Why Can’t I Keep Friends? SLU Helps Teens with Asperger Syndrome
To most SLU students, friendship comes easily. Mealtime, intramurals and weekends are fun, not stressful. But in the occupational science and occupational therapy department, SLU students are helping high schoolers for whom friendship remains a mystery. SLU's novel program for teens with Asperger syndrome teaches participants the skills to communicate and make friends, and then cements the lesson with SLU students showing them how it's done.
|Student volunteers Melissa Weinacht and Lydia Royeen|
"It's amazing how much people can change in six weeks," said Alicia Karpel, an occupational therapy Master's student and mentor for this summer's social skills program. "Teenagers who stared at the floor and wouldn't make eye contact have started making conversation.
"It opens your eyes to understanding other people in a new light."
The project began with an email. Jeanne Eichler, instructor and lead therapist in the occupational science and occupational therapy department, received a note from a high school student with an unusual request. He wanted help with ordinary social interactions - making friends, talking to girls, doing group work at school.
The Angst of High School
While feeling anxious in social settings isn't unusual for high schoolers, the teenager's diagnosis of Asperger syndrome makes navigating these everyday events difficult and prone to miscommunication and missed social cues.
"Nobody lets these kids know that everyone faces these same issues," said Eichler. "The consensus is that high school is a good time for kids with Asperger's to tackle some of these challenges. These are issues their peers are facing, too."
Eichler decided to create a teen social skills program, something the occupational science and occupational therapy department at SLU's Doisy College of Health Sciences already had in place for younger children, specifically geared toward helping teens with Asperger syndrome feel more comfortable interacting with their peers.
After sending out several emails to gauge interest, she received more than 100 responses, finding that her small inquiry had been forwarded to parents eager to find resources for their teens.
Asperger syndrome is an autism spectrum disorder often characterized by difficulty in social interactions. Because teens with Asperger's often are academically successful in school, parents report finding little help for their children, who, Eichler says, may have trouble making and keeping friends.
"These kids struggle," Eichler said. "Their teachers and peers might never know they have this diagnosis. Often they are bright, college-bound kids who struggle in their social interactions. How do you cope in a world that doesn't perceive the world the way you do?"
A New Model
Eichler, who has worked with kids with autism for 15 years, says that parents report that schools often pulled kids with Asperger's and high functioning autism out of class and put them with other children with the same diagnosis to practice social skills, with limited success.
Instead of replicating this model, Eichler set up her occupational therapy program to focus on specific tasks that are critical for success for high school age students and young adults. Less self-conscious, the teens became engaged in working to meet their goals and learned social skills along the way.
The first sessions were held last summer, and new groups met throughout the fall and spring. Activities included a photo scavenger hunt at the zoo, a visit to a pizzeria, a cooking day in SLU's nutrition and dietetics food labs, a game night and a trip to the science center.
This summer, participants broke up into several groups with particular themes, like the "Restaurant Critics Group," which is visiting different types of eating establishments, including fast food, fine dining and international cuisine.
Woven into the "field trips" are activities that encourage social interaction. For example, at the zoo, the teens were on a mission to take photos for a scavenger hunt. To complete the game, they were required to approach people they didn't know at the zoo and ask for their help with specific tasks, such as taking a picture of their group.
SLU Students Set Example
Eichler added several components to ensure the program's success and increase the likelihood that the teens would have positive social interactions.
Student volunteers from SLU's occupational and physical therapy programs participate in the activities alongside the high schoolers. Without calling attention to their role as mentors, the volunteers talk with the teens, modeling positive social behavior and demonstrating successful interactions.
One SLU student mentor and occupational therapy graduate student, Monica Jefferson, remarked on the progress she saw over a few weeks.
"It's nice to see the teens come out of their shells. Some of them didn't talk at all in the first session. Now, not only are they talking, they're laughing, getting their hands dirty and laughing together during group.
"In life, good communication, effective communication is so important. This experience has shown me the importance of social skills."
It's a lesson Jefferson will take with her when she graduates and begins work in occupational therapy.
"It's been a fantastic opportunity," said Jefferson. "I want to work in pediatrics, and this experience has given me so much insight into what it takes to plan a group therapy session. It's taught me to be flexible and go with the flow. I'm learning more about Asperger syndrome and how it affects teenage experience."
|Jeanne Eichler, occupational therapy instructor|
While the teens are busy, their parents meet separately, offering an informal support group to discuss their children's experiences as well as family and personal challenges that they have in common.
Strategies for Friendship
In addition to the activities, the teens meet with Eichler, a licensed therapist, and the student volunteers to talk about their frustrations in social settings and to learn strategies to improve interactions.
"Body language can be an enigma for someone with Asperger's," Eichler said. "For example, they may incorrectly interpret anxiety as anger. It's often something that must be learned from scratch.
"Often, these kids set very high standards for themselves and beat themselves up when they don't succeed. They are frustrated after a negative social interaction when they don't know what they did wrong or what to do to improve.
"They often ask ‘Why can't I keep friends?'"
One group talked about honesty versus diplomacy. In another session, the boys in the group asked to talk about "how to decode girls." Writing their questions on index cards, they asked one of the SLU student volunteers their questions: "How do you talk to a girl you don't know? How do you ask her to sit with you at lunch? What do you do if she says no? What do you do if she says yes?"
Organized as an occupational therapy group with interventions and follow-up and led by a licensed therapist, the cost to participate is $300 for the six-week group and $100 for an initial assessment.
After the first six-week session, one parent reported that her child had invited another teen from the group over to hang out -- a first, and a sign of friendship that is not taken for granted.
Stephanie Fay, an undergraduate occupational therapy student who is working with the social skills group this summer finds the experience inspiring.
"I've seen a lot of progress, some huge changes. The first day or two kids were shy and uncomfortable. I remember one of the boys didn't make eye contact the first day I met him and he was really quiet. Then, at a later session, he was able to initiate conversation and maintain eye contact. It was just really exciting to see the progress.
"It's an awesome experience to see everything coming together."
For more information about participating or volunteering in the program, contact 314-977-8514 or firstname.lastname@example.org.
Long a leader in educating health professionals, Saint Louis University offered its first degree in an allied health profession in 1929. Today the Doisy College of Health Sciences offers degrees in physical therapy and athletic training, clinical laboratory science, nutrition and dietetics, health informatics and information management, medical imaging and radiation therapeutics, occupational science and occupational therapy, and physician assistant education. The college's unique curriculum prepares students to work with health professionals from all disciplines to ensure the best possible patient care.