Multimedia Connections: A Case Study of A Child With Asperger’s Syndrome
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Multimedia Connections: A Case Study of A Child With Asperger’s Syndrome

Abstract

Asperger’s Syndrome is an autistic spectrum disorder which is characterised by often severe communicative deficits which include a lack of use and reciprocity of non-verbal communications, impaired two-way interactions and an inability to understand the rules of social behaviour. This paper reports the process, findings and observations of a case study of an eight year old child diagnosed with Asperger’s Syndrome, over a period of eight months. A review of research which indicates the merit of the use of computer and specifically, multimedia technology, in supporting students who have learning and social problems is presented. This study focusses on an attempt to use multimedia to encourage and develop social interactive skills in a young subject who has Asperger’s Syndrome.

 


 

Introduction

This paper presents the findings and outlines the conduct of a qualitative eight month case study of an eight year old child who has been clinically diagnosed with Asperger’s Syndrome. During the course of the study an attempt was made to introduce the child to a multimedia computer programme in the hope that he would first, gain some facility with this technology and second, assimilate a number of societal morés which would be of advantage to him as he forms social and emotional connections with others.

The choice of information technology as an agent of change was taken in the light of an extensive and pre-existing corpus of published research and informed observation which strongly indicates that the use of computers and their associated language processing software not only helps support children with learning difficulties but also tends to link classroom learnings to more readily socially identifiable milieux. These milieux are increasingly represented by the world of multimedia which includes television, popular music and computer games.

This study is a product of a number of weekly, forty-five minute, computer sessions with Jason (a pseudonym) and reflects on the dialogue between researcher and young informant. Data were gathered in the form of anecdotal notes and samples of Jason’s multimedia compositions. Further information was garnered during interviews with Jason’s parents and class teacher. A large number of journal articles and other texts, including internet world wide web pages were consulted. Information and comments on this information forms a literature review which heads this paper.

It has always been the prime intention of this researcher to create a viable and educationally legitimate learning environment for Jason and the focus of this case study has not been the reportage but has been rather more concerned with the maintenance, expansion and modification of this environment to suit the unique requirements of the subject. At all times during the past eight months, the project has been in flux (and is still being modified) as Jason does not readily accept a top-down teaching/learning model and takes much delight in challenging anything he perceives to be standard and acceptable to his peers. Jason does not recognise power structures and does not modify his responses according to the age or status of his correspondents. Modifications took the form of lingering longer in some areas which this researcher (but obviously not Jason) had previously considered trivial or to be dealt with in a shorter time-frame. On other occasions, carefully prepared and seemingly integral material, was rejected by the young subject. Nevertheless, rejection was not always without worth in terms of gaining insight into Jason’s deductive and emotional processes and successes more often than not, evolved from the new beginnings we were obliged to employ.


The new literati

As we near the new millennium, the headlong rush to disseminate and store more and more information has become a veritable stampede. Strommen (1992) and Rushkoff (1997) make the observation that, as a result of this stampede the very nature of our previously linear society has been transmogrified. The new literati of this brave new world are no longer professors, doctors and philosophers, nor are they the barons of industry and commerce. They are our children. The new world is a world of MTV, of the video game, the personal computer and the internet. No longer do our children satisfy themselves with the linearity of network programming, suffering themselves up, as we do, to the programmers televised version of reality. The modern child channel hops, devouring a host of programmes and watching two or three simultaneously. The MTV style of quick scene cuts of one or two seconds, once frowned upon by film-makers is now the norm in cartoons, advertisements and, of course, music video clips. The child seems to be more interested in the texture of the message rather than the text.

As adults we tend to tune off when these methods are used and even deplore the inability of our children to concentrate for more than a few minutes. In fact, as Rushkoff (1997) suggests, what we are doing is passively accepting others’ programming and the children, paradoxically, are behaving in a more ‘adult’ discriminatory, eclectic manner by appropriating what they perceive as important.

Decades of dialogue in learning theory support this notion of self-actualisation. Piaget developed a model of the child as constructivist, as ‘an active participant in the acquisition or construction of knowledge’ (Shade and Watson, 1990, p.380). This model has been revisited by many and Papert (1980), as a student of Piaget, extrapolated Piagetian rhetoric by suggesting that children ‘simply lack appropriate materials with which to work’, defining these as ‘objects-to-think-with’ (p.380). The famous Papert turtle is one of these objects-to-think-with. As the child programmes the turtle, syntonic (responsive and adaptive) learning is encouraged rather than dissociated (rote) learning (p.380). In fact, the computer itself has become an object to think with.

Jonassen (1991) and Strommen (1992), both arguing from a constructivist standpoint, claim that context-free learning lacks relevance. Learning must reflect real world issues and be immutably linked to the child’s real needs. Children are systematically exposed to information which has been decontextualised and stripped of meaning. Jonassen suggests that problem-based and activity oriented contexts better reflect the real needs of children. Too often bald information and facts are thrust upon our children to be digested without consideration of what schemata young learners have in train. As Rieber (1996) suggests, children are wired to learn through their own play, that play is children’s ‘work’ and that the ‘transmission model’ (p.45) of teaching where the teacher is the omniscient conduit of a generally recognised and approved body of information, is no longer appropriate. It is inappropriate because information is no longer a stable commodity. What one teaches this morning as incontrovertible fact may be antediluvian rubbish by the afternoon. The proliferation of the World-wide Web has set up a vast warehouse of constantly changing information which is rapidly altering how we learn. What we commit to memory needs to be mediated by the knowledge that a few keystrokes can give us access to in-depth information on any subject at any time.


Word processing: an emancipation

A number of researchers (Bangert-Drowns, 1993; Chandler, 1984; Cochran-Smith, 1991; Jones, 1994; Kuechle, 1990; Marston, Deno, Kim, Diment & Rogers, 1995; Robinson-Stavely & Cooper, 1990; Seawel, Smaldino, Steele & Lewis, 1994, have noted that computer use (in particular, word processing) is a particularly effective learning tool for writers and readers, surpassing pencil and paper composing and often liberating young learners with disabilities from the painful mechanics of composing in the traditional methods.

Chandler (1984) sees word processing as an emancipating experience for children. The surface element of composing is a very important factor in formulating an ethos or spirit for creative writing. Chandler suggests the discovery of the ‘Delete’ key is a watershed for the young author. Pen and paper writers at all levels of competency often do not like being reminded of their inadequacies by looking at their crossed out, scratchy attempts (as teachers, we are delighted when we see this burgeoning skill … the first sign of revision) and often as not will destroy the page and rewrite. Chandler’s point is that these false starts "Build steadily up into a major disincentive to write at all" (p.35).

A majority of these studies have been carried out on mainstream students but the findings can be extrapolated to children with learning disabilities or delays. Rieber’s (1995) case study of his own significantly disabled child takes a step further, in that it introduces the use of computer-based microworlds as a learning environment for children with developmental and behavioural disorders (in his case Pervasive Developmental Disorder and ADHD). Rieber’s son, Thomas, was introduced to a structured programme of university and home computer access using the software, Macpaint, Kidpix and Hypercard as well as programmes specifically developed by Rieber. The computer has become a major ally in Rieber’s efforts to equip his son with survival skills and Thomas has entered into what some call a "cognitive partnership" with the computer. The computer offers a chance for at risk students to problem solve and write creatively with a minimum risk of failure as well as the offer of "motivation, self-pacing and privacy" (Scott, Kahlich & Barker, 1994).

A study by Jones (1994) which compared written and word processed compositions by second graders found that those who used a word processor assimilated skills which transferred favourably to their subsequent pen and paper writing. Bangert-Drowns (1993) found similar results. Participants in this meta-analysis of a number of studies were drawn from all grade levels. During the course of the analysis, Bangert-Drowns found, " Studies of remedial instruction for students who had previously demonstrated difficulty with writing indicated greater improvements from word processing experience than studies with typical writing instruction" (p. 87).

Not all researchers are convinced that word processing and desktop publishing are the way to go. Perhaps the best example of the power of the word processor "lies in its ability to hold text in a state of limbo" (Mann in Crompton, 1989, p.57). The child with writing problems, once au fait with this process, need not feel threatened by the knowledge that re-drafting means rewriting the whole piece. Yet Donald Graves, the founding father of process writing, talks about this type of revision in the pen and paper mode as putting "a good manicure on the corpse" (1983, p.4). Detractors often suggest that the computer offers only cosmetics for writers.

In a comparative study, Shaw, Nauman and Burson (1994) found that handwritten pieces were superior in that they were longer, more spontaneously creative and better punctuated (p. 322). Nevertheless, many researchers in the area of learning disabilities (see p.5) are enthusiastic about the use of computer technology to enhance learning with at risk students.


Multimedia and the Worldwide Web

Early word processing can be likened to Henry Ford’s first vehicles and his production line to the exponential proliferation of word processing software. To continue the metaphor, the modern automatic, sophisticated automobile could be compared to recent developments in multimedia software and hardware. Multimedia uses word processing as a cement to bind a number of elements including graphics and textual linking (hyperlinks), audio and video/animation. Access to the World Wide Web is now, more often than not being included in multimedia software. More recently, papers and studies have included these new multimedia potentials ( see Strommen, 1992; Daiute and Morse, 1994; Hunt-Berg, Rankin & Beukelman, 1994; LaMont Johnson, 1996; Najjar, 1996; Rieber, 1995,1996 ).

Daiute and Morse (1994), produced a wide ranging study which used multimedia writing tools to extend and challenge at risk students, Dauite and Morse concentrated on their participants’ strengths. Their subjects worked "better in visual and aural than in textual modes" (p.221). As Dauite and Morse observe, many children, often from disadvantaged backgrounds, have little interest in the value of literacy and perceive the classroom to be an alien environment (p.223). There is a strong need to allow children to reflect their own backgrounds and culture in their school-based output.

Daiute and Morse (1994) concentrate on non-print media. The subjects of their study were able to create pieces which involved using multi-media to scan and record personalised libraries or stacks of music, speech and images. Subjects were allowed to create compositions using these stored media. It was found that previous recalcitrant writers and readers responded positively to these inputs and produced creative and polished work. The researchers make the observation that non-readers and writers develop skills in extracting information from media other than text. Graphics, music and television are accessed in "gestalt terms", that is, their understandings and thinking processes are the process of a wholistic interpretation (p.226). In this respect, those who are able to interpret, elucidate and respond to these forms of media possess their own form of literacy which contains strengths which can be built upon. The linearity of textual formats requires a certain type of concentration and single-minded purpose which is limiting or even inappropriate for some learners.

Exposing these at risk students to multimedia is also about building self-esteem as learners and, in many cases serves as a catalyst for their creative drives. The previously quoted pro word processing/multi media studies support the contention that in the long term, children who are successful with technology, transfer these skills to pen and paper tasks. Self esteem as reader/writers is also enhanced.


Hyperstudio

This particular case study involves the use of the software Hyperstudio (Wagner, 1995) which has been used in an attempt to skill a young Asperger’s child in the affective domain. Hyperstudio is a multimedia computer programme which was originally developed for Macintosh systems and uses the Macintosh Hypercard format (it is now available in Windows format). The programme mimics a physical stack of cards by embedding ‘buttons’. The stack’s individual cards may contain graphics, text (which has the facility to scroll, allowing large tracts of text to be displayed on one screen), hyperlinks, which can also be used to navigate to other cards and video. The hyperlinks are activated by moving a pointer or hand icon over a highlighted word or graphic and clicking. Video movies may be selected and embedded in any card and again activated by buttons or hypertextual links. Digitised photographs and other images can also be imported into Hyperstudio stacks. Audio can be selected from a number of sources, which include microphone input. Other software programs also may be accessed through buttons. On the Macintosh version, hyperlinks to internet web pages are also possible.


Asperger’s Syndrome

Asperger’s Syndrome (AS) was first proposed in 1944 by Hans Asperger, an Austrian psychiatrist who described in his paper, ‘Die Autistischen Psychopathen’ a condition which was characterised by ‘ pedantic and stereotyped speech patterns, clumsiness, obsessional interests and deficient social behaviour’ (Goble, 1995). It was not until 1991, however, that the first English translation gained a world-wide audience. In fact, Leo Kanner had first described the condition, one year earlier in 1943. Kanner’s paper focussed on negative personality traits of parents who were cold and rejecting. It was Kanner’s premise that these parents often influenced their progeny who withdrew from social interactions. This ‘refrigerator mother’ (Goble, p.17) hypothesis did not stand up to subsequent research but, along with Asperger’s work and a burgeoning interest in Autism, the 90s saw a renewed focus on AS.

The main features of AS first become ‘obvious during early childhood and remain constant throughout life’ (Jackel, 1996). These symptoms and degrees of disability vary between subjects. Jackel reports that symptoms are only rarely diagnosed before the age of three and are more common in boys than girls.

In 1994, Asperger’s Disorder was first quantified as a specific disorder and was included in The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (1994). The excerpt appears below.

From DSM IV (p77):


Diagnostic Criteria for 299.80 Asperger’s Disorder

A. Qualitative impairment in social interaction, as manifested by at least two of the following:

  1. marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction

     

  2. failure to develop peer relationships appropriate to developmental level

     

  3. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g. by a lack of showing, bringing, or pointing out objects of interest to other people)

     

  4. lack of social or emotional reciprocity

B. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:

  1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus

     

  2. apparently inflexible adherence to specific, nonfunctional routines or rituals

     

  3. stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)

     

  4. persistent preoccupation with parts of objects  
C. The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning


D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years)


E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than social interaction), and curiosity about the environment in childhood


F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.


AS is a pervasive developmental disorder (PDD) which falls into the spectrum of Autism. Klin and Volkmar (1996) observe that ‘there are many similarities with "autism without mental retardation" (or "Higher Functioning Autism")’ (p.1). Klin and Volkmar noted that AS and Higher Functioning Autism (HFA) could perhaps be one in the same condition. Goble (1995, p.17) suggests that the (then) most accepted view was that AS was ‘a less severe form of Kanner’s Autism.’ Notwithstanding these reservations, it would appear that AS does have specific and identifiable elements as evidenced in the quoted diagnostic criteria.

Perhaps the most compelling and idiosyncratic behaviours of AS sufferers are in their impaired social interactions. Some of these behaviours, commonly exhibited by children with AS, are listed by Williams (1995, p.10):

‘Children with AS show an inability to understand complex rules of social interaction; are naive; are extremely egocentric; may not like physical contact; talk at people instead of to them; do not understand jokes, irony, or metaphors; use monotone, stilted or unnatural tone of voice; use inappropriate gaze or body language; are insensitive and lack tact; misinterpret social cues; cannot judge "social distance"; exhibit poor ability to initiate and sustain conversation; have well developed speech but poor communication; are sometimes labeled "little professor" because speaking style is so adult-like and pedantic; are easily taken advantage of (do not perceive that others lie or trick them); and usually have a desire to be part of the adult world.’

With respect to the ‘adult-like’, professorial speaking style, Williams goes on to note that the pedantic speech and large complex vocabularies often give a false impression that they fully understand what they are talking about, when in fact they are merely parroting what they have heard or have read (p.13). Goble (1995, p.19) also makes mention of this seeming facility with language. Careful studies have shown that the speech lacks substance and is ‘socially one-sided’. In addition, children with AS often exhibit echolalia (repeating, parrot-like overheard words and phrases) and use them in inappropriate social settings (Carruthers and Foreman, 1989).


Learning and language

People with AS learn in a different way to many other learners and frequently have excellent rote memories, particularly for the minutia of their chosen specialist subject. Despite this good rote memory they tend to lack higher level, metalinguistic skills and problem-solving ability. Goble (1995) observes that the AS individual often has trouble with "emotional nuances (and) multiple levels of meaning" (p.14) as contained in novels and are more at home with scientific, non-fiction texts. General knowledge and their own personal connotations are often mixed and confused making their written expression often difficult to fathom.

Spoken language is also problematical for the AS person. Initiating a conversation has particular pitfalls as an AS individual may launch into a conversation without reference to the ongoing conversation (if in a group) or strike up a conversation without referring to the generally accepted proprieties of connected or apposite ideas. For example, the informant in this case study once greeted me with, "Did you know that cheetahs are the fastest animals on land?"

Attwood (1997) notes that "once the conversation has begun there seems to be no ‘off switch’ and only ends when the child’s pre-determined and practised ‘script’ is completed" (p.31). The supreme egocentricity of the child with AS leaves no room in his/her repertoire for listening to the conversation of others. They often make it patently obvious that they are not listening to other speakers, even when the speaker is speaking directly to them. That is not to say that most of us, quite often, are bored or disinterested with the conversation of others and that this is a peculiar trait of the AS individual. The difference here is that the child with AS cannot, it seems, dissemble as we have learned to do when we nod appreciatively or smile in the correct contexts while having the figurative blinds up, as it were. Attwood (1997) also notes that the child with AS is unable to repair a dysfunctional conversation and also has trouble maintaining a topic with which they feel discomfort (p.32).


Emotions

When one meets a person with autism or AS one is often struck with the impression that they seem indifferent to the emotions of others (Attwood, 1993). AS sufferers do have, often immense, difficulties in interpreting the emotional cues and clues present in the expressions, intonation and other body language of those with whom they interact. Yet AS sufferers are not totally indifferent and often over-react (and proportionally under-react) in response to the emotional behaviour of others. There seems to be no schemata present upon which to scaffold emotional behaviour patterns. Children with AS are capable of learning emotional survival skills but will never totally internalise the vast repertoire of social skills and morés which ‘normal’ people assimilate as a natural process of social development.

Children with AS are so often solitary players, allowing others to join their games only if they do so according to the child’s rules. Young children with AS do not appear to be concerned about making friends, nor can they effectively define friendship. A friend is often described as someone who gives one something. This was a common definition given by Jason in early interviews. A friend was someone who ‘gives me lollies’. Towards the end of the study period, Jason’s responses had changed to, ‘It’s someone you like’, or ‘somebody who helps you read and stuff’. I would suspect that these latter responses had been learned during the process of the study intervention and that they now represent an accommodation within Jason’s metacognitive scaffolding, but no more than this. It is just an accommodation, as one can’t help noticing when Jason, rather laconically, trots out his responses. The AS child’s definition does not deal with emotions but practicalities. Attwood (1997) cites the case of the child with AS who is asked why he did not talk to other children in the playground and who answered, ‘ " No thank you, I don’t have to" ‘(p.13) or again, the young man who made a judgement on whether to befriend a person on the basis of them driving their car with the sunvisor up or down (p. 22). In the latter case, it would seem that some kind of successful relationship must have been established with a visor-up (or down) person in the past and this characteristic alone had become an obsessive prerequisite to friendship (p.21). The Asperger child, in later years increasingly continues to find friendships a devastatingly difficult and perplexing minefield of emotions and social imperatives.


Social problems

Social problems of people with autism spectrum disorders (ASD) which include AS, remain perhaps the most difficult problems to address. Some research even suggests that social impairment is the major deficit in ASD (Autistic Children’s Association of Queensland, 1995). Although many ASD people are quite sociable, their attempts at socialising remain not very effective. Communication problems can be addressed by explicit rote learning. "The meaning of eye contact, gaze, various inflections as well as tone of voice, facial and hand gestures, non-literal communications, such as humour, figurative language, irony, sarcasm and metaphor, should all be taught in a fashion not unlike the teaching of a foreign language" (Klin and Volkmar, 1996, p.9).

The supremely egocentric child with AS cannot brook interference with his/her plans or rituals. Inappropriate physical contact, which includes invasion of personal space, is as common as inappropriate verbal communication and Attwood, (1997) cites a number of anecdotal references which include a child with AS kissing a complete stranger on the lips and a young man who had heard that babies sometimes cry when their safety pins accidentally open and prick them and who began to check the clothing of a strange crying child.

It is important to train the AS individual to cope with meeting new acquaintances. Klin and Volkmar (1996) suggest practising in front of a mirror or watching a video recording of exemplars for particular meeting occasions. The research, as outlined in this paper, contains an attempt to expose a child with AS to a number of common emotions and a selection of modelled responses to a variety of social situations which it is hoped may eventually tend to ‘normalise’ social interactivity. Through this exposure, which includes drilling and hands-on manipulation of the multimedia properties, a learned pattern of behaviour may be accessed by the child when confronted with emotional and social situations. If the correct response is learned and applied appropriately, the young subject of this case study may find himself more able to interact appropriately and be accepted in the wider community.

In Jason’s study, ‘appropriate’ responses were modelled by this researcher and parents throughout the treatment period and, of course, by parents in the home. Jason’s successive approximations towards the desired behaviours were celebrated and rewarded. Contiguity of reinforcement was an important consideration as these new behaviours did not slot easily into already well developed and securely imbedded schemata. Some reinforcers used were sweets, small gifts and computer time for favourite games. The final element of the process was the opportunity for Jason to practise his new responsive behaviours, and the interactive nature of the software allowed for ample opportunities for this type of practice.


Theory of Mind

Wing and Gould (1979 in Wing, 1996) conducted a study on children ‘with autistic features’ (p.25) in the 1970s which found that they had in common an absence or impairment of social interactive, communicative and imaginative skills. These three impairments which are commonly reported in connection with Asperger’s children are referred to now as ‘the triad’ (Frith, 1996). Wing and Gould also discovered that these children had a narrow, repetitive range of interests and activities. Frith (1996) further defined this impairment as a specific cognitive deficit which was to be associated with the term ‘Theory of Mind’ (Happé, 1994; Baron-Cohen, 1995; Goble, 1995). This theory notionalises the existence of a conception of our own and the attribution of mental states of mind in others. It was found that autistic spectrum children cannot conceptualise that others have thoughts, plans and beliefs dissimilar from their own. As Frith observes, ‘the capacity for mentalising – which appears to compel us to explain behaviour as caused by mental states – has far-reaching effects on our inner imagination as well as on our social relationships and on communication’ (p.49).

The autistic/AS child has an impaired ability to mind-read or mentalise and subsequently has difficulty in explaining, and perhaps more importantly, predicting the behaviour of others. In a study by Baron-Cohen, Allen and Gillberg (1992), where toddlers were screened for behaviours which were hypothesised as being indicators of autism, two behaviours stood out as missing in a number of children who were later diagnosed as autistic. These behaviours were pretend play and joint attention (or protodeclarative pointing – pointing to bring an other person’s attention to something discovered by the child). It would seem that children with autism/AS, lack a theory of mind as early as 18 months and even perhaps at birth.

Happé (1994) and others have attempted to quantify and measure theory of mind. She cites the classic "Sally-Ann task" (Wimmer and Perner, 1983 in Happé, 1994, p.40) where a child is shown two dolls, Sally and Ann. Sally has a covered basket and Ann has a box. Sally has a favourite marble but has to leave. She puts her marble in her basket and goes out. While she is out, the mischievous Ann takes Sally’s marble and puts it in Ann’s box. The child is asked where Sally will look for her marble. Happé reports that the majority of autistic children (Roughly 80% – Baron-Cohen, Leslie and Frith, 1985 in Happé, 1994) could not correctly answer the question. Frith (1996) reports that about 80% of normal 4 year old children and Downs Syndrome children of a lower mental age than the autistic children, got the answer right – that Sally would look in the basket where she first put it. Frith maintains that this misunderstanding, "a global bewilderment" (p.50), could account for the triad of impairments from which autistic spectrum children suffer.

The implications here for children with AS are many. Frith (1996) makes the observation that a failure to attribute mental states would result, for example, in an inability to feel empathy, an inability to understand somebody’s intentions to communicate and an inability to understand pretence (p.49). Theory of Mind deficits would, in a large part, account for the AS child’s lack of communicative and emotional reciprocity. Being able to mentalise the thoughts and feelings of others is a vital skill, and so too the ability to identify one’s own emotions and feelings. The child with AS tends to attribute emotional significance to only a limited number of their feelings, far too few and far too idiosyncratically to allow them to function and adapt successfully to life (Wing, 1996, p.82).


Jason: a case study

Some Milestones:

     Date of Birth: 10. 8. 89
     Birthweight: 2720 g (5lb 15oz)
     Length: 52 cm
     Head circumference: 32cm
     Duration of Labour: 7 ½ hours (born at 36 weeks – no special care necessary)
     Smiled: 5 ½ weeks
     Turned over: 14 weeks
     Sat up alone: 29 ½ weeks
     First step: 42 weeks
     Walking: 12 months
     Slept through night: 2 yrs
     Speech: Sentences – 2 ½ yrs
     First word: Light
 

These milestones indicate a normal development (Hoffman, Paris, Hall and Schell, 1988), for motor skills ( p.111) and speech (p.171), but with the exception of the late onset of a full night’s sleep which typically begins in the last half of the first year (p.86).

Jason (a pseudonym) is an eight year old boy who was diagnosed in May 1996 as suffering from Asperger’s Syndrome (AS). It is of interest to note that Jason failed the Theory of Mind test performed by the diagnosing clinician (The Sally-Ann Test). Paradoxically the diagnosis, made by a clinical psychologist, was greeted with some relief by Jason’s parents who for some time had noticed that Jason was different from other children. In fact they had spent many sleepless nights agonising over the fact that Jason did not appear to show or reciprocate love, that he lacked expression or expressiveness, that he seemed to prefer his own company and that he appeared frustrated and bewildered by a whole range of social conventions. To have Jason labelled as an Asperger’s child was a daunting and unpleasant experience, yet when the psychologist took the time to go through the list of common symptoms (diagnostic criteria) and offered a range of coping strategies, his parents felt for the first time, that at last they were in a position to help Jason contend with his problems.

Perhaps, just as important, was the parents growing awareness and relief, that Jason’s problems were not the direct result of their poor parenting skills. It would seem that the Kanner refrigerator mother theory still has currency at least as an informal folkway in modern times. Jason’s mother has had some bitter experiences with other mothers, fathers and schoolteachers who have been quick to blame her and her spouse for over-indulgence or lack of parenting skills. One mother actually offered to take Jason home with her for a week and that he would come back a changed boy!


Background

Jason’s parents report that Jason has an aunt (mother’s side) who suffers from a Bi-polar (Manic-depressive) disorder and had had a nervous breakdown. This aunt was also strange in some of her mannerisms. How much of this strangeness was caused by the onset of her disorder can only be guessed at. Jason’s mother did, however, suggest the possibility that she may have Asperger’s Syndrome.

Jason’s mother reported that she cried all the time when he was very young and seemed hypersensitive to noise. In the hospital the nurses would not keep him in the nursery, presumably because his crying disrupted the other children. When he came home he would often cry inconsolably for hours. At other times he appeared studious and serious although he would chuckle when tickled. He did not appear to enjoy being cuddled. He always had a dummy or other object in his mouth and did not play with toys or watch TV. He did like to play with pots and pans.

Jason’s brother Gordon (a pseudonym) was born in 1993 and has been a source of joy to the family. Jason’s mother observed that Jason seemed to like his brother’s company, but could be very cruel to him. Aggressive, rather than cruel, behaviour by children with AS is commonly reported (Attwood, 1997, Williams, 1995) and this aggression is usually linked to frustration. This researcher witnessed Jason put his hand over the mouth of his young brother while holding him firmly with the other hand. It seems Gordon was talking when Jason wanted to talk. Gordon’s face was pumping to a nice shade of magenta when his mother pulled Jason away. Jason’s mother turned his head towards her (he often does not engage with eye contact) and calmly said, Jason, do you know how Gordy feels when you put your hand over his mouth?

The conversation continued with asphyxia, fear and anger being (re)defined. Mother would define and son would repeat (albeit rather laconically) her definitions. I had the feeling that this was an ongoing process in the household. Later that afternoon in our session Gordon stood beside Jason as he worked on the computer. To our delight Jason put his arm around his little brothers shoulder and hugged, holding him for around thirty seconds. This may have been a learned social response, but at that moment it seemed totally appropriate and encouraging.


Early schooling

Jason’s first experience with Pre-school was not a happy time. The Teacher-in-charge was a stern disciplinarian and insisted that Jason conform. She was appalled when Jason jumped queues, refused to share or reacted aggressively towards her and other children. Jason’s father admitted that Jason did, at times, knuckle other kids. Jason is definitely cast in the Old Testament eye-for-an-eye mould and was soon labelled as an aggressive bully. It would also appear that the Pre-school teacher resented the fact that Jason spoke to her as an equal (Jason does not modify his communication style according to whether he is speaking to an adult or a child). Jason became very oppositional and upset and would sit at the breakfast table picking at his fingernails on Pre-school mornings. His parents noted he was developing a stammer. After two months Jason’s parents transferred him to another Pre-school where the teacher, who appeared to be more nurturing (a male), was able to make some connections with Jason who became more settled.

The first two years of Jason’s Primary schooling have been, at times, volatile but in sum have been productive and positive. Since his diagnosis, Jason’s parents have started using more effective strategies, have attended the Managing Young Children Project (MYCP) course with the Intensive Programme extension and regularly attend an Asperger’s Syndrome support group. Jason’s current teacher has been fully briefed on Asperger’s Syndrome and Jason receives learning support.

Academically Jason is within the average range. A recent Neale Analysis of Reading Ability – revised, indicated that Jason did not have any reading problems. Jason does not always learn new concepts with ease and needs a variety of approaches to elicit the best results. He looks for patterns and has a strong visual memory which was obvious when he first imported a computer-graphic background for the Hyperstudio card he was preparing for his electronic portfolio. At once he looked quizzically at the photo of Jupiter (see Appendix 1). It’s upside down was the response. In fact The Great Red Spot was depicted in the northern hemisphere in this graphic. An explanation that there is no up or down in space did not satisfy him. To this day the graphic appears to annoy him.


Obsessions/interests

Already, Jason has developed a special interest in Egyptology, especially mummies, Incas and UFOs. He is a walking fount of information on these subjects and is ghoulishly fascinated by what lies beneath those ancient strips of linen (but what little child is not?)

Jason presents as a good looking child with regular features. He is of slightly above average height and walks and runs with a slightly stiff gait (motor irregularities are often reported about children with AS). Jason avoids eye contact and often sits with a mask-like expression. First impressions were that Jason appeared to be quite a normal eight year old but when I engaged him in conversation it became obvious that his social communication was idiosyncratic. Conversations are very one-sided and he speaks quickly, almost frenetically at times.

Jason has an obsession with death and gets inordinately sad when ducks are mentioned. The sadness revolves around the violent death of a beloved pet. Although he has shared the details with me he has asked that they not be available for reading here. As well as his fascination with mummies, he has an abiding interest in the ritual of burial. Recently he was working on a computer game and noticed a grey field in the construction area. He told me that it was a peat bog and made the observation that he didnt want dead bodies in his village. When I asked him for more information he proceeded to tell me about the Danish peat bog where a medieval felon had been executed and buried only to be perfectly preserved for centuries. Jason tells me he does not want to grow up to be a man. Presumably this is connected to the fear of his own mortality. Jason’s fear is potent and almost palpable but he cannot describe what fear is, nor will he attribute feelings of fear to himself.


Jason’s Programme

For some time, as a teacher in Jason’s school, I was aware that Jason had been diagnosed as a child with Asperger’s Syndrome, and a subsequent casual conversation with his father led to my offer to work with Jason on a regular basis. Further conversations with his parents resulted in the formulation of a set of learning goals or aims which it was hoped this intervention would achieve. The goals are not academically oriented and focus on behavioural elements. These were the goals which were agreed to:

To build a working repertoire of social skills which include: 

  • an ability to attend to and respond appropriately to conversations with others in one-to-one situations (including a requirement to allow input by the other speaker and the need to process and respond to this input).

     

  • an ability to curb inappropriate aggressive behaviour

     

  • an ability to contribute appropriately in group situations (including turn taking, sharing, giving and accepting compliments and the acceptance of a group purpose which on occasion transcends the immediate needs of the subject).

     

To provide Jason with strategies so that he can interact successfully with others, including:
  • Maintaining eye contact, greeting and farewelling

     

  • Learning by drill and practice standard responses to a number of common social situations (see p.30). Using these responses appropriately.

     

  • To skill Jason in areas of multimedia gaming and Desktop publishing in order that he can become an ?expert? which will provide an entrée for the formation of new friendships.

Jason’s parents have never been concerned about his academic progress other than when emotional problems interfere with his day to day learning. We felt that developing a facility with computer technology, including multimedia, would encourage others to seek Jason out to help them with their computer problems (the school was, at that time, upgrading to multimedia computers in the classrooms). Becoming a class expert in this area would generally tend to improve his standing in the school community and through interaction with others, hopefully also tend to demystify Jason who was already being avoided by some because of his idiosyncratic behaviour.

Hyperstudio (Wagner, 1995) was being installed on all classroom computers and this researcher’s class was already developing electronic portfolios (see Appendix 1) which included personal information and work samples in a number of curriculum areas. The intention was to build an electronic portfolio for Jason which was not meant to become a repository for curriculum material but more an exploration of self. The printouts of a number of Jason’s portfolio pages at Appendix 1 are reasonable facsimiles of the Hyperstudio stack but, are without sound or video, which was an integral part of the portfolio.

Jason’s first sessions revolved around a getting to know you approach to the computer. He was allowed to explore the computer desktop and was gradually introduced to the software. His sessions ran for 45 minutes, once a week using the software Hyperstudio (Wagner, 1995) and Simtown (Maxis, 1995).

Simtown is described by the distributor as an educational toy rather than a game. The child manipulates a number of variables which include housing, shops, roadways and environmental parameters in building their virtual town. The interface is primarily driven by mouse/icon point and click using a menu on the border of the construction area. The player is also able to create his/her own human and animal inhabitants and monitor their progress as the town grows. Icon monitors allow the player to gauge progress as the town expands or atrophies according to the player’s inputs. A number of elements need to be balanced to maintain a healthy growth, including the ratio of houses to businesses, the quality of the air and availability of raw materials including water.

Jason loves this programme and would spend all of his time interacting in his idiosyncratic way with it, if allowed (see p.26). Access to the game in our sessions was limited, however, and offered as a quid pro quo for a commitment from Jason to work on his Hyperstudio stacks. As is often the case in the qualitative paradigm, the study is often subject to unexpected outcomes which redirect or inform the research. Lincoln and Guba (1985) say as much in one of their definitions of naturalistic enquiry. What emerges as a function of the interaction between inquirer and phenomenon is largely unpredictable in advance; because the inquirer cannot know sufficiently well the patterns of mutual shaping that are likely to exist (p.41). In fact, Jason’s predilection for this particular programme influenced the structuring of our subsequent sessions and allowed this researcher a number of useful insights into the cognitive processes of children who have been variously labelled as personality disordered. One example was Jason’s apparent lack of a feeling of ownership for his virtual town. He was unmoved when he witnessed it begin to decay due to his lack of attention to the environment. In fact he appeared delighted when his buildings started to show signs of crumbling!

Observing how "normal" children commonly interact with Simtown proved invaluable as a means of comparison with Jason’s approach to the programme. For instance, many young players were concerned with the balance between houses and businesses. If the see-saw icon at the top of the construction area tipped on one or the other side of the fulcrum, most young (and virtually all older) players would show concern over the imbalance and attempt to rectify the problem by immediately building more houses or businesses. Failure to rectify this situation results in a static population.

Jason, despite having his attention drawn to the see-saw, appeared to show no interest in his town’s population, nor did he see any need for order in the streets or any need for housing tracts or business centres. His houses and business ranged all over his virtual community. At one stage he discovered the bulldozer and proceeded to destroy every tree on his estate. When he was reminded that if all the trees were gone there would not be enough oxygen in the air, Jason replied, "It’s not a real place". This pragmatism is common of Jason and perhaps common of most AS sufferers. Two examples of this literal obsessiveness follow. During the construction of Jason’s Hyperstack, he looked at the stack name and observed with deadpan expression, "I’m Jason, how can that be Jason". On another occasion I drew a picture of a large aggressive male confronting a small Jason look-alike (Appendix 2). I was attempting to define fear for Jason. He was not impressed and said that he was not scared because the man was "only this big" (indicating the size of the drawing with his fingers). It is important to note that neither of these utterances were intended as jokes. As Williams (1995) has observed, those who have AS seldom recognise metaphor and are particularly literal and seldom understand jokes and particularly, irony (p.10).

Obsessive behaviour is also a hallmark of the AS individual and Jason is no exception. When first introduced to Simtown he was taught that he could double-click on the roof of any house to remove the roof and click on a number of "hot spots" inside. These "hot spots" would activate short animated sequences replete with sound and humour. Jason was happy to deroof a number of his houses over and over again. He would chuckle happily at the animations then repeat the process. When asked if he were happy when he was laughing, Jason would say "no" or "I suppose so". He has a similar reaction to the opening credits of Simtown when the digitised laughing voices of young children play. Jason always smiles and laughs with them but refuses to acknowledge that their laughing makes him happy. I suspect it does, yet he is still unable to identify his empathetic reaction to these emotional cues. Then again, this researcher consistently cries at the end of Shirley Temple movies despite the fact that his intellect rejects the cynical attempt at emotional manipulation by the film’s director!


Jason’s Hyperstudio programme

As previously described, Hyperstudio’s interface involves the creation of hyperstacks. A hyperstack contains any number of linked, single "page" hypercards. Cards are linked using digitised "buttons" or highlighted hyperlinks (Hyperstudio’s Windows version does not have hyperlinks per se but a "cheat" was developed where invisible "buttons" performed a similar function).

The Hyperstudio cards which were developed to help Jason with identifying emotions and feelings were built during the weekly 45 minute sessions (see Appendix 1). Jason’s input was integral to the programme and his selections of video, sound (including recordings of his own voice) and graphics served to customise and personalise the stack in an attempt to develop a sense of ownership in Jason. This was only partially successful, the least successful being the "Emotions" cards (See "Emotions Cards" p.33). These cards had two scrolling text areas. One area was devoted to Jason’s definitions of particular emotions which were typed exactly as Jason dictated, and the other (the contentious one) was a definition of the particular emotion which was developed by this researcher and Jason’s parents (One parent was always in attendance during sessions with Jason). Jason has pointedly and consistently rejected our interpretations of each emotion studied. He reluctantly admits that the definitions do probably correspond with the emotions of others but steadfastly informs us that they do not apply to him. Jason makes a point of visiting our boxes during each session with a dismissive, "not me….not me…not me!" as he reads down the scrolling text.

The initial card (Appendix 1) first needed a background and this was imported from the resource CD which forms part of the Hyperstudio programme. Jason selected a photograph of Jupiter. He immediately remarked that the Great Red Spot was upside down (see p. 10). Jason’s photo was then imported as a JPEG image from another programme and pasted electronically onto the card. Earlier I had taken a number of photos of Jason and had asked him to make expressions to correspond with a number of emotions. Some of the photos were good impressions of the appropriate emotion while others, which represented slightly more complex feelings were very hard for Jason to replicate. An example was his difficulty differentiating between "sadness" and "loneliness" – perhaps quite difficult for most people. Yet Jason also had problems with "sadness" and "fear" which seemed a much simpler task.

After pasting these elements, a number of buttons were generated. These were titled "About Me" (an early inclusion to set the stage), "My Movies" (the latter added after this session when I observed Jason’s interest in the video collection supplied by Hyperstudio), "My Emotions", and "Feelings". "Feelings" was the first button to be added (Appendix 1) and was merely intended to explore "Happy" and "Sad". "My Emotions" was a later addition and forms a subset of "Feelings". Emotional vulnerability continues to be problematic for the child with Asperger’s. Williams (1995) observes that children with AS lack the emotional resources to cope with classroom demands and are often overwhelmed "when things are not as their rigid views dictate they should be" (P.13). Attwood (1997) and Happé (1994) and Wilson (1993) make similar observations. "My Emotions" was selected as a button on the basis that emotions could be in some way quantified for Jason. In a Brunerian sense (Lefrancois, 1985) this act of quantifying or categorising serves to reduce the complexity of Jason’s environment. As Jason explores the selection of emotions presented, it is hoped that he will discover links and commonalities which will aid in a better metaconstruction of what emotions are.

Jason and I explored the video library of Hyperstudio and Jason selected two appropriate videos to represent these feelings. The video selected for "Happy" shows an animated child’s drawing of a butterfly flitting amongst flowers to a jaunty tune. The "Sad" video was difficult to select as none of the videos available truly represented sadness. Jason seized upon another animated child’s drawing of young boy being scared by a spider and screaming. Jason appeared to enjoy this video immensely and replayed it with delight until the computer ran out of RAM and hung up!

These videos once selected take one to cards where Jason has placed his definitions of the two feelings. The "Sad" link is brimming with aggressive bravado. "When other kids bash me in the face. That hurts them too because I pounce on them and bash them in the head." Again Jason seems unable to come to terms with "Sad". Somehow he has equated sadness with aggression, pain and a hawkish "eye-for-an-eye" morality. The assimilation of a set of moral precepts will be a long hard road for Jason given his difficulties with defining emotions and recognising the signposts of emotions in others. In terms of Kohlberg’s developmental stages of moral judgement (Kohlberg in Atkinson, Atkinson, Smith and Hildgard, 1985, p.85) Jason is at Stage 2, Level 1 which is defined as preconventional morality where the child obeys rules to avoid punishment and conforms to obtain rewards. Of course the majority of his age cohort are no further along the continuum than Jason, yet, as a child with Asperger’s Syndrome, it would appear that Jason may never make the transition to the "higher" levels as defined by Kohlberg.

Klin and Volkmar (1996) suggest that social interactivity can be taught to children with AS much in the same way as a new language with each new element being made "verbally explicit and appropriately and repeatedly drilled" (p.8). As Attwood (1997) observes, there is remarkably little resource material to skill children with AS in an ability which is acquired naturally by other children. Attwood suggests using books like the "Mr Men" series or using mirrors to practise expressions. One suggestion made (p.26) involves the recourse to stock safety phrases or sentences which can be learned. An example: "I’m sorry, I’m not sure I know what you want me to do"?  In much the same way, yet also providing an audio input, these computer stacks are allowing for this all important drill and practice in social proprieties.

The final element of Jason’s Portfolio includes a number of stacks each of which offers Jason three alternative audio responses to a social situation. Jason reads the directions, plays the three audio responses then selects the "correct" response button. If he selects the "correct" response he is rewarded with a "wow!" An "incorrect" response is greeted with an "Uh-oh!" Facsimiles of some of these "Talk About It" stacks are at Appendix 3. There are 15 audio response stacks in all, and these are hyperlinked to Jason’s Home Stack in his electronic portfolio. The titles are as follows:

  • How to Join a Conversation
     
  • How to Say You Are Sorry
     
  • How to Give Compliments
     
  • How to be a Good Listener
     
  • When You Are Teased
     
  • Being Angry
     
  • How to Cool Off When You Are Angry
     
  • Being a Good Sport
     
  • Getting Permission
     
  • Being Afraid
     
  • Saying What You Feel
     
  • Knowing How You Feel
     
  • How to Ask Questions
     
  • Thanking People
     
  • Listening Well
     

(A number of these titles have been adapted from Wilson [1993]).

These response stacks contain a repertoire of effective oral communication skills and are designed to be revisited on numerous occasions in the hope that Jason will develop some automaticity in his responses to each situation. It is hoped that there will be some form of social spillover which he can resort to when he is faced with similar situations in his day to day life.

As an example, "How to Join a Conversation" contains the following audio text which is activated by the pressing of the tape icons:

* (adults)
"Would you like to play tennis with me this afternoon"?
"I would, but I think I’ve pulled a muscle in my …..
(child interrupting)
"Hey did you know they took out mummys guts and put stones in"?
 

* (adults)
"Would you like to play tennis with me this afternoon"?
"I would, but I think I’ve pulled a muscle in my …..
(child interrupting)
"Hey you, where’s my hockey stick"?
 

* (adults)
"Would you like to play tennis with me this afternoon"?
"I would, but I think I’ve pulled a muscle in my leg".
"Oh that’s no good".
(child)  "Excuse me mum and dad, can I come and play tennis with you this afternoon"?
 

Jason’s responses to these small interactive vignettes ranged from slightly bemused interest to outright rejection. First, it was obvious that the interface delighted him. Every button and icon was clicked and he seemed to derive a fiendish delight out of selecting the most inappropriate response and playing over and over again (in the cited case, the "mummy’s guts" interruption was favoured).

Yet he was able to identify the antithetic response very quickly, which suggests that he was aware of the intent and purpose of the exercise. To contend, disagree and challenge are often markers of intelligence and, as is often the case with children with AS, Jason exhibits these attributes in large lashings. He was able to identify all of the most incorrect responses with ease. Their appeal may lay mainly in the fact that these responses involve aggression and provocative language (for example, "Toby’s brain’s in neutral again, he’s put his bag in my spot!"), while the "correct" responses (" I get really upset when you put your bag in my spot…etc") never seem to have the same impact. Jason identifies with and is comfortable with the familiar culture of the film and video media which values the wisecrack and the smart rejoinder.

Daiute and Morse (1994) say as much in their paper which advances the premise that as educators we must listen to the voices of these popular cultures, building on the strengths of children who express themselves eloquently in their preferred multimedia patois. Rushkoff (1997) makes similar observations, warning that the old linear society is sinking into obsolescence. It could be argued that these factors are independent of and unrelated to problems associated with Asperger’s Syndrome yet, at least in Jason’s case, they form an integral part of his social education, linked as they are to a common expression of a readily identifiable lingua franca and iconography.

Perhaps the limited stimuli of these particular multimedia representations of social interactions, trimmed as they are of body language and other distracters, are more accessible and readable for children with AS.


"Emotions" cards

From quite early on in the course of the study it was clear that Jason not only had difficulty recognising the emotional states of others but also was perplexed and bewildered about his own emotions. His parents reported that he would seldom cry but did so often at inappropriate times – sometimes when it appeared reasonable that he should be feeling happy. On occasion, at appropriate times, he would burst into tears and cry inconsolably (at cemeteries) yet not be able to explain why he was crying. Jason’s parents and I developed a list of emotions and emotional situations as follows: 

  • Anger
  • Happiness
  • Sadness
  • Fear
  • Excitement
  • Loneliness
  • Togetherness
  • Winning
  • Losing

Photos were taken of Jason expressing these emotions and were digitally imported onto his Hypercards. When the cards were linked to a home card (Appendix 1) Jason was then asked to have his version of the emotion typed in a scrolling dialogue box next to the version offered by his parents and this researcher.

Jason’s version of each emotion was at best pedestrian and at worst dismissive. For example, when asked to define "Happiness" his answer was "Happiness is when we get toys or lollies". After reading our version of Happiness (Appendix 1) he added this written response, "Jason does not think happiness is doing good things for other people". When quizzed on this he replied, rather tersely, that he didn’t feel good when he did nice things for people, We assured him that most people did feel good. He replied, "That?s not me". "That’s not me" or "Not me" was a common response when visiting these cards.

One can only accept Jason’s right to deny altruistic internal attributes, or to exist in a completely egocentric world. There is no way we can experience first hand the emotions of another human being and ethically, it may not be appropriate to attempt to inculcate our sense of values into others. Jason’s honest pragmatism, his seeming inability to dissemble and his rock-like isolationism in a veritable sea of emotions may be linked to the sensory overload characteristic of many children with Asperger’s (Attwood, 1997; Carrington and Graham, 1997). Jason’s mother reports that Jason was very sensitive to noise and strong light as a small child and does not like rough fabric against his skin – socks have to be worn seam out. Jason informs us that almost all ointments "sting like acid" on his skin. To disavow emotions is perhaps one of a number of coping strategies which seals him off from this unrelenting waterfall of external input.

Attwood (1997) makes mention of one idiosyncrasy of some children with AS which may shed some light on Jason’s dismissive behaviour when exposed to the "Emotions" response Hypercards. Attwood refers to the AS "scientist" who likes to explore the emotions of others by making outrageous, often macabre statements in order to explore the reactive emotional responses of others. Perhaps Jason’s provocative dismissing of our preferred responses is in fact a challenge and an exploration in just this manner.

Jason’s other objection to our interpretations of emotions was the choice of language. He would not agree with "Happiness is feeling good all over" because, as he rightly observes, his "toenails never feel good". Undoubtedly, a far more practical approach to this problem would be to negotiate the "correct" response with the child, even though this would be a task of daunting (and time consuming) proportions.

As this study draws to a close, it seems Jason has made identifiable progress. He now looks me in the eye when he speaks to me, his conversations are generally apposite and two-way. He will sometimes relent from a favoured topic and accommodate the input of others and has been less aggressive towards his brother. This is not to suggest that Jason is undergoing a cure. What it does suggest is that the Herculean efforts of his parents and in some small way, the treatment involved in this study, has given Jason the opportunity to slowly mount in place a battery of learned responses within his cognitive scaffolding. It has been and continues to be an intellectually exhausting process for Jason.


Discussion

The acquisition of social skills, or more specifically survival skills, is of primary importance for children with AS, as the syndrome is characterised by communicative and social interactive deficits. This study has sought to equip the young subject with a repertoire of "standard" responses to a wide range of social situations. Research into these communicative/social deficits of children with Asperger’s syndrome suggests that concerted practise of appropriate social responses is an effective method for the gradual acquisition and automaticity of the desired responses (Attwood, 1997; Goble, 1995; Klin and Volkmar, 1996). Other research (see p.4) has shown that computer technology has proven to be a superior learning tool both for mainstream and learning disabled children. Researchers such as Daiute and Morse (1994) and Rieber, (1995,1996) have proposed that computers can also serve as a conduit to improving self-esteem and see many social/emotional benefits in the use of multimedia by young disadvantaged or disabled learners.

Children with AS do not appear to assimilate many of the social proprieties and functions which most of us take for granted. As one of the major aims of this study was to expose the subject to a substantial array of social situations and then drill him with appropriate responses, it was hoped that such an exposure would be facilitated best if the number of distracters present in regular social, face-to-face, communications were reduced. The medium chosen was computer multimedia. Although the programming of software is necessarily a complex and convoluted process, the interface between end-user and software does not involve the complexities of body language which so easily confuse and frustrate children (and adults) with Asperger’s syndrome. Despite this attempt at a partial affective decontextualisation, the computer programming was not devoid of cultural and social impact.

The Hyperstudio programme which was developed for this young subject reflected a wide range of social and emotional situations which, it was felt, that Jason would be exposed to in his day to day life. There was no concerted attempt made to research or inculcate a code of moral or ethical behaviour based on theologies or other cultural imperatives. Having said this, there is no real way any researcher is able to stand aloof and unaffected by his or her cultural environment and the moral precepts being encouraged in this study may be anathema to members of disparate and minority cultures.

It is important to note here that a child with AS is not the most forthcoming of informants. They do not share their inner processes candidly and prepossessingly. It is so often an exercise of emotional and intellectual swordplay when one confronts an subject with AS in an attempt to confirm or disconfirm hypotheses. Jason’s continual dismissal of the coded "correct" responses in both the "Emotions" cards and the "Talk About It" cards was a source of considerable frustration.

It would seem then that conversations with children with AS are more productive on an intellectual rather than an emotional level and the brick wall which was encountered when questioning Jason about his emotional responses was best breached when researcher and informant applied logic and pragmatics to their conversations. An instance of this process was when Jason was asked what he would do if he accidentally knocked over a child when he was running. When asked how he would feel in that situation, he was unable to respond. When asked what he would do, he was rather more forthcoming and could be guided through the stages of going to the aid of the child and proffering apologies.

Children with AS live in a solipsist universe and find great difficulty in generalising learned behaviours for particular situations to related or similar situations (Klin and Volkmar, 1996). Data gathered during the course of this study repeatedly confirms Jason’s inability to readily generalise communicative skills learned either at home, in his regular classroom with his regular teacher, or with this researcher. A case in point is Jason’s rejecting and defiant behaviour towards relieving teachers when his normal teacher is absent, despite the fact that a similar regimen is followed and the teacher has been fully briefed on Jason’s requirements. The mere (to us) fact that it is another person delivering the same message does not ride well with Jason nor do similar transpositions of both personnel and environments sit well with other individuals with AS (Carruthers and Foreman, 1989).

As Attwood (1997) observes, the changing of established routines can be a source of great distress to the child and it would appear that Jason is no exception. Nevertheless, changes are inevitable and careful preparation for change so that it does not become inimical to the well-being of the child with AS is vitally important. The social skilling involved in this programme, in some way, prepares the child for change. The audio players change but the successive messages are imbedded in the same familiar hyperbuttons in each card (see Appendix 3) and their messages are not evanescent as is human speech but fixed and exactly replicable.

The child with AS is a master of the non sequitur. What we often see as a logical or natural inference may draw a complete blank with these children . We are often unable to identify with what seem at times to be the most bizarre and dissonant examples of cognitive links which the child makes but, at the same time, the child is quite comfortable with his/her own internalised metacognitive processes. The big difference is that our cognition is based on a culturally homogenous reflective data base while the AS child’s cognitive structures are seemingly randomly eclectic and idiosyncratic.

This study also seeks to attempt to equip a young child, diagnosed with AS, with an expertise in technology . It was hoped that this newly developed skill would encourage his classroom peers to ask for advice or share experiences with him, providing an acceptable social entrée. Social acceptance is a major hurdle for the child with AS, especially when he/she is receiving so many seemingly disparate social messages which need to be sorted classified and then applied appropriately.

Despite the fact that Jason is a member of a relatively homogenous and conservative society which values altruism, caring, love, sharing, fairness, understanding and reciprocity of emotions (unless it is overly effusive), he is still barraged by paradoxes. "A good sport" is valued in this society unless he lets his team down. Aggression on the sportsfield is condoned if it is for the good of the team. Freudian anal retentiveness, queue jumping, selfishness, blinkered single-mindedness (unless for a worthy cause), stubbornness, truculence or aggression are frowned upon. Then again, those who lead are deified in one breath but defiled in the next as "big heads". No wonder the child who lacks the social "wiring" of his or her peers is confused and bewildered by the inconsistencies and manic whirl of modern Western life.

The AS child is often so confused that he/she withdraws into a protective shell. Jason often tells us he is "bored". "Bored’ covers a plethora of emotional situations. He is "bored" on a roller coaster or "bored" when he is sick or hurt and "bored" when most of us would feel angry or frustrated. Sometimes Jason is "bored" when he really is bored! On these occasions we leap to tell him that he is justified in feeling bored, that the word is a fair description of the emotion. It is through these small but positive approximations and reifications of emotions that Jason is being given the tools to tackle a complex and perplexing world. Just as in his struggle to appropriate spoken and written language, he is again faced with a gargantuan decoding task. We are able to assume the trappings of social conventions almost as if through osmosis. Societal imperatives seep into our psyches from the moment we are born. Not so for the AS child who accumulates these protocols in a feat of constant intellectual gymnasticism rather than the unconscious receptivism which others of us are lucky to be born with.

The use of technology to enhance the learning outcomes of students has proven to be successful, often liberating young writers from the stultifying shackles of physical and communicative disabilities. Multimedia has taken the process one step further in that it has been used by many to allow its users to reflect and celebrate their socio/cultural origins and predilections. Multimedia computers are not physically accessed by large numbers of these young people, but many elements which are reflected by multimedia are imbedded in the cultures of young children, including television, music videos clips, Sega, Nintendo and the like. The Hyperstudio programme which Jason worked with presented a montage of these elements and he was readily able to identify with its audiovisuality.

Perhaps the relatively new ground which this study is exploring is the use of computer multimedia to seek to modify social/emotional disorders. In one respect the computer software has been employed in this study as a drill and practice tool (rehearsal of appropriate social responses), while in another it becomes a stable and familiar port in what must be a veritable emotional storm for this particular AS child. Familiarity, stability, adherence to routine and confidence are profoundly important predicators to learning for the Asperger?s child. In Jason’s case it took some months before the novelty of the hardware and then the software were not distracting elements. Carrington and Graham, (1997) make mention of a young Asperger’s child who becomes disruptive when asked to sort, cut and paste pictures of an animals onto a worksheet. The sheer volume of sensory stimuli which include the feeling of the paper and the paste on the fingers becomes overwhelming when added to the room noise level and other distracters (p.11). Jason is also cast in this mould but manages to find something approaching solace when immured in his computer programmes.

One further element which has not been discussed here involves access to the Worldwide Web. Asperger’s children who have developed a facility with computers increasingly will be offered opportunities to either contact other children with Asperger’s syndrome or those who share their specific (and often very narrow) interests. Adolescents would perhaps most benefit from interacting with other Asperger’s youths as developing social contacts becomes increasingly more important to teenagers. Children with Asperger’s, of any age, may find internet relay chat an attractive option stripped as it is of the often dreaded complexities of physical proximity. Intimacy once removed may be the perfect training ground for the forming of more traditional friendships and even romances. This is undoubtedly an area which would benefit from further research.

There seems little doubt that the concerted enterprise which has been undertaken to equip Jason with workable social survival skills is taking effect. His parents report fewer confrontations both at home and school and he appears notably more settled and at ease. In some part, this could be due to the introduction of the computer as an instructional tool. Computing technology offers some notable advantages over other instructional tools when dealing with Asperger’s children, not the least of which, to anthropomorphise, is its "patience". The computer does not become bored with repetition. Given the same input, it will reply with the same answer. Humans are likely to respond in dissimilar ways to the same questions and individuals often reserve the right to change their minds. Computers do not rely on body language to embroider meaning nor do they dissemble, prevaricate, importune, argue or delay gratification. Nevertheless, they can be immensely frustrating, as most of us who have tackled the occasional multi-branching adventure game software can attest to.

I have noticed that Jason (and this may be idiosyncratic) does not respond to the competitive challenge in adventure games. In a flying "shoot-em-up", Jason became shaky and restive and chose to fly away from the enemy aircraft. He was content to fly over the French countryside, continually lowering and retracting his undercarriage and shooting off the last of his ammunition. When asked if he would like to land his aircraft he replied that he just wanted to fly and did so for a further 20 minutes until he accepted my offer to land his Spitfire for him.

The whole concept of verisimilitude can be a source of frustration and bewilderment for the pragmatic Asperger’s child. In Jason’s case, the sensory overload experienced in the heat of "battle" was emotionally threatening for him, yet he would often turn to me and remark that it was "only a game" as if to find reassurance.

What Jason did like doing was to bulldoze massive tracts of his Simtown environment, to create line after line of repetitive meaningless text and to constantly revisit and replay known and familiar point-and-click interfaces. It is this familiarity, predictability and reliability which is so attractive to the child with Asperger’s syndrome, something which computer technology linked with resourceful and informed software programming has every potential for making a positive contribution in the management and skilling of children with Asperger’s syndrome.


Postscript

The completion of this case study report has not meant the end of our sessions and Jason, along with his family, continues to keep in contact socially. On these occasions Jason enjoys using the computer. He senses the complete lack of formality in such situations and has explored a number of the software programmes available on my computer. I am hoping that some time in the near future I will be able to introduce him to the internet and Web-chatting as well as allowing him to explore Web pages dealing with his special interests. This may prove to be a launching pad for the establishment of a new network of friendships for Jason and allow him the opportunity to practise and consolidate skills he has already developed during these past eight months.

E-mail to Anthony R. Forder

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Software

Hypercard (Apple Corp.)

Hyperstudio (Roger Wagner, 1995)

Kidpix (Apple Corp.)

Macpaint (Apple Corp.)

Simtown (Maxis, 1995)

 

 

© l997 Anthony R. Forder

For permission to reprint or if you have questions, please send an e-mail to Anthony R. Forder:
[email protected]
 

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