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Just Making Friends?

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by

Jess Hill

on 26 April 2014

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Transcript of Just Making Friends?

Just Making Friends?
The Unique Perspective Occupational Therapy Brings to Social Skills Training for Adolescents with High Functioning Autism
References
Strengths
Limitations
Core Beliefs of Occupational Therapy
Where Does Occupational Therapy Fit?
PP
P
O
E
So What?
The Struggles of Adolescence
Occupational Performance
Impact to Psychological Well-being
Social Impairments of HFA
Quiet and Aloof
Quiet
Stand-offish
Socially awkward
Lack facial expression and eye contact
Does not seem interested in interacting with peers
Seemingly rude

Loud and Outgoing
Loud
Lack tact
Seems inappropriate and often offensive
Seems to speak without thinking
Embarrassing behaviours
Does not accept others opinions
Limited ability to participate in a reciprocal conversation
Seems to disregard personal space

Difficulty showing empathy
Difficulty understanding and reciprocating emotions
Difficulty understanding the unwritten rules of social interaction
Lack of facial expression and eye contact
Inability to recognise and appropriately interpret social cues
Inability to interact with peers or develop peer relationships
Inability to use non-verbal behaviours to regulate social interaction
Depression (approx 70%)
Anxiety (approx 84% - 17% experiencing social phobia)
Catatonia (approx 17%)
Loneliness
Lowered self-esteem
Lowered self-worth
Suicide ideation
Adaptation difficulties
Developmental delay
What are we talking about exactly?
In the broader context of professional identity, explore the unique perspective occupational therapists can bring to social skills training for adolescents diagnosed with HFA.

Professional Identity
Increased risk of academic failure
Long-term impact on ability to gain and maintain employment
Long-term impact on ability to develop and maintain meaningful relationships
Lack of leisure activities and interests
Overall decreased perceived quality of life and occupational satisfaction

Common interventions
Behavioural modelling
Behavioural rehearsing and role play
Performance feedback
Coaching
Social Stories
Video modelling
Cognitive behavioural interventions
Psychology
and
Social Work

Difficulty generalising skills to the "real world"
Limited evidence showing long-term impacts
Continued deficits in educational and employment success
Required interventions to be tailored to the teens specific social behaviour in order to maximise their potential
Increased confidence in social environments
Increase in social competence
Increased social initiation and willingness to participate
Improvement in a range of associated problem behaviours, including: affect regulation, self-isolation, stereotypical behaviours and self-harm
Reduced levels of anxiety and depression
An overall improvement in social skills as reported by teens, parents and teachers.
"The primary goal of occupational therapy is to enable people to participate in the activities of everyday life" (WFOT, 2012).
"Occupational therapists achieve this outcome by working with people and communities to enhance their ability to engage in the occupations that they want to, need to, or expected to" (WFOT, 2012).
Person
Environment
Household
Classroom
Workplace
Community
Consider the demands of this environment, physical, social, emotional, socio-economic, sensory and cultural
Occupation
What does the individual want or need to do?
What occupations or tasks are combined to create the persons roles or identity?
What occupations are most meaningful to the individual?
What skills are required for the desired occupations?
Collaborate with the adolescent, parents, employer, teachers, etc
Specific interests
Motivation, values and goals
Strengths and challenges
Cognitive abilities
Performance pattern
Person-Environment-Occupation Model
(Law et al, 1996)
"Contexts and situations that occur outside the individual" (Law et al, 1996).

Main environments of adolescents include:
Context
Group or individualised programs
Possible parent intervention
Role-plays tailored to the participant's daily occupations
Participants maintained improvements over six-week period and at one-month follow up
Participants improved both verbal and non-verbal behaviour
Reports from parents and teachers showed that participants generalised their new skills into "real-life" situations
Strengths
Limitations
Follow up is required at 3, 6 and 12 month intervals to explore long-term effects
Larger number of participants is required to increase the generalisation
Occupational Therapy Across the Lifespan
Regulation of emotions and behavioural responses
Processing of sensory information
Self-care skills
Organisation and planning
Independent work skills
Assistive technology
School or work functions
DEVELOPMENT OF SOCIAL ABILITIES
INTERPERSONAL SKILLS AND PEER RELATIONSHIPS
Many more...
Occupational Therapy and Social Skills Training
Social Competence is a crucial aspect of successful occupational performance
Social skills allow an individual to successfully function within their environment enabling them to meet their occupational goals.
While psychosocial approaches aim to improve specific behaviours, occupational therapists address all aspects impacting a persons occupational performance.
Occupational therapy models that combine, psychosocial aspects, assist clients to improve occupational performance rather then one specific skill or isolated behaviour.
Behavioural challenges
Emotional response
Degree of autonomy
Sensory challenges
Taking into consideration that each adolescent is unique
Current Literature
Autism Spectrum Disorder
ASD
Autistic Disorder
Asperger's Syndrome
or
High Functioning Autism
Pervasive Developmental Disorder- Not Otherwise Specified
Occupational Performance
Lack of social competence continues to be considered as one of the most debilitating symptoms of HFA for occupational satisfaction
Occupational therapy has a unique role to play in social skills interventions with adolescents with HFA
To assist adolescents with HFA reach their full potential occupational therapists must understand their role with this population.
More Research is needed!!.
Gutman, S. A., Raphael-Greenfield, E. I., & Salvant, S. (2012). The effect of an occupational therapy role-playing intervention on the social skills of adolescents with Asperger's syndrome: A pilot study. Occupational Therapy in Mental Health 28(1), 20-35. doi: 10.1080/0164212X.2012.650953

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Hillier, A., Fish, T., Siegal, J. H., & Beversodorf, D. Q. (2011). Social and vocational skills training reduces self-reported anxiety and depression among young adults on the autism spectrum. Journal of Autism & Developmental Disorders, 23, 267-276. doi: 10.1007/s10882-011-9226-4

Hyman, S. L. (2013). New DSM-5 includes changes to autism criteria. AAP News from http://aapnews.aappublications.org/content/early/2013/06/04/aapnews.20130604-1.full.pdf+html

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Lasgaard, M., Nielsen, A., Eriksen, M. E., & Goossens, L. (2010). Loneliness and social support in adolescent boys with autism spectrum disorders. Journal of Autism & Developmental Disorders, 40, 218-226.

Laugeson, E. A., Frankel, F., Gantman, A., Dillon, A. R., & Mogil, C. (2012). Evidence-based social skills training for adolescents with autism spectrum disorders: The UCLA PEERS program Journal of Autism & Developmental Disorders, 42, 1025-1036. doi: DOI 10.1007/s10803-011-1339-1

Law, M., Cooper, B. A., Strong, S., Stewart, D., Rigby, P., & Letts, L. (1996). The person-environment-occupation model: A transactive approach to occupational performance Canadian Journal of Occupational Therapy, 63(1), 9-23.

Loukas, K. (2007). Occupational therapy with adolescents in school-based practice: A qualitative inquiry of emergent roles, philosophy and practice. Creighton University Post-Professional Doctoral Program.

Lugnegard, T., Unenge Hallerback, M., & Gillberg, C. (2011). Psychiatric comorbidity in young adults with a clinical diagnosis of Asperger's syndrome Research in Developmental Disabilities 32, 1901-1917. doi: 10.1016/j.ridd.2011.03.025

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Pisula, E., & Lukowska, E. (2011). Perception of social relationships with classmates and social support in adolescents with Asperger syndrome attending mainstream schools in Poland School Psychology International 33(2), 185-206. doi: 10.1177/0143034311415784



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Baghdadli, A., Brisot, J., Henry, V., Michelon, C., Soussana, M., Rattaz, C., & Picot, M. C. (2013). Social skills improvement in children with high-functioning autism: A pilot randomized controlled trial. European Child Adolescent Psychiatry, 22, 422-442. doi: 10.1007/s00787-013-0388-8

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Cramm, H. (2003). The person-environment-occupation circle tool: A simple way to bridge theory into practice In Theory Meets Practice (Ed.).
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Doble, S. E., Bonnell, J. E., & Magill-Evans, J. (1991). Evaluation of social skills: A survey or current practice Canadian Journal of Occupational Therapy 58(5), 241-249.

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(Gutman, Raphael-Greenfield & Rao, 2012)
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Whitehouse, A. J. O., Durkin, K., Jaquet, E., & Ziatas, K. (2009). Friendship, loneliness and depression in adolescents with Asperger's syndrome Journal of Adolescence 32, 309-322.

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Image 1: “Rainbow umbrella”, (October 2013). Retrieved from:
http://www.clker.com/clipart-rainbow-umbrella-1.html

Image 2: “Alone in a crowd”, (October 2013). Retrieved from:
http://somervillekitchen.blogspot.com.au/2011/08/yet-another-decent-street-food-vendor.html

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Image 8: Puzzle in the mind”, (October 2013). Retrieved from:
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Image References
Acknowledgments
To all those who have supported me in the development of this presentation, particularly my three younger brothers who have continued to inspire me throughout my entire course.
Jess Hill
"The occupational therapist's concept of what it means to be and act as an occupational therapist (Mackey, 2007).


(Whiteford &Wright-St Clair, 2005, adapted by Denshire 2013)
[Image 1]
[Image 2, 3, 4]
[Image 5, 6,7]
[Image 8]
[Image 9]
[Image 10]
[Image 11]
[Image 12, 13, 14]
(Attwood, 2011; Hyman, 2013; Koning & Magill-Evans, 2007; My Asperger's Child, 2013; Pisula & Lukowska, 2011)
(Asperger's syndrome Foundation, n.d.; Bejerot & Wetterberg, 2008; Farrugia & Hudson, 2006; Lasgaard et al, 2010; Lugnegard, Hallerback & Gillberg, 2011; Shtayermman, 2008; The National Autistic Society, 2013)
(Baghdadli et al, 2013; Broderock et al, 2002; Koning & Magill-Evans, 2007; Laugeson et al, 2012; Lerner, Mikami & Levine, 2010; McMahon, Lerner & Britton, 2012; McMahon, Vismara & Solomon, 2012; Mitchell et al, 2010; Sticher et al, 2010; Sticher et al, 2012)
(Baghdadli et al, 2013; Broderock et al, 2002; Koning & Magill-Evans, 2007; Laugeson et al, 2012; Lerner, Mikami & Levine, 2010; McMahon, Lerner & Britton, 2012; McMahon, Vismara & Solomon, 2012; Mitchell et al, 2010; Sticher et al, 2010; Sticher et al, 2012)
(Baghdadli et al, 2013; Broderock et al, 2002; Koning & Magill-Evans, 2007; Laugeson et al, 2012; Lerner, Mikami & Levine, 2010; McMahon, Lerner & Britton, 2012; McMahon, Vismara & Solomon, 2012; Mitchell et al, 2010; Sticher et al, 2010; Sticher et al, 2012)
(The American Occupational Therapy Association, n.d.)
(Dukla & Jarus, 2005; Doble, Bonnell & Magill-Evens, 1991)
(Brown, 2009)
(Strong et al, 1999)
(Law et al, 1996; Strong et al, 1999)
(Asperger's syndrome Foundation, n.d.; Hiller et al, 2011 The National Autistic Society, 2013)
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