Expert: Catherine Ridenour - 3/20/2006

Question
Thanks Catherine for responding.
    The man was diagnosed with A.S. when he was a child.  We live in Western PA.  He went through High School and graduated and had some job counseling but cannot keep a job because of his reaction to people's expectations.  He just gets mad and they fire him for inappropriate behavior.  I asked his mother about getting a job counselor as he had many years ago who supervised his work and was a go between between himself and his employer.  His mother said because of budget cuts he probably won't receive any more help like that.  He lasted a couple of years at a laundry at a nursing home but was fired for using his cell phone at work when his boss told him to put it away and he would not.
   Since then he has worked detailing cars but meets not very nice people there who use and abuse him.
    He had a girlfriend who took all his money and got him to sign loans for her new car.  Now his credit is shot and he is broke.
   His parents tell me that over the years the county has diagnosed him and given him all kinds of medicine.  He definitely is a.s. and takes some medicine to keep his aggression under control.
   He seems to think he is benefiting from meeting with me but all he does is talk about past episodes of people picking on him and how he showed them.  he speaks in ways a child would but at his age that kind of behavior would get him in jail.
   I am unsure if he will listen to "sense" and have tried to steer him into jobs where he can work alone.  But he is very stubborn and wants things his way.  he thinks everyone is taking advantage of him and won't take it.  For instance he won't work for under $10 an hour and under 40 hrs per week but most jobs here are much less and part time.  He wrecked his car so his mom has to take him around. His dad is disabled with a stroke and can't get along with him.
   any help in helping me to understand how A.S. people think and how to "reason" with him would be appreciated.



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Followup To
Question -
Hi,
  I am a pastor.  A 28 year old man has been seeing me 2 days a week for an hour.  He lacks social skills and can't keep a job.  He lives with his elderly parents and gives them a hard time.  
   He is intelligent in ways but just doesn't seem to understand the world and either makes people want to stay away from him or antagonize them to the point of getting in trouble.
   I listen to his stories but don't know how to help him.
   I emphasise with him that he should stay away from what he calls "the crows" people who peck at him and antagonize him.  I am trying to help him find a job.  He is a nice guy if he could find his nitch.
    Can you give me any advice on what I should be emphasizing?
Answer -
Hi Don,

First, not to make you feel bad, but it is Asperger's Syndrome.

This fellow probably does have Asperger's but he could also be bi-polar or have schizophrenia.  He needs to see a psychiatrist, first, to find out if he needs medication.  While A.S. does not respond to medication the other things I mentioned do.

If it turns out he does have AS, he is going to need quite a bit of help finding a "niche."  Since he has reached adulthood without a diagnosis, he's pretty smart and good at covering for his deficits.  He is also beyond an age where social skills training will do much good unless he is VERY willing to cooperate.

I assume you live in the United States.  Most likely, the best strategy is to get him on Supplemental Security Income and into some kind of technical training for a job he has the interest for.  That might get him out of his parents' home.  Frankly, that should be one of the primary goals, for their sake if not his.

Write back and let me know your city and state and I'll see if I can find some resources for him.

They didn't prepare you for this in Seminary, huh?  Thanks for caring.

Catherine

Answer
Hi Don,

Unfortunately, the story of this man's life is not uncommon.  

There is a paranoia component for many who have autism.  It's pretty understandable since they don't understand the motivations of others and when they end up on the short end of the deal, they attribute it to evil intent on the part of the other. Of course, as you have heard from this man, abuse does frequently occur. That also contributes to the paranoia.

Absolute thinking is the other thing that is plaguing this man.  Only $10 an hour and 40 hours a week is a "real" job. His refusal to accept re-direction is going to keep getting him fired and I don't know how you can get him to change at this point.

Obsessing on past events is the third component that is standing in his way.  I'm sure when you say "he talks like a child" and "it could land him in jail" you are referring to revenge fantasies.  These, alas, are also common.  It is good he is receiving medication support.  Encourage him to continue to seek out a psychiatrist familiar with autism to manage his medications.

Again, I would hope you can help him get SSI.  He certainly has the track record to prove he cannot support himself.  He also needs a financial guardian to see that no one rips him off, again.  This should not be his parents, they don't need to deal with the resentment this will generate.

I found the website for the Autism Society of Pittsburg.  They may be able to guide you to more useful resources.

http://www.autismsocietypgh.org/Default.htm

Best wishes,
Catherine