DrCameronJackson@gmail.com
The Friends Program, located in Palo Alto, California, is a therapeutic group designed to address the developing needs of young children with Asperger’s Syndrome and their families.
Laurie Levanthal-Belfer, Ph.D. is the Director of The Friends Program and can be reached at Dr.LaurieLB@gmail.com and on the web at www.thefriendsprogram.com
Dr. Levanthal -Belfer was the speaker for Asperger’s Disorder: A Developmental Approach to Understanding Asperger’s Disorder, Assessment and Intervention held in Aptos, CA on 2-26-2011. This was a conference attended by psychologists, nurses, marriage and family counselors and interested public.
What did attendees learn? Some notes:
Asperger’s Disorder became diagnosis in 1994 and will not be a separate diagnosis in the next DSM-V expected out in a year or so. Asperger’s Disorder will be eliminated. Instead there will be Autistic Spectrum Disorder.
What I learned looking at my notes: Asperger’s Disorder children at age 4 or 5 play more like a child of 2 or 3. They have intense interests which may change but the intensity of the interest is notable. Transitions are difficult for them. They have one way to go to school and if a parent or other person deviates that will spark a melt down. They cannot take the perspective of the other. The therapy groups work a lot on white lies and how to tell them. Children with Asperger’s Disorder are “black-white” children that think there is only one way to do things.
Parents cannot ask children with Asperger’s Disorder, “What did you do today?” Think of Asperger’s Disorder children like a computer with files. You have to find the right file and open it. Likewise, a parent has to inquire, when you were on the playground during recess what game did you play? That kind of specific questioning — akin to opening a specific file — helps a child to know how to answer a question.
It’s important that parents “cut the white space” — the unstructured time. When children with Asperger’s Disorder know exactly what to do they talk less about their current intense interest. Many children with Asperger’s Disorder have sensory regulatory issues which Dr. Leventhal-Belfer thinks are related to anxiety. Asperger children can be so loud themselves and yet over sensitive to noise. Usually when doing an intake some family members are identified as having Asperger symptoms.
Dr. Laurie Levanthal-Belfer likes the Robert’s test for assessment. The Robert’s test is a projective test that shows social situations. She uses kinetic family drawings to see how family members relate to each other. Often one parent has traits highly similar to the child with Asperger’s Disorder. Dr. Levanthal-Belfer has found that the same strategies that work with children also work with the spouses that have Asperger’s Disorder traits.
Concerning assessment: Dr. Levanthal-Belfer asks for home videos, does school observations, takes a developmental history and does a parent interview. She will use the Wechsler IQ tests for assessing cognitive abilities. She assesses how the parent and child interact by having them build a house out of blocks, do clean up, do a learning task (puzzle, read a book, teach the child how to be President). She wants to see how the parent leads the child and vice versa.
Of note for therapists: Dr. Levanthal-Belfer said that insurance pays for treatment but not for diagnosis. She asks, but how do you do appropriate treatment without accurate diagnosis? Linda Lotspeich, M.D. suggests that therapists give 3 different diagnosis depending on the audience.
She tells graduate students to first rule out Autism before considering Asperger’s Disorder.
California schools take the position that if the child can do age appropriate work then they will not offer an IEP.
The key part to The Friends Program is the parent component. And generalization is key. written by Cameron S. Jackson DrCameronJackson@gmail.com
