Expert: Dr. Sharon A. Mitchell - 7/3/2011

Question
QUESTION: I would like information or direction on how to to communicate with adults who have Aspergers.

I am hosting a male college student from Japan, age 21, who I believe has aspergers. He has lived with us for 6 months and avoids all interaction with the family, can not communicate with us. For example, when asked a question at the family dinner table(he eats in less than 10 minutes and then leaves the table), he closes his eyes, puts food in his mouth or drinks, then tries to say something which of course we can not understand. When told to wait and finish his food or put the glass down, he just closes his eyes and smiles, may be mumbles but never answers the question. I have inquired if his knows of asperbers disorder and he says yes. He will not comment further. He will never engage in conversation or activity with us.

He enjoys self teaching of the piano, and is very good. He enjoys gardening, and the study of Chemistry. He can speak Engliish. He leaves the home when ever we entertain, and goes for day trips on his bike but wil not mention where or anything else about what he does. he will not answer questions about how his day is or what he did. just says "normal day".

He is nice but is always by himself in his room. When asked to assit with something he says ok, but does carry out the action. He is clean but does not clean up after himself completely. He has never taken the opportunities to go anywhere with us, or socialize with anyone. He goes to college daily and otherwise stays to himself in his room, but does leave his bedroom door open sometimes. He enjoys our cat and dog.

How can my family help him, communicate with him and get him to give feedback, and establish a relationship with him. I have researched aspergers behaviors but have not found any information on how to draw him out, bring ourselves in to his world, or interact other than talking about chemistry or gardening.

In Japan, he says he has 2 friends, enjoys gardening with his parents when not in school, and never goes anywhere socially.
He knows he social interation issues and agrees he is uncomfortable in social gatherings or crowds. how can we help him and to connect with our family?

ANSWER: For a young man with Asperger's or at with the social characteristics you describe, coming on an exchange trip was very courageous. He's lucky to have landed with such an understanding host family.

My one son did a year's exchange at a university in Japan and is currently in South Korea doing the same thing. He does not have an ASD (autism spectrum disorder) but still talks about the cultural onslaught, the fatigue of constantly operating in another language and with different food and customs. This is quite a task your exchange student has undertaken.

Most people with ASDs (and Asperger's falls under this umbrella term) work very hard to manage things when in public. The effort they put forth is often far greater than any of us would expend in a day. Seeking refuge alone, such as in a bedroom, playing the piano, gardening or other activity that gives them peace would be relief. Solitary activities do not place socializing demands on a person who finds being with others difficult.

It might help if you think of autism or Asperger's as a processing disorder where it's hard for the person to handle more than one incoming piece of sensory information at a time. It might be hard for the person to both look at you and listen to your words at the same time. It might be hard for him to both eat and talk/listen at the same time.

Or, putting food into his mouth when you ask him a question at dinner may be a coping strategy he's learned. If his mouth is full that gives him a few more seconds to try to process what you just said before coming up with an answer. Speaking with him mouth full may have made people in the past give up trying to talk with him.

One characteristic of people with ASDs is a preoccupation with what interests them. Your student seems to have an interest in gardening, a soothing activity. If you are interested in developing a relationship with him, this might be a place to start. Be near him when he gardens. At first, don't worry about forcing him to talk. You could work alongside him in quiet companionship; this would put him at ease and not make him feel that your presence demands he strive to be social. If you talk, make short comments about the work at hand without demanding much from him, other than to pass you the trowel, or if he thinks that plant looks all right there or if this branch needs pruning. Just being with him, even without conversation will be enough for him to get used to. Gradually, over time, increase your verbalizations, but never too much and not demanding too much of him. Show that you enjoy being with him and enjoy and appreciate the work he's doing.

Often the questions we ask people are open-ended, designed to allow the person a conversational opener. That is likely what you are doing when you ask about his day at school. For a person with weak conversational skills such questions are hard to answer. "How was your day?" "Fine." There. He's correctly answered your question. In your mind, you might have expected him to elaborate but from his point of view, he answered the question you asked.

Another of his interests is chemistry. If the occasion arises, you could ask him to explain some chemistry concept. Say a cooking recipe called for sour milk but you have none. You remember reading somewhere that pouring vinegar into milk would make it acceptable to use in such recipes. Could you ask him to explain how this could be? He'll be more comfortable talking to you if the subject is in his area of interest.

Auditory processing is a common weakness in ASD people. Even though your student might have perfect hearing, his problem will be in making sense of the words that he hears. His processing speed might be slow. When you ask him a question, wait. Just wait. You may need to wait up to ten seconds for him to respond. During the wait, don't repeat or rephrase your question. Just wait until he has time to process what you said then formulate his answer. For many of us, this wait time is uncomfortable but it may well be worth the wait as you hear the interesting things your student has to say.

Given the social difficulties of most people with ASDs I can see why your student would leave when you have company. His intention will not be to be rude but to avoid a situation that's hard for him. Think of someone shy going to a cocktail party; it could be agony. Think about you going to Japan and managing to be with a couple people you had gotten to know. Then another group drops by and the language and processing demands shoot way up. There are cross conversations, noise, laughter and people moving about. Someone with ASD would not know where to stand, what might be expected of him. If he has sensory sensitivities (as do most people with ASDs) then he might be leery of being touched if someone brushes by. The level of noise might rise to uncomfortable levels for him.

In your reading on autism and Asperger's, have you come across the term "theory of mind"? It's hard for a person on the autism spectrum to guess what is in other people's minds. And at the same time, he will likely assume that whatever is in his mind is also in yours. So, if he takes off on his bike, he knows where he is and that he is safe. It would likely not occur to him that you do not share that same information. You may need to be explicit in the rules you lay out - if he is leaving the house for more than an hour he must tell one of you (or write it down in a specific place) where he's going and an estimate of when he thinks he'll return.

Does this give you a place to start? Again, he's a very lucky young man to have landed with a family like yours.

Best wishes to all of you,

Dr. Sharon A. Mitchell


---------- FOLLOW-UP ----------

QUESTION: Thank you so much for your insights. They were helpful.  I wonder if his parents sent him to the USA to "have to" develope some level of social skills/life skills as I do not see why he did not stay in Japan for his education. (He was here a couple of years ago for 9 months to learn English but it did not go very well academically.) His father owns a company of some sort, involving labs and chemistry,  and it is intended he will work there one day.  Do you know if ADS is recognized in Japan? I know they are slow to acknowledge and treat mental health issues.

I wonder if people with such ADS welcome information about the disorder. He has replied he knows his has social relations issues. I feel like I want to give him information to research ( he is always on his computer) so that he can "help himself" and "try" to practice with our family. I have seen some wonderful home videos of yourng people with this disorder and seems that it brings them peace to know they are a disorder and it is not that they are "strange" etc. Just different and what those differences are.

 Thank you for your kind words of his staying with us. I am the Director of the homestay program, and we have had a few foster children, with various mental health issues,  in a behavioral modification program stay with us. I think a greater good intended him to be with us (we knew nothing of his personality before he arrived).

1. Do yout think I should ask him  if he has ever received any help for his social problems?
2. Can you direct me to some sites that may be beneficial for him to review?
3. How to help someone with ADS develop empathy for others? etc.

Answer
Through my son's experiences in Japan and Korea, I've learned that proficiency in English is greatly prized. Many Asian universities actively seek exchange partnerships with North American universities to share knowledge and gain experience in Western culture. Since your student's father owns a chemical company, I can see why they would see this as a valuable opportunity for their son and a potential asset to their firm.

Even in North America, it wasn't until the mid-to-late 90s that people were being diagnosed with Asperger's. The syndrome was first described in the 1940s by an Austrian psychologist, Hans Asperger. But in the 40s the world was concerned with far weightier matters and little attention was paid to Asperger's work when he described a subset of autistic youth who were highly verbal and intelligent.

In the late 80s a grad student named Lorna Wing sought a research topic and brought Asperger's work to our attention. This recognition came in England, Australia, Canada and the US then later in other countries. So, given the fact that your student is 21 I doubt that he received much in the way of services as a child and may not have had a formal diagnosis until nearing adulthood.

Some families, while they recognize that there is something different about their child, may focus on the fact that he's bright and does well academically. There are even some professions where the lack of social skills are more easily overlooked. Perhaps that is the sort of career this young man will seek, working independently in a lab where he can be highly focused and absorbed in his work, with minimal interaction with others.

I agree with you. With knowledge comes power. I've often been asked to explain to a young person that he/she has Asperger's. Never once has the child been upset. They say things like, "I've always known I was different. Now I have a name for it and know that there are others like me."

We all have patterns of strengths and weaknesses. If you know what these weaknesses are you can start to build skills in that area or strategies to work around them. Without the awareness, though, it's harder to find your way.

There are any number of excellent books that might help this young man. My preference is books written by articulate adults who have an ASD, rather than books written by professionals about ASD.

Luke Jackson is a young man with Asperger's. He wrote this book when he was 13. It's a good starting point, as long as your student is not put off by the title. (Given the fact that English is his second language, he may not pick up on the nuances.) Take a look at it here: http://tinyurl.com/3njcy9e.

Both Jerry Newport and his wife Mary have Asperger's. Jerry wrote a good book called Your Life is Not a Label: http://tinyurl.com/3m7urj5.

It wasn't until he was an adult that John Carley was diagnosed with Asperger's. Take a look at his book here:  http://tinyurl.com/3k6334a.

When you start researching autism and Asperger's on the internet you get credible websites and some not backed by research. Many offer opinions, which comes with pluses and negatives. Much of what you read will be by/for parents seeking help for their young children. Others have one method to sell and will try to convince you that nothing else will help. Many sites leave you feeling depressed.

I prefer ones that describe this as a difference rather than a disability. Here are some thoughts by John Elder Robinson, an adult with Asperger's: http://www.wrongplanet.net/article401.html.

Temple Grandin is probably the most famous adult with autism. Here is just one of her books: http://tinyurl.com/3q468q8. Last year HBO made a movie of her life: http://tinyurl.com/3l6nple.

I'm not sure how he'll take it if you ask if he's received help for his social problems. Could you instead ask for ways you could help? What makes him feel more comfortable?

There is one final book I'd recommend. It's thicker, which may put some people off, but it's frank and very helpful and written by two adults who have autism, called "The Unwritten Rules of Social Relationships: Decoding Social Mysteries Through the Unique Perspectives of Autism" (http://tinyurl.com/3qfzusp).

Dr. Sharon A. Mitchell