek a private provider. AANE staff, or other families, may be able to help you find someone in your area. Call AANE, talk to the parent in one of our face-to-face support groups, call a parent from the AANE Parent Networking List, or post your problem on AANE’s interactive message board.
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By: Linda Weisberg, LICSW, Newton, MA
Social workers can assist individuals with Asperger’s Syndrome in a number of ways depending upon their age, level of cognitive ability, range of symptom severity, and family concerns.
Social workers provide supportive counseling to parents of young children whose diagnosis is unclear during the preschool years. This uncertainty creates significant stress for parents. Counseling can help parent cope with the wide range of emotions they experience during the diagnostic process and afterwards when the child with Asperger’s Syndrome attends early intervention programs and elementary school. Social workers also aid families in finding appropriate respite care, recreational opportunities, and psychiatric service if medication for the child or other family members is needed.
Many social workers focus on the individual with Asperger’s Syndrome in the context of the family. They are well aware of sibling issues and the strains on the parents’ relationship and help by providing marital counseling, parent guidance and behavior management strategies. Extended family members such as grandparents may not understand the problems of raising a child with Asperger’s Syndrome, and the social worker might recommend a family meeting to help ease tensions.
Adolescents with Asperger’s Syndrome face a number of challenges. A social worker may help them to channel their individual interests to better understand their social relationships and sexuality. As families begin to consider plans for their children beyond high school, social workers provide counseling to ease the transition and to also identify educational and vocational programs and housing options available to young adults.
Independent living and sustaining employment or performing adequately in a supportive job placement can often present challenges for adults with Asperger’s Syndrome. Social workers can offer supportive counseling and clinical case management.
Clinical case management is a directed form of assistance by a social worker, who with the client’s permission, coordinates vocational, residential, and social programs. Family members are usually involved. Supportive counseling for both adolescents and adults with Asperger’s Syndrome includes learning to interpret social situations in order to improve social skills and to appropriately manage work responsibilities.
Social workers may bill insurance companies or an HMO for their services if they are members of provider panels. It is necessary to check with the particular social worker to ascertain if he/she can bill your particular insurance plan. Otherwise, it is possible to pay privately, and some practitioners might offer an extended payment plan or sliding fee.
To find a social worker who can assist you, call the Social Work Referral Service of the Massachusetts chapter of the National Association of Social Workers at 617-720-2828. Also your physician, local school system or local Asperger association might assist with a referral to a social worker.
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By: Teresa M. Kohlenberg, M.D, Belmont, MA
The psychiatrist is a medical doctor who has trained in the diagnosis and treatment of emotional disorders, using both “talking” therapy and medication. Psychiatrists usually complete at least a year of basic medical training (internship) and three years training in mental health care of adults, after which Child Psychiatrist add two years training with children and adolescents. There are also some Child Psychiatrists who initial training is in Pediatrics. Child Psychiatry training provides a great exposure to the developmental issues involved in Asperger’s Syndrome and related disorders, as well as the different medications available and their proper use in children. Many (but not all) psychiatrists who work with children with these disorders have gotten additional training or exposure in specialized settings.
What a child psychiatrist offers depends to a certain degree on their training and areas of expertise. The following list starts with the services more child psychiatrist offer, then includes services some, but not all, will offer.
Most will:
Some will:
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By: Gary Eisenhower, Ed. M, Marblehead, MA
Appropriate treatment planning for a child with Asperger’s Syndrome involved a constellation of individuals-including informed parents, teachers, psychopharmacists, pediatric neurologists, behavioral psychologists, neurophysiologists, clinical psychologists, etc. In my experience, it seems that the clinical psychologist often plays a coordinating role in the overall treatment plan for the child with Asperger’s.
The clinical psychologist may be initially involved in the diagnosis of Asperger’s Syndrome and associated disorders. Common secondary diagnoses include ADHD, depression, generalized anxiety, or more specific anxiety disorders such as OCD or panic attacks. Treatment of these disorders involves specific therapies and consultation with other professionals.
The clinical psychologist also must help identify and reduce stressors in the environments in which the child functions. As stress is lowered generally around the child with Asperger’s, the child will be able utilize his/her own talents and interests, rather than having to generate inappropriate defenses against troublesome stressors. At a minimum, this will include necessary informational discussions with the child’s family and school regarding appropriate expectations for peer group interactions, family interactions, learning style, etc. Family therapy, Chapter 504 plans, special education plans and summer planning are common interventions at this level of treatment.
The clinical psychologist will likely be involved with the child and family for several year, sometimes on a monitoring relationship two or three times a year, sometimes doing family therapy, and sometimes more frequently and regularly with the child as new concerns may emerge.
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By: Suzanne Dowdall, Ph. D, Wellesley, MA
And Kathleen Curran Ph. D, Newton, MA
A neuropsychologist is a licensed psychologist who has received a doctorate (Ph D., Psy. D, or Ed. M) signifying extensive instruction and supervised training, and has received additional specialized training in behavioral, psychological and emotional aspects of neurological disorders. The work they perform includes diagnosis, treatment, as well as consultation regarding a variety of disorders, including Asperger’s.
Evaluative tools employed by neuropsychologists include interviews with both the client and significant others, observations, as well as a wide array of ‘standardized’ tests where and individual’s performance can be compared with their peers) and may include academic and personality tests. This information is integrated to paint a complete diagnostic picture of neuropsychological strengths and weaknesses in a variety or areas (for instance: social-emotional functioning, expressive and receptive language skills, visual/spatial organization, problem solving, memory and learning, attention). Recommendations are created and neuropsychologists will often work collaboratively with a variety of other professionals to share and communicate their findings.
Basing their work on an understanding of the impact of brain functioning on behavior, thinking, learning, and emotion, neuropsychologists are able to help individuals, their families, and other working with them to capitalize on strengths and address difficulties.
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By: Ellen Perrin at the Center for Children with Special Needs, New England Medical Center, Boston MA.
An interdisciplinary team evaluation aims to identify children’s strengths and weaknesses in medical, cognitive, emotional, academic, linguistic, social, motor, and sensory domains, and to integrate them into a coherent picture.
Most interdisciplinary teams are compromised of some combination of developmental-behavioral pediatricians, psychologists, or neuropsychologists, educational specialists, speech/language pathologists, clinical social workers, physical therapists and occupational therapists. An advantage of working with an integrated team is that the information and advice that you will be give is consistent and not contradictory.
Developmental-behavioral pediatricians take a long-term development and ecological view of children and families, and are particularly familiar with the necessity to work together with other professionals and parents. They also can evaluate and treat some of the psychiatric symptoms that often contribute to children’s difficulties. Developmental behavioral pediatricians may be especially helpful in pulling together the various evaluations and recommendations, and in following the child’s and family’s progress over time. Psychologists evaluate the child’s cognitive or intellectual strengths and weaknesses and can identify aspects of the child’s learning and emotional style. Children with AS are often quite bright, but may have subtle organizational problems or rigid thinking styles that affect independent work, organization, written output, and abstract thinking. Educational specialists look at children’s academic skill development in reading, writing, spelling, and mathematics. This assessment helps to determine what educational interventions will be most likely to be effective.
Many children and adults with AS have difficulty with pragmatic language, that is the ability to use language appropriately for social communication and reciprocal social interaction. Speech/language pathologists look at the child’s language functioning, not only in terms of linguistic development and receptive and expressive language, but in the areas of higher-order language and pragmatics. Physical and occupational therapists evaluate and help children to improve the motor clumsiness or visual-motor integration problems which affect their strength, tone, ability to participate in sports and writing tasks in school, and address their sensory integration problems.
Clinical social workers assess how the child is functioning at home and the stressors his/her difficulties may be causing within the family. They help the family identify these issues, provide individual and family therapy, assist with information about resources and referrals to community agencies, and provide support and advice for advocating within the school system.
The advantage of a team of professionals who work together is that you will get one comprehensive evaluation with recommendations that are consistent with each other.
By A Parent
I can’t pinpoint the exact moment that I realized that my eight-year old daughter had Asperger’s. It doesn’t seem all that long ago, when she was three, that I moved her from a family day care to a larger center, hoping that she would meet children her age and make friends. Though I anxiously wanted her to have play dates, she seemed to prefer roughhousing with the boys instead.
I remember wondering if I was crazy to argue with her well-intentioned lead teacher, who thought she was perfectly fine. How could she be fine, when every time I came to pick her up she would be walking around in circles flapping her arms!
My daughter never gave them any trouble, so they didn’t notice that she wasn’t paying attention. I was so relieved when I had the chance to take her to the town preschool for an evaluation; however the were unable to complete the testing because she couldn’t stay still and concentrate. They didn’t think I was crazy, but rather thought that I should get some help to find out what was going on. The day I moved her into the next class at the day care center, the teachers were horrified to think that the other teacher thought she was normal!
I gave up practicing direct care social work when my daughter was one-year old. It found it too taxing and, after 15 years of giving counsel, it left me without enough energy to give to my daughter. In my career, I was so good at identifying what was wrong with others, but with my daughter, I assumed I was looking for problems that didn’t exist. Even family members thought she was fine and did not agree with me when I thought there could be problems.
With my background, I figured that I knew best about getting the services my daughter needed, yet it was too hard to think that there was something wrong with her. No one ever told me that life wouldn’t just work out once you got married, had kids, and moved to the ‘burbs.’ Meanwhile, my child was in the preschool program and I was content that she was getting help for her language-based problems.
We were very fortunate to find Dr. Daniel Rosenn, who tested her and diagnosed Asperger’s. After going to conferences for several years, I can now say the word, Asperger, without softening my voice, or yelling it angrily as if the word would make her a leper. I heard Dr. Rosenn give me the diagnosis, and I read his report several times. Finally, I knew I had to get the services for her.
I had slipped into denial thinking, “Well, she is getting help at school. That will take care of it.” My mother, to this day, keeps telling me she thinks her granddaughter is just like other children and that no one can tell. She says that when her little brother follows his sister around, it looks just like she is playing normally and no one would see a problem with her circling the yard while moving her arms in circular motions.
I have gone to AANE conferences twice a year to hear more, and been fortunate that my in-laws attended the grandparents’ workshop one year. I finally made my husband attend one conference and the look of sadness in his eyes said it all. I usually buy two or three books each conference and have amassed a nice library that I find too painful to read through completely.
What day did I accept my daughter’s Asperger’s? I am still accepting and understanding now. We can go from one day hearing her telling a friend on the phone not to be upset, to another day hearing her screaming in the park because a neighbor won’t let her help plant a bush because she was told she doesn’t know enough. Can I accept what I read about Asperger’s happening because of family genetics? My husband and I have gotten past this, as anger and finger pointing about who has the craziest relatives leaves us painfully isolated. I know now that there is nothing I could have done to prevent this (you know… maybe if she hadn’t bumped her head…) but I feel confident that I can read her and understand when she is confused, drifting off, or anxious. I know that I can help her understand these things, and that I am smart enough to make sure she gets the services she needs.
When she grows up… will she be self-supporting? Will she be happy? Will she get married? Or will I be like the happy mom I saw on 20/20 who was really glad her adult son with Asperger’s would always be living with her? I think what is important is that I will always be proud of the things she can do well, or pleased that she sometimes seizes more happiness from a moment than most people.
I know I will always be critical of a diagnosis which could limit her, but then she does seem to be limited by her difficulty with transitions. To ease my daughter’s distress, it has become second nature to me to organize each day’s activities around the degrees of simulation. I am a mother bear, on the constant lookout for the enemy (stress) which will hurt my cub. That is how I have to cope and that is how she will get the best out of me.
By: The parent of a ten-year old.
The one thing I am sure of is that my son is on the autistic spectrum. It has taken years to be able to own that statement.
When my son was three he went to a small neighborhood pre-school. Towards the end of his year there, his teacher asked to meet with my husband and me. She told us there was something different about our son, and since our intentions were to enroll him in public school for K1 the next year, we should begin the process of evaluations as soon as possible. I left the meeting with no idea what she was talking about. It was another three years before I started to learn.
At the beginning of 1st grade his teacher, who had also taught him the year before, approached me in the schoolyard and said, “We have to talk.” I cried then as I cry now at the memory. Thus began the search.
The school department conducted their evaluations. On the advice of other more knowledgeable parents I was guided to reject the school evaluations and get independent evaluations which we did. I first heard the word “Asperger,” from the neuropsychologist at the hospital. A second doctor who did the pediatric neurodevelopment evaluation suggested a diagnosis of High Functioning Autistic Spectrum Disorder. I continued the search wanting confirmations. Next he was seen and evaluated by two psychiatrists and an additional psychologist at the school. He was enrolled in a social skills group and has recently completed a 3 year Developmental Disorders Research Project. Today he is having testing at the school to fulfill his three-year re-evaluation requirements. Tomorrow is the I.E.P meeting. Middle School starts next year and I have no confidence he will get what he needs with what the school department will offer.
The question remains: what was I thinking and feeling when I first learned the diagnosis? It was never that one moment in time, but a series of moments. There were the late nights on the web. My first conversation with Dania at the AANE, and the first books read. The parents at the School Age Support Group offer a lot of comfort. They show me it’s not poor parenting skills at play here and help me understand him better and better. The denial creeps in and out among the clarity and acceptance. Moments of great pride and embarrassment. Early on, I had a recurring question: “Is he unable or unwilling to: stay seated, keep his hands to himself, do his work?” I now believe that he is often unable. I keep thinking that he will outgrow some behaviors: learn to be organized, understand that five minutes is not an hour and vice-versa. Be able and want to have a back and forth conversation. Know to think before he acts, or to stop talking when he has lost his listeners. Maybe even ask me a question about something I care about, or someday talk about his feelings. But it has all yet to be seen.
I’m reading The Autistic Spectrum, by Lorna Wing. It seems to be the best book to date that describes my son. He’s only ten but shows incredible promise. I can’t allow the world to snuff out his genius. My job in the next decade is to ensure that he is exposed to schools and people that see the greatness that I see in him. The next few years are critical.
By Susan Shamus
Recently, as I watched my son drive off on his way back to college, I couldn’t help but marvel at how far we have all come.
When he was first diagnosed with PDD at age three (nobody was then referring to Asperger’s Syndrome), my son was busy skipping, swinging, and stemming while trying to manage the daily work of kindergarten. Loud noises sent him, with covered ears, away from group encounters, while the world of books and cartoons seemed to be his source of comfort and relief.
Over the years of speech/language and occasional therapy and psychologists visits, the need for sensory stimulation disappeared and new concerns arose. We wondered if he would ever be able to cross the street alone or manage his own money? Would driving a car ever be in his future? We worried each day that he headed off to school about the difficulties he would encounter living in his world. Yet he hung there, a real hero, never complaining and always trying his very best despite the many obstacles that were in his way.
Now, 17-plus years later, this fiercely independent young man is a real example of what can happen if parent remain hopeful and flexible in their vision for their child’s future. What happened? How did he get to where he is today? We now believe it was a combination of his hard work, all the interventions, normal development, and the willingness to “think out of the box” in developing working strategies to help him manage his world as it changes. It involved learning about AS, and accepting him for his uniqueness and the richness that he brought to the family.
It was, and is, not always easy. It has required that, as parents, we knew when we needed to take time for ourselves and set time aside for other family members, and when to ask for help when we were overwhelmed. It has involved taking care of ourselves and staying balanced so we would have the energy to care for out family.
Today we are still involved in an on-going process. We and our son have the rest of college, the world of work, and independent living ahead of us. These challenges, too, will require new strategies, lots of conversation, and a healthy respect for the ebb and flow of it all as we try to navigate through.
But now we are confident that while we may not know what the exact outcome will be, we do know we will not limit our visions of what the future holds.
Susan Shamus has a private practice at Special Needs Advocacy and Personal Life coaching. She specializes in helping families with children with AS find a balance between caring for their families and themselves. Her telephone number is: (617-332-3844).
Here is a much needed book that specifically addresses the needs of adolescents with AS, most of whom did not have the benefit of an early diagnosis and early interventions. There is whole generation who had the eureka experience (Asperger’s Syndrome, that explains it!) when they were already on the cusp of separating from mom and dad.
Dr. Bolick, a clinical psychologist who specializes in autism spectrum disorders, draw on her extensive experience with the AS teens. Each chapter beings either with the account of an actual child in a real situation, or with a snippet of a student conversation overheard in the school hallway. Each scenario presents a difficult situation, on that might be encountered by any teen, but it further complicated by sensory integration problems and theory of mind issues. These range from executive functioning glitches to sexual intimacy quandaries.
Dr. Bolick takes on a specific challenge in each chapter, explains why it is an AS challenge, and how it can be managed. Interspersed throughout the book are shaded sidebars that further clarify a concept (e.g. preoccupations as obsessive compulsive behavior) or offer details on how to manage specific tasks, such as laundry and note taking.
Most notable perhaps, is how Dr. Bolick’s respect and admiration for the teens depicted comes through. The chosen format acknowledges the individuality and personal strengths of each one. She is obviously a psychologist who truly listens and learns from her patients and has managed to write a book that not only reflects her considerable scientific and theoretical knowledge but also has a lot of heart.
Theresa Bolick consults to schools and maintains a private practice in Nashua, New Hampshire. She lives in Massachusetts with her family.
By Jason McCormick, Psy.D.
As a doctoral student in psychology thinking about my doctoral project, I wondered if part of the social difficulty experienced by individuals with AS could be attributed to problems navigating the complex language of humor. This idea stemmed from my internship at the Children’s Evaluation Center in Watertown, where I helped to evaluate many children on the Pervasive Developmental Disorder spectrum. I noticed that their sense of humor was not attuned to that of their peers and wondered if individuals on the uppermost end of the spectrum, those with AS, also perceived humor differently than their peers. The difficulty for a child with an atypical sense of humor is that they are less likely to draw others to them through this medium. This is especially the case during the teen years, when peers are often very unaccepting of differences.
To determine if teenage boys with AS have an atypical sense of humor, I compared the humor production and perception of two groups of adolescents: those diagnosed with AS and those without the diagnosis. To reduce interference from other variables, the members of the two groups were matched for age (within six months), estimated IQ (within one standard deviation), and gender (all male). Each group contained 15 members.
According to Gardner and Brownell, researchers who developed the humor measure that I used in my study, flexible thinking is important in understanding jokes. Punchlines in jokes are funny partly because they are unexpected. Additionally, according to these researchers, big picture thinking is essential in understanding jokes, as it allows the listener to understand how the surprising punchline coheres with the joke body. As individuals with AS often demonstrate rigid thinking, a desire for the preservation of sameness, and difficulties with big picture thinking, it seems that individuals with AS would have trouble perceiving and producing conventional humor.
My research suggests that students with AS produce and perceive humor in ways that are different from their same-age peers. They tended to prefer jokes with straightforward endings more than did students in the control group, and their humor production was often less organized and less formulaic. However, I clearly recognized that the boys with AS both wanted to laugh and to make others laugh. Therefore, rather than calling this finding a humor deficit, humor atypicality is perhaps more appropriate.
The navigation of social interactions is not one skill, but a set of skills that includes reading facial expressions, interpreting nuances, understanding the possible motives and wishes of others, regulating emotions, and facility with language. While individuals with AS typically have average to well above average verbal cognitive abilities they often have difficulty using language in ways that connect them to others.
The literature highlights the importance of humor in developing and maintaining relationships. It has been shown to reduce social uncertainty and anxiety, increase intimacy, and allow for the safe expression of delicate matters (e.g., sexual interest).
Since humor plays such an important role in relationships, the possibility of humor atypicalities would help explain some of the social difficulties seen in the AS population. This information might be of use in aiding diagnosis. More importantly if normative humor (which I’m defining as humor that facilitates relationships) were shown as an area of weakness in individuals with AS, this information would be an important firs step in possible remediation.
Humor, specifically jokes, involves cognitive capacities that are often challenging for individuals with AS. According to Gardner and Brownell, researchers who developed the humor measure that I used in my study, flexible thinking is important in understanding jokes. Punchlines in jokes are funny partly because they are unexpected. Additionally, according to these researchers, big picture thinking is essential in understanding jokes, as it allows the listener to understand how the surprising punchline coheres with the joke body. As individuals with AS often demonstrate rigid thinking, a desire for the preservation of sameness, and difficulties with big picture thinking, it seems that individuals with AS would be at risk for difficulties perceiving and producing conventional humor.
The difficulty of a child having an atypical sense of humor is that they are less likely to draw others to them through this medium. This especially the case during the teen years, when peers are often very unaccepting of difference. Difficulties perceiving humor can create feeling of marginalization in students when they a re surrounded by laughing peers who got the joke. Additionally, they may become ideal targets for teasing; for instance, without understanding the sarcasm in a put-down, these students are unable to fight back. The humor production findings in my study give further evidence that students with AS are at a social disadvantage. With decreased ability to make peers laugh, teenagers with AS have less access to a powerful tool for facilitating relationships.
The identification of these issues has implications for possible intervention. The Father of one adolescent boy with AS that I met with told me that, from and early age, he had coached his on elements of humor. This seems to have paid off; the judges gave this participant some of the highest ratings of all the participants in the study. If thisw student in any indication, humor skills can be explicitly taught with some success. By giving the individuals with AS these skills, they are given a more equal chance with regard to social interaction.
For a more detailed account of my study, and for list of references, the interested is referred to my doctoral project, housed at the Massachusetts School of Professional Psychology library.