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Asperger’s Syndrome and Paranoia
In children with Asperger's, paranoia--or misreading the motives of others--is an aspect that can be disheartening to patients and to the parents of children with the syndrome. Paranoia can further isolate other children, strain any current “friendships," and, in some cases, it can lead to verbal outbursts or physical violence. When a child with Asperger’s becomes paranoid, he fails to make a distinction between accidental and deliberate acts. They have trouble conceptualizing the beliefs, thoughts, feelings, and knowledge of others.
Unlike other children who know when they are being teased with friendly or unfriendly intentions, a child with Asperger’s does not have the same knowledge available to him. Fortunately, there are several ways to help develop cognitive abilities and create experiences that will help ease paranoia. These include friendship role playing and social stories™.
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Friendship Role Playing
Children with Asperger’s cannot rely on intuitive abilities in social settings. They must rely on cognitive abilities and experiences. These children can benefit greatly from role playing under the direction of their parents. The parent can facilitate social play at home with siblings or other children who have been invited over for a play date. The parent should encourage basic sharing, helping, and comforting one another.
Parents can also practice one on one with the child by using child speak, meaning typical utterances of children of the same age. The parent must be equal and reciprocal in terms of cooperation, ability, and interests. The parent must demonstrate specific social cues and stop here and there to encourage the child to see or listen to the cue. The parent should explain what the cue means and how the child is expected to respond.
Once the parent feels that the child is making great progress, a “dress rehearsal" with another child might help the child progress even more. The other child, maybe an older sibling, can act as a friend in order to provide additional guided practice before the skills are used in a setting with peers.
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Another method of learning relevant social cues, thoughts, and behavioral script is called “Social Stories™." The strategy was developed in 1991 by Carol Gray, Director of The Gray Center for Social Learning and Understanding in Grand Rapids, Michigan. A social story describes a situation, concept, or skill in terms of relevant social cues, common responses, and perspectives in a specifically defined style and format. The goal is to share accurate emotional and social information in a reassuring and informative manner that is easily understood by the child with Asperger’s paranoia symptoms. Each story discusses a social situation and explains why the children in the story behave the way they do. A hug, for example, is described as something children use to comfort one another when sad or upset about something. The story makes it clear that the hug isn’t meant to be offensive or condescending, but rather helpful.
Social stories™ and friendship role playing can be effective if done at home, but research suggests that these strategies may prove to be even more effective if carried out in a classroom environment.
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The Complete Guide to Asperger's Syndrome, Tony Attwood, Jessica Kingsley Publishers, London and Philadelphia
Mayo Foundation for Medical Education and Research (MFMER), at http://www.mayoclinic.com/health/aspergers-syndrome/DS00551
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