Programs Aimed at the Development of the Emotional and Social Skills of Pupils with Asperger's Syndrome

doc. PhDr. Petra Jedličková

Introduction

Each of us is a unique personality, just as every child with Asperger's syndrome is. We each have our own characteristic perception, thinking, way of expressing emotions, and our own style of forming social contacts. When something does not work out, no one harshly judges us for this emotional and social "failure." We try to learn from the mistakes that occurred and thus continue in further development. Asperger's syndrome, however, often prevents these skills from being perceived "through the eyes" of the general population. Therefore, pupils with Asperger's syndrome need to be directed in the right direction, taught to understand all the necessary expressions and social rules. We should not forget to develop necessary social, emotional, and self-care skills, correct communication abilities, and through this integrate them as much as possible into life, after which they greatly long to live. On the basis of these facts, we provide the reader with an overview of various programs that, among other things, focus on developing the social and emotional skills of exceptional people.

Programs suitable for the development of emotional and social functions of pupils with Asperger's syndrome

Treatment and Education of Autistic and Related Communication Handicapped Children – TEACCH

The method of education of children with autism and related communication disorders, based on structured teaching, was developed in 1972 by Prof. Eric Schopler in North Carolina, USA. In creating this program, he also worked with parents of children with these disadvantages, and the result of their joint work became the most widely used program in the education and schooling of people with ASD. Structuring of the program allows people with AS to know what is expected from them, how long the given activity will take, when and where it will take place, and what will follow that activity. Parents value very much that it develops communication, improves behavior, and prevents their child's problem behavior (Dvorská, 2010; Mesibov, Shea, 2010; Thorová, 2016; Žovinec et al., 2019).

The basis of the TEACCH program is respect for three rules: visualization, structuring, and individualization. The rule of visualization consists of visual support for the pupil, which at the same time helps with better imagination, as a child with AS has deficits in abstract perception and thinking. We therefore visualize the daily routine for the pupil, which allows a higher degree of independence, improves orientation in time, and differentiation of individual activities. We can achieve visual support by using pictures, symbols, objects, pictograms, photos, drawings, diaries, or by creating a "daily plan," or schedule. These mentioned daily plans usually contain the pupil's name with his or her symbol/photo, pictures of the day's routine, and are usually placed horizontally or vertically so that the pupil with AS has easy and independent access to them (Jedličková 2019, in Žovinec et al., 2019; Thorová, 2016).

Structuring, also referred to as physical structure, brings into the education of pupils with ASD precise rules for organizing education, environment, and the child's working activities. Such rules help the pupil remove uncertainty, fear, and confusion, and create a sense of safety, certainty, and acceptance of demands or tasks (Jedličková 2019, in Žovinec 2019; Thorová, 2016).

As for the rule of individualization, we must treat each student with AS as a unique and individual being. It is necessary to know the personality of each individual with AS well enough, the manifestations of his or her disadvantage, the level of each developmental area, situations that are unpleasant to them, and situations that may trigger displays of problem behavior. This knowledge helps us evaluate the pupil individually, prepare a suitable individualized education plan for them, and also choose suitable educational strategies, activities, or an appropriate type of communication strategy (Dvorská, 2010; Mesibov, Shea, 2010; Jedličková, 2019, in Žovinec et al., 2019).

Applied Behavioral Analysis

Applied behavior analysis, abbreviated ABA, is a scientific approach focused on improving and correcting different kinds of behavior, not only in pupils with problematic behavior but also in pupils with ASD. In addition to eliminating undesirable behavior, replacing it with behavior more socially acceptable, it also develops social, communication and self-care skills, or improves the overall adaptability of children with disabilities (Cigánková, 2016; Prokopová and Bartoňová, 2021; Thorová, 2016; Žovinec et al., 2019). The core principles of this approach were first laid down by B. F. Skinner together with other professionals in the field of behavior disorders. However, O. I. Lovaas first applied it in the 1960s at the Neuropsychological Institute of the University of California in LA. Since those times, ABA has been considered a very effective and widely used approach in the education of students with autism spectrum disorder and other disorders as well. One of its advantages is that it is measurable and focused on the individual needs of each child, reinforcing behavior while avoiding punishment and supporting through positive rewards (Cigánková, 2016; Maštenová, 2016; Thorová, 2016; Žovinec et al., 2019).

ABA is considered an approach that is structured, systematic, and focused on uncovering functional relationships between events. Therapists work in different areas divided into partial steps. This means that the therapist or instructor will present a pupil with AS with a so-called discriminative stimulus (Sd), when they give the child an instruction and wait for the child's subsequent reaction. Sd can take the form of a gesture, facial expression, or some verbal utterance. If the pupil with AS reacts correctly to that stimulus, a positive reward is offered, such as praise, but if not, they need to be guided. Then we use negative reinforcement, which lies in the immediate removal of an unpleasant impulse after the desired response (Maštenová, 2016; Thorová, 2016; Žovinec et al., 2019).

Z. Maštenová (2016) reminds us that we must not forget thorough knowledge of the child's personality and symptoms, because only then is it possible to set appropriate expectations and fully break down the steps that lead to improvement of the AS pupil's skills (Maštenová 2016, in Prokopová and Bartoňová, 2021).

STAMP

The Stress and Anger Management Program (STAMP), which we translate into our language as Program zvládania stresu a hnevu, was created by three recognized clinical psychologists – A. Scarpa, A. Wells, and T. Attwood. The dominant strategy of STAMP is emotional education and cognitive restructuring of children with AS and high-functioning autism aged five to seven. In connection with this age, the most common components of program group sessions are activities such as various games, singing, stories, etc. An important detail is that in addition to children, their parents are also involved in STAMP, to whom it is explained through a therapist (but not their own child's therapist) how to behave, what to do, and how to proceed with completing weekly home assignments (Scarpa, Wells, Attwood, 2019).

STAMP is implemented over nine weeks, during which shared sessions are held once a week, lasting about 60 minutes. The task of the first sessions is to get acquainted with different emotions. It is appropriate to start with positive emotions to achieve a pleasant atmosphere, later moving naturally to negative ones. In subsequent sessions, therapists focus on relaxation techniques and social thinking. The penultimate and final sessions are devoted to a summary of acquired knowledge, which children usually interpret with therapists with the help of dramatization of a group story or creating a poster or advertisement. They often record the stories, and in the last session this video is given to them as a keepsake and a tool for the future. Through it, they can later recall the acquired skills (Scarpa, Wells, Attwood, 2019).

These sessions have an identical structure consisting of calming the children, welcome, singing, discussion/story, some activity. The children then have a snack, they stick on stickers, therapists assign homework, and after saying goodbye they go home. This structure is displayed in a visible place for children with AS (Scarpa, Wells, Attwood, 2019).

As for homework, children complete it in cooperation with their parents. These are usually projects, such as cutting out emotion pictures and possibly assembling them into a glossary (Scarpa, Wells, Attwood, 2019).

From the therapist's side, there is a need for thorough knowledge of program participants and planning each session. This is divided into three phases, where the therapist sets the duration of each activity, lists materials, and plans activities. Lessons and materials, as well as recommendations, are very well prepared in the manual from the program creators titled "Dítě s autismem a emoce" (Scarpa, Wells, Attwood, 2019).

Zippy's Friends

A similar program to the previous one is Zippyho kamaráti, created by the British organization Partnership for Children. In Slovakia it has been implemented since 2013, and outside our country it is used in another thirty countries. Its primary task is the development of both social and emotional skills in children aged 5 to 7 years. It primarily focuses on developing communication and empathy, processing emotions, forming and strengthening friendships, coping with conflicts, and stressful situations (Bražinová, 2019; http://zippyhokamarati.sk/).

It is implemented year-round through playful and age-appropriate activities. It is appropriate to use mainly in school settings under the guidance of a special pedagogue, school psychologist, or another pedagogical employee who takes on the role of a mediator enabling a pupil with Asperger's syndrome to find their own solution to the given situation. The only condition for carrying out the program is that the pedagogue undergoes one-day training with a subsequent certificate (Bražinová, 2019).

The core of the program consists of six "modules." These are then arranged into 24 playful and interactive lessons. This means each module contains 4 lessons. Themes of the presented modules are:

Feelings (sadness-happiness, anger-disgust, nervousness and jealousy)
Communication (improving, listening, seeking help, expressing)
Making and losing friendship (maintaining friendships, coping with loneliness or rejection, resolving friendship disputes, making friends)
Conflict resolution (bullying, conflict resolution, recognizing appropriate solutions, helping others in conflicts)
Coping with loss and change (changes and losses as part of life, coping with death accompanied by a visit to the cemetery, learning from change and loss)
We cope (ways of coping with various problems, helping others, adapting to new situations, shared celebration – awarding diplomas and a summary of acquired knowledge) (Bražinová, 2019; Bražinová, Polťáková, 2020).

Within these lessons, children learn to talk about things that cause them problems, they conduct different kinds of discussions, and, of course, help and support each other. As in the STAMP program, the child always receives some homework, which is completed with parents or someone close, so that the child's family is informed about the curriculum covered in the program and can therefore reinforce acquired skills at home and in the wider environment (Bražinová, 2019).

Second Step

Another option for developing social and emotional skills is the program Second Step, originally titled Druhý krok. Its origin in 1986 is credited to researchers from the international organization Committee for Children, who developed this program for children from preschool age through the end of school attendance (Paľová, Piľková, 2018; https://paneuroszs.sk/web/app/uploads/2017/05/Druh%C3%BD-krok-PDF.pdf ).

The goal of this program is, as with the others, elimination of aggression, acquisition of problem-solving tactics, improvement in social competencies, and understanding of one's own emotions and others' feelings. These are then divided into three blocks: practicing empathy, emotion steering, and solving problems in interpersonal relationships. Their fulfillment is usually carried out through dramatization of a problem story, where practice always focuses on only one social skill (Paľová, Piľková, 2018).

JASPER – Targeted Treatment on Joint Attention, Symbolic Play and Engagement Regulation for Children with Autism

The very name of this program itself carries the core of the intervention provided to children with autism and of course also Asperger's syndrome. Its essence is therefore supporting social communication, attention focusing ability, symbolic play, and support for engagement and regulation (Kasari et al., 2022).

At the origin of the JASPER approach stands Dr. C. Kasari, who built this targeted modular intervention on a natural developmental-behavioral approach (NDBIS). JASPER is intended for children from one to eight years old, but it can also be used with older children, as certain sessions always differ depending on the abilities and age of the child. This approach allows the individual to experience natural unexpected events in an environment appropriate to their developmental stage of learning (Kasari et al., 2022; Vivanti, 2022; https://www.jaspertraining.org/about; https://acva.sk/intervencie/ ).

Children with Asperger's syndrome or another autism spectrum disorder in short sessions through shared attention, engagement and play with various toys learn to improve relationships with their surroundings and improve interaction with various objects. Therefore, the goal of each meeting is to intensify flexibility, variety, interaction time with a social partner, complexity of initiated play abilities, and the tendency toward spontaneous communication. All meetings most commonly take place through play and play activities with various toys, etc. It is also necessary to note, however, that before each intervention, it is necessary for a child with ASD/AS to be assessed by a specialist who evaluates the child's level of play and communication abilities. The specialist then creates goals appropriate to their development and abilities. They also select motivating toys for the child with which those meetings will take place (Kasari et al., 2022; https://acva.sk/intervencie/ ).

Developmental, Individual-Difference, Relationship-Based model – DIR / Floortime model

The penultimate program presented for developing emotional and social skills is the DIR program using the Floortime model of relationship therapy, whose goal is to create healthy foundations for intellectual, emotional, and social skills, and also to achieve healthy development of an individual with AS. Its authors are recognized American experts Stanley J. Greenspan and Serena Wieder. As a result, this program is used most mainly in the USA. In addition to the emotional and relational level, it contributes to development in other areas as well, such as cognition, motor skills, communication and sensory processing (Jedličková, 2019, in Žovinec et al. 2019; https://raisingchildren.net.au/autism/therapies-guide/dir-floortime-model).

The DIR abbreviation contains three main models:

D – developmental: development of all stated abilities. A child with ASD is to learn the rules of social and social behavior, communicate, while being able to use nonverbal communication elements appropriately. To regulate their behavior, improve self-care activities, independence, but also to think logically, solve problems, and more.
I – individual differences: Here it is necessary not to forget the uniqueness of each child. Each one expresses their feelings differently, receives stimuli differently, or works with their thoughts differently. Therefore, during intervention it is necessary to take into account the individuality of children and choose correct development and education strategies.
R – relationship-based: considering the relational level and creating new interpersonal relationships. This means the child must be able to work at and maintain relationships not only with parents but also with other people in their environment such as educators, caregivers, peers, etc. (Jedličková, 2019, in Žovinec et al., 2019; Greenspan, Wieder, 2008).

As for the Floortime approach incorporated into the DIR program, it is a form of relational therapy for children with ASD, in which parents and, in some cases, other therapy participants (therapists, special educators) lower themselves to the child's level, referred to as the floor, and thus carry out all play activities with the child. They need to actively engage in play, participate in all planned activities, and proceed according to the child's rules. The goal is to contribute through this influence to the development of mental, cognitive and emotional growth of children with ASD/AS so that they are not what their diagnosis is, but who they are (https://www.autismspeaks.org/floortime-0).

Finally, we should also note what we consider a significant advantage of the DIR/Floortime program, namely that it is possible to implement it not only in a "therapeutic" but also in school or home settings.

Promoting Alternative Thinking Strategies – PATHS

We classify the PATHS program also among programs developing emotional and social skills, whose implementation is led by a teacher. It focuses primarily on developing self-confidence, self-confidence, self-esteem, praise, as well as guiding pupils toward responsibility and understanding other people's behavior. It also strengthens understanding and verbal expression of one's own emotions. All of these skills are included in four areas of the study plan (Willingness and Self-Control; Feelings and Relationships; Problem Solving; Supplemental lessons), which, in addition to methodology, is an important part of PATHS (Hutyrová et al., 2019).

The program was initially developed for pupils with hearing impairment. Later, the focus shifted primarily to students with hyperactivity and attention disorders. However, we can say that due to its versatility this program can be applied to all children, including pupils with Asperger's syndrome (Hutyrová et al., 2019).

Conclusion

It is important not to forget that people with Asperger's syndrome also want to live a unique life to the greatest possible extent similar to ours. They can achieve this only by understanding the rules of social behavior, other people, and also all the pitfalls this world brings. The aim of the contribution was to point to the broad range of programs that allow pupils with Asperger's syndrome to fully develop their emotional and social skills, and thus comprehensively develop their exceptional potential.

Autorky: doc. PhDr. Petra Jedličková, PhD. Katedra pedagogiky PF UKF Mgr. Mária Hrenáková Katedra pedagogiky PF UKF

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Programs Aimed at the Development of the Emotional and Social Skills of Pupils with Asperger's Syndrome

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