Aspergers is Not the Same as ODD (Oppositional Defiant Disorder)!

People with Asperger’s usually collect labels like ADHD, anxiety disorders, or bipolar disorder before they’re diagnosed with AS. The label that annoys me is Oppositional Defiant Disorder. Is there a difference between people whose Asperger’s-related behavior is misunderstood and ODD? I find that ODD is sometimes simply a description of behavior without a cause.

Insurers ask for diagnoses based on ICD 10, the “handbook” of diagnoses. One of the official ICD 10 descriptions of AS is that it’s a “neuropsychiatric disorder whose major manifestations is an inability to interact socially; other features include poor verbal and motor skills, single mindedness, and social withdrawal.”

ICD 10 describes ODD as a behavior disorder and a psychopathological disorder. It’s described as a “recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures.”  The criteria include “frequent occurrence of at least four of the following behaviors: losing temper, arguing with adults, actively defying or refusing to comply with requests or rules of adults, deliberately annoying others, blaming others for own mistakes, and being easily annoyed, angry or resentful.”

ICD 10 is right in my experience in describing those with Asperger’s Syndrome as “single minded.” This is a real strength when doing tasks, following rules and being honest. However, single mindedness can also include inflexibility or even severe rigidity in sticking to a point of view.

Treatment for Sensory Processing Disorder

Sensory processing disorder (SPD) can make participation in life activities—what occupational therapists refer to as occupations—very difficult. Luckily, there are options and strategies to help improve sensory processing and make life much smoother and more enjoyable.

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Sensory-based occupational therapy (OT), may look like play to adults, but to the child it is their work and necessary for improving overall abilities to process sensory information more appropriately. Jumping, swinging, climbing and playing in multisensory mediums—such as shaving cream, beans, rice, or play dough—all have a place in their growth and the development of sensory processing abilities.

Components of a Behavior Intervention Plan

The complexities of High-Functioning Autism or Aspergers Syndrome may present themselves in behaviors that may be either excessive for specific situations or lacking.

Strategies developed to target such behaviors are often included in packages known as behavior intervention plans (BIP), behavior support plans (BSP), behavior management plans (BMP), positive behavior support plans (PBSP), and several others.

The primary purpose of a behavior plan is to outline and describe strategies that prevent problem behaviors, teach new behaviors that replace problematic behaviors and

Social (Pragmatic) Communication Disorder

In addition to the changes related to individuals with Aspergers and HFA, the DSM-V introduced a new condition in the diagnostic category of communication disorders: Social (Pragmatic) Communication Disorder (SCD). SCD is marked by difficulties with pragmatics—aka practical everyday use—or the social use of language and communication. Therefore, SCD is concerned with an individual’s use of verbal and nonverbal social communication in everyday life.

The condition is of particular interest to individuals with Aspergers or HFA because, in the DSM-V, it specifically states that individuals who have marked deficits in social communication but whose symptoms do not otherwise meet the criteria for autism spectrum disorder (ASD) should be evaluated for social (pragmatic) communication disorder.

Finding the Functions of Behavior in ASD Children

When a child with Aspergers or High-Functioning Autism demonstrates challenging behaviors, we tend to blame the child’s autism. However, these challenging behaviors are not a byproduct of autism, rather learned due to ineffective means to get needs met—especially when there are barriers to communication.

functions of behavior

Bottom line: if an individual does not have a way to communicate appropriately, he or she will find a way to communicate in another way (e.g. screaming or hitting).

Keeping in mind the ABCs of behavior from our previous post, let’s discuss the key to changing behavior.

Punishment in ABA for Individuals with ASD

While the word “punish” often conjures up bad thoughts for parents and professionals, punishment and reinforcement are key when looking at behavior change through ABA. Punishment in ABA decreases the chances that a particular behavior will occur again, as opposed to reinforcement which increases the likelihood of behavior.

punishment

Let’s look at the behavior analytic definitions of punishment specifically:

Positive Punisher

  • Positive punishers may occur naturally in one’s environment. A child pets a strange dog and gets bit on the finger causing pain. After this occurs, the child does not pet strange dogs. That is considered a positive punisher because the bite/pain (presented stimulus) decreased petting strange dogs (outcome).
  • A parent can use positive punishment as well: siblings are fighting; mom yells “stop it right now!” and the kid’s reaction is to end the fighting. Mom provides the stimulus of yelling, which decreases future occurrence of fighting.

Negative Punisher

  • A negative punisher would be when the removal of a toy ends the fighting between two children. This removal decreases chance of it happening in future.
  • “Time out” is also considered a negative punishment. When used correctly, it removes all reinforcement from the immediate environment resulting in a decrease in future occurrence of the punished behavior.

Introduction to Aspergers and High-Functioning Autism

Autism is described as occurring on a spectrum because the symptoms can vary from a complete lack of communication with others to difficulty understanding others’ feelings. This range of symptoms is why the  diagnostic term is referred to as Autism Spectrum Disorder.

Spectrum, Autism, Aspergers

Aspergers Syndrome, sometimes also called High-Functioning Autism, falls under the category of Autism Spectrum Disorder. (And yes, this remains the case, no matter what you may have heard about the newly-published DSM-V. But, the DSM-V is the subject of another blog). Aspergers Syndrome is viewed as being on the “mild” end of the spectrum because its symptoms differ in degree and severity from other forms of autism.

DIR/Floortime Method for Social-Emotional Growth of Children with ASD

Although our emphasis is often focused on early intervention, it is important to consider various types of interventions that can grow with the child with Aspergers or HFA as they grow into adolescence, another area of huge potential growth. One approach that has demonstrated clinical impact is DIR/Floortime. This method is a relationship-based, developmental framework that is geared toward supporting foundational social-emotional capacities.

The DIR Model, or Floortime, aims to support higher level thinking abilities of multicausal and reflective thinking by building foundational stability in self-regulation and co-regulation with another. DIR/Floortime incorporates techniques and strategies geared toward promotion of more stable and more flexible emotional regulation in the child or adolescent.

Challenging Behaviors and Appropriate Skills in ABA Explained

As I mentioned in my previous blog, there are thousands of published research studies to support the effectiveness of ABA in treating autism and Aspergers. Specifically, ABA seeks to decrease challenging behaviors and increase appropriate skills that are seen in many individuals with autism or Aspergers.

Challenging Behaviors and Appropriate Skills in ABA

To help understand what your ABA therapist seeks to accomplish, let’s cover what these terms mean: