Quality of Life: Autism Spectrum Disorder

Quality of Life: Asperger’s Syndrome & ASD

Q. A. Bradford

San Diego State University

Running Head: Quality of Life: Asperger’s Disorder & ASDBradford 1

0. Abstract

How can rehabilitation counselors improve the quality of life for

persons with Asperger's Syndrome & ASD? Rehabilitation counselors

can improve the quality of life for persons with Asperger's

Syndrome & ASD by adjusting the QOL's baseline and benchmarks

relative to both the dreams and the limitations of the consumer.

First we’ll explore the nature of Asperger’s and Autism Spectrum

Disorders. Then we’ll look at a variety of benchmarks and

baselines indicators for quality of life in general, including

some general governmental benchmarks, philosophical

considerations, societal approaches of measure, most

authoritatively exemplified by those measurements utilized by our

governing bodies, and finally health care industry qualifiers of

health and life and finally our advocacy for our consumers and

clients as whole persons. In the case for Autism Spectrum

Disorder and Asperger's Disorder, some tests may play less of a

role than others. Then we’ll look at the natures of hopes and

dreams most often held by populations diagnosed with AS via an

analysis of interviews. Then we’ll discuss accommodations and


therapies for the functional limitations that are included in ASD

diagnosis. Disabled as able bodied, disability as a limited

condition, and methods of advocacy for the ASD diagnosed: Society

as a body, bigotry as an ailment, propaganda as a treatment.


I. Introduction

“How rehabilitation counselors can improve the quality of life

for persons with Asperger's Syndrome?" Rehabilitation counselors

can improve the quality of life for persons with Asperger's

Syndrome by adjusting the QOL's baseline and benchmarks relative

to both the dreams and the limitations of the consumer.

II. What the nature of Autism Spectrum Disorder & Asperger’s

Syndrome?

Asperger’s syndrome was first described by Hans Asperger in 1944

originally as “autistic psychopathy”. He distinguished it from

general autism by recognizing communicative impairments from the

age of three, whereas general ASD remained characterized with

delayed speech prior to three. In a 2008 article, Matson &

Wilkins described AS symptoms as including halted speaking,

intellectual myopic interests, a lack of “normalcy”. At the same

time, communicative despondence may not have been an issue,

except for in the case of sudden expressions of unhappiness. And

what seems quite subjective to be a symptom of medical literature

in my opinion, AS patients were described as not fully being


apart of the exchange in socially communicative interactions.

According to the points of diagnosis, the median prevalence of

Asperger’s Syndrome is about 3 in 10.000 cases. Which is lower

than autism which is diagnosed and five times a higher rate of 13

in 10, 000. (Matson & Wilkins 2008)

And again the WHO’s diagnostic is similar in identifying

Asperger’s Syndrome under four criteria: A) an insufficiency in

verbal, reciprocal, or cognitive growth. But only diagnosable if

the child has mastered single word expressions by the age of two

and that the child is using communicative phrases by three. Self

advocacy skills, adaptability and environmental interest by the

time the child is three should match their intellectual

development. But the child’s motor skills can be slow or clumsy

and okay to overlook. And unique preoccupations are also common

and fine to overlook; B) Qualitative problems in social

reciprocation are diagnosed under the criteria as autism; C) But

a significantly recurring interest in serial patted behavior,

interest and activity in an obsessive fashion is also evaluated

along the lines of autism; D) The symptoms are not inclusive of

pervasive developmental disorder, schizotypal disorder, simple


schizophrenia, reactive and disinhibited, obsessional personality

disorder, obsessive compulsive disorder (WHO 1992). But because

handing out complex diagnosis to anyone can result in huge social

stigma and difficulty in self-image, many of the co-morbid

factors are not directly related to the illness, but instead are

co-occurring. Issues such as depression, anxiety, Tourette’s

syndrome, ADHD and epilepsy all have a prevalence in Asperger’s

diagnosed populations.

III. What are proper QoL benchmarks for ASD?

Lets now look at a variety of benchmarks and baselines indicators

for quality of life in general, including some general

governmental benchmarks, philosophical considerations, societal

approaches of measure, most authoritatively exemplified by those

measurements utilized by our governing bodies, and finally health

care industry qualifiers of health and life and finally our

advocacy for our consumers and clients as whole persons. In the

case for Autism Spectrum Disorder and Asperger's Disorder, some

tests may play less of a role than others. Although Maslow’s

Needs Hierarchy is the basis of most childcare programs, adult


society seems to deviate from policies that acknowledge the

intrinsic needs Maslow’s scale centers upon.

The Organization for Economic Co-operation and Development (OECD)

Better Life Index assesses individuals from a variety of eight

factors, (1) Employment status, health status, work/ life

balance, education and skills, social connections, civic

engagement and governance, environmental quality and personal

security. Although the most popular standard for measuring

national development, the GDP that OECD releases is oriented

especially for a production model. Its an indicator of business

and industry much more than the human condition. The fixation

upon it indicates the reporters concern with capital and material

gains but it is not at all person-centered, nor driven. As a

sociological model it suits capitalizationism well, but for

person-centered capital, it still doesn't consider the personal

quality of life indicators for autonomous productivity and

personal capital. (Goldstein 2014) Robert Kennedy stated, "Gross

National Product does not allow for the health of our children,

the quality of their education, or the joy of their play," he

said. "It does not include the beauty of our poetry or the


strength of our marriages, the intelligence of our public debate,

or the integrity of our public officials." Looking across our

border to the north in Canada, the evaluation of QoL utilizes the

Canadian Well-Being Index (CIW) which evaluates on an eight point

basis of Community Vitality, Democratic engagement, education,

environment, health populations, leisure and culture, living

standards and time use. The qualities seem consistent with

environmental and social cues, perhaps reflecting the socialized

welfare nature of the Canadian welfare and education systems.

When QoL is evaluated in healthcare, the basis revolves much more

on an symptom orientation using various self-reported tests,

including the Nottingham Health Profile, Quality of Well Being

Scale, EuroQoL, Short Form 36, Sickness Impact Profile and Health

Utilities Index.

Another commonly used measure are Activities of Daily Living/

Instrumental ADL. A good example of an assessment scenario

utilizing ADL/IADSL goes as follows:

"A young woman with Asperger’s Syndrome dislikes shopping. She

says it is too noisy and busy. After further discussion, she and

her occupational therapist determined she had difficulty with


processing sensory information. The noises and sights at the mall

were overwhelming to her. Together, the young woman and the

occupational therapist designed a sensory program and

compensation techniques that would allow her to successfully

complete her shopping. The sensory program consisted of exercises

that, when done on a regular basis, helped her improve her

ability to process sensory input from her environment. The

compensation techniques included shopping at a smaller mall or

store at times that aren’t typically busy, and to practice a

social script. The social script is a way to role-play and

practice interaction before it actually occurs. This “rehearsal”

helps to increase one’s confidence and skills."

This last assessment of ADL/ IADL definitely is an effective

method of a consumer, VR counselor, occupational therapist team

approach. Although it seems clinical, in conjunction with an

occupational therapist, rather than just client hearsay or

managers and teachers, the capability of the consumer can be

neutrally assessed. Because both the consumers and their

supervisor or teacher may have conflicting narratives, as an

intercessor, a VR counselor can seek work with an OT to get an


understanding of the client’s capacity and levels of

accommodative need.

Dr. Robert Shalock, a scholar out of Canada, formulated a

specific benchmarking system after recognizing how funding for

welfare programs that help individuals is always subject to

limitation. He suggests that we all “focus on outcomes first”.

Because funding depends on program outcomes, he recommends ISPs

based on personal outcome scale (Shalock 2011).

V. Accommodations and therapies specific to the functional

limitations of the ASD diagnosis.

One of the important factors for AS diagnosed individuals is

often behavior management and educational interventions. A

plethora of recommendations exist that focus on socialization,

reduction of antisocial behaviors, communication strategies and

strengths based education systems and are echoed again and again.

An article by Valerie L. Gaus specifies five self-reported

difficulties of a pool of ASD diagnosees as 1)

social/interpersonal issues, 2) dating and sexuality, 3)

depression, 4) employment dissatisfaction, 5) frustration with

their living situation. Furthermore, she reports that families of


the individuals deal with six difficulties of 1) anger/disruptive

behaviors, 2) obsessions, compulsive behavior, intense/narrow

interests, 3) withdrawal/depression, 4) lack of

motivation/procrastination, 5) poor ADL skills/self-care and

organization, 6) odd behavior in the community/ legal problems

(Gaus 2010).

In a 2009 issue of European Child & Adolescent Psychiatry, myriad

recommendations were made starting with 1) educational

programming tailored to learning styles; 2) formal teaching of

social protocols; 3) information presented in proportion to its

whole context and in its discrete segments; 4) classes

administered in numbers that allow for intimate interaction; 5)

desegregation and incorporation into general peer group and

activities; 6) Adapting curriculum to accommodate for issues such

as speed, delivery and clarity; 7) Adaptive skills curricula of

scheduling, practicing and rehearsing, etc. should be implemented

and evaluated via the Vineland adaptive behavior scale (VABS); 8)

Improvement of organizational skills by use of scheduling,

scripts, rules, lists, etc.; 9) Context emphasized pragmatic

language skills via group class interaction (Volkmar 2005).


Recently for the Advanced Practicum in Cognitive Disability

course, taught by Dr. Degeneffe, I interviewed one of our

presenters who lives with an ASD diagnosis. In his presentation,

he presented a large amount of information about the “unspoken”

social rules and non-curricular environments in which there is a

lack of education or planning. He emphasized how we spend our

time in passing periods, during recess, after school and all of

the other unstructured interstices between school, work and

family life. He brought to light that events that enrich our

quality of life like dances, sports, clubs, recreation and

leisure activities are overlooked and remain exclusive and

elusive. I related deeply to what he had to say. My own

experience with subcultures and cultures is that most “rules” are

unspoken and our comprehension of these customs usually defines

our “intelligence”. Even living in Japan for a period of time, I

picked up droves of information on language and society. But even

working professionally in Japanese language and with Japanese

business and being technically effective, the discrimination

against the lack of “intuition” was strong. It would be very

interesting to do a demographic analysis on those diagnosed with


Asperger’s according to religion, ethnicity, gender, race, class

and political standing.

Educational and Employment Adaptations

There definitely has to be a development of laws that ensure

companies don't interfere with the constitutional rights of

cognitive developmentally diverse workforces and consumers. When

the Lehman Shock that rocked the international economy occurred

in 2008, the influence of predatory business structures became

very apparent. But it wasn’t the first or second time predatory

business and uninformed consumers destabilized national

economies. It of course is a recurring issue in markets like the

USA. The Great Depression, Enron, Solyndra… Somewhere in the

void of placing our hope against the limited time of our lives in

currency rather than ourselves, we are taken advantage of or take

advantage of others. We resort to pejorative excuses, calling the

distraught “stupid” or the ruthless “crooks”, neither side

realizing that the complicity in “unspoken rules” creates an

atmosphere that adversely affects the symbiotic basis of our

existence as human beings. Educational policy must show


consideration of learning capacities, styles and LD

discriminatory practices have to be abandoned.

Technological Accommodative Approaches

Information design plays an integral role. Often, so fixated on

the most prestigious specializations and intelligences, many

overlook the underlying importance of how information is

conveyed. From my years of experience in graphic design, basic

principles such as complimentary colors, hierarchy of importance

in font sizing according to the nature of information, clarity of

serif versus sans-serif fonts, the amount of text, boldness,

italicization, underlining, etc. all play integral roles in the

comprehension of visual information. Diversification of teaching

styles and information delivery is a vital part of affecting

educational policy in the favor of alleviating the conditions of

those diagnosed with AS and HFA. In an autobiographical novel by

Daniel Trammet--a person diagnosed with AS--speaks about his

coping process. He especially cited his abilities in synesthesia,

a predilection to comprehending multiple kinds of information at

the same time, in his case colors and numbers. An educational

policy that ensures that information delivery incorporates both


audio and visual learning styles Social education curriculum.

Virtually all of the articles I read that addressed

accommodations also included Cognitive Behavioral Therapies. Out

of my own experience teaching ESL, the national Japanese English

language curriculum I taught for three years emphasized

information delivery in a fashion of music, rhythm, highly

visible visuals, and absolutely concise delivery.

VR & Video Game Simulators

Although the pedagogical deliveries are very manual,

disintegrated and traditional, with the developments of video

gaming and virtual reality, I would imagine the integration of

virtual reality simulation will be the way of the future. Science

fiction authors have alluded to this technique as an educational

and training method in fictional properties like Star Trek, Marvel

Comic’s X-MEN and their “danger room” and many others. Technology

and improved graphics resolution provides many solutions and is

already available evident in products like Google Glass, Sony VR

headsets, and wall projected touch screen as manufactured by

companies such as Panasonic like the ones I used teaching ESL in

Japan. VR simulators to cover curricula of social and cultural


interaction can improve the comprehension of civics and more,

reducing the counseling hours necessitated and increasing the

potential number of sessions clients need for therapies and

retraining.

There is easily available evidence that supports that digital

simulations assist the learning development particularly of

students with autism. Some digital assessment and treatment

technology already in research and on the market include SMART-

games on the Pluff platform, which produced test results that

indicated it “Overall results suggest that Pluff is acceptable,

usable, and enjoyable for higher functioning children with ASD

and that the directions for operating the controller were easily

understandable” (Gotsis 2010).

Another digital platform is Small Steps Big Skills which was

reviewed in two studies, one in the Journal of Intellectual and

Developmental Disabilities and in the Journal in Education and Training in

Developmental Disabilities. The platform was said to have very

favorable results: “Findings from the beta version of the game

showed that linking these elements is an effective way to teach

skills, and results were published in two special education


journals. The first study results published in Education and

Training in Developmental Disabilities in December, 2009 showed

three elementary aged students with autism mastered all three

skills taught through a beta version of the video game and

generalized the skills to their natural environment. In a second

study published in Intellectual and Developmental Disabilities in

June, 2010 results showed three middle school-aged students with

intellectual disabilities increased the percentage of steps

completed in the correct order after playing the game” (Anonymous

2011). Conclusively, platforms like Small Steps Big Skills

utilize video modeling and the Pluff platform provides real-time

empathy reading simulation without the need of constant counselor

interaction for retraining purposes.

Applied Behavior Analysis

“Applied Behavior Analysis (ABA) is an evidenced-based treatment

for improving the functioning of children diagnosed with autism.

It addresses the core deficits of ASDs including verbal and non-

verbal communication, social interaction, restrictive repetitive

behaviors, inflexibility, and peer relationships, to name a few.

While it has been successfully used for over 30 years,


modifications and improvements of the ABA techniques have created

a new look for classroom applications.” (Gotsis 2010)

Incidental Teaching

Another method is incidental teaching methodology which revolves

around the student’s or consumer’s initiation. The idea of

focusing on the focus of the ASD diagnosed person is obviously

much more person centered than critically analyzing their are of

interest and instead using it as a learning mechanism. In the

technique, “The student initiates for an item either verbally or

gesturally, and the teacher responds in a manner that requires a

second initiation from the student. Following the second request,

the student is provided with the desired item. For instance if a

child points to a pencil, the teacher may respond by saying,

“What do you want?” triggering a second gesture to the pencil or

the verbalization, “pencil,” which is reinforced with the desired

item.”(Pelicari 2010)

Pivotal Response Training

Pivotal response training (PRT) is a set of instructional

strategies that are brief, specific, and focus on tasks chosen by

the child. PRT also utilizes contingent reinforcement directly


related to the desired behavior and attempts at engaging in the

desired behavior. For instance, if a student demonstrates

interest in drawing, place materials in his or her view; if he or

she requests a “crayon,” provide the crayon and follow through

with a drawing activity. PRT has recently been shown to cause

significant improvement in toddlers (Pelicari 2010).

Picture Exchange Communication System

Another option is the PECS system which relies on visual

communication strategies. The implication of this in both

education and research for its use in more public applications

can definitely accommodate those who are more visual in their

learning predispositions. PECS very much assists in helping the

expression of people with ASD. One study indicates that PECS,

“can be utilized in the natural environment to teach learners how

to initiate communication and have their needs and wants met. It

utilizes pictures, single words, phrases, and sentences to help

bring about appropriate verbal and non-verbal communication

skills.” Much like Asian cultures that rely upon gestures like


bowing and pictographic symbols, visual communicative

accommodations are an effective methodology (Pelicari 2010).

Technology Aided Classroom Teaching

“Innovative uses of technologies are another “new look” strategy

for classroom intervention. One such device, Technology Assisted

Classroom Teaching (TACT), developed by The Center for

Neurological and Neurodevelopmental Health (CNNH) in Voorhees,

NJ, is a teacher-initiated remote behavior capture system with

access to professional support and expertise. This technology

utilizes a camera and a small computer to efficiently record

target behaviors, both antecedents and consequences, and also

acts as an aide in teaching new skills. Behavior and teaching can

be viewed in real time over Health Insurance Portability and

Accountability Act (HIPAA) compliant Internet portals, or can be

captured and reviewed at a later date by a behavior analyst or

other clinician. Teachers control the device, and data can be

collected as needed. Such an approach reduces any “reactance”

effects or distractions of an extra observer being physically in

the classroom, and is very cost efficient, as there are no travel


or other expenses of having a behavioral consultant attend in the

classroom—often when the target behavior does not occur. TACT

will also allow the Behavior Analyst to take data on a daily

basis and provide the necessary feedback fostering behavioral

progress and success in the classroom. TACT technology is viewed

confidentially and in compliance with laws and regulations.”

(Pelicari 2010)

VII. Conclusion: Advocate away from Stigma and Focus on

Psychosocially Responsible Public Policy.

In a great article that addresses the inherent biases often held

by those in places of privilege over those not--in this case

those who hold the stigma of being physiologically different--the

presumptions, anticipations and attitudes all expressed in our

narratives serves as a very explicit indicator of the harmony or

disharmony of our interaction. An excerpt that illustrated the

value of the minority versus minority interaction of LD

constituencies (the mother and child) versus the constituencies

of pedagogy (the teachers and administrators) is epitomized by

their narrative/ counter narrative.


"This dynamic, this narrative/counter narrative exchange, is

similar to the dynamic that birthed the LD category. The early LD

advocates described by Sleeter (1987) were responding to

oppressive narratives that they felt would have devalued their

children — narratives that would have stripped them of their

intelligence, their emotional stability, and/or their affiliation

with dominant cultural, narratives that would have associated

their privileged white offspring with the children of the poor

and the ethnically othered." (Hale 2010). The frustration is this

advocacy centers upon the crux of self-mastery of uncontrolled,

altered or still developing ability which requires patience and

accommodation. However, like many consumers of the VR counseling

field, they’re stuck in a home setting with parents overwhelmed

in dealing with the negative narrative of the public system

that’s often too busy to help and therefore stigmatizes the

individual. It’s a tragedy when consumers are intercepted by

prisons, institutions, etc. because their teachers and guardians

couldn’t adapt the system to them. Although there are extreme

cases in the failure of advocacy and the system itself failing to

serve physiological diversity of our population, there too are


highlights in the amazing advance and potential that can be

tapped via personalized learning programs and accommodations of

learning styles and physical capacities.

Hale’s article goes on to address the strongly pedagogically

rooted issues. The article acknowledges that… "the protagonist is

always the social standing of a child and his parents. The

antagonists are the ideological assumptions that underlie

schooling and the perceptions and biases of those in the school

community. The conflict is the struggle between competing views

of the child, the antagonistic view being that the child is lazy

or stupid and the parents' being an affirmation of their child's

positive essence. The plot, driven by the central conflict, moves

from incident to incident of difference, exposition, and shame

until finally the parents, drawing on resources only available to

the relatively privileged, enlist experts who wield the symbolic

power of science to inoculate their child from criticisms and

aspersions, while locating the cause of his difficulties within

him. The dénouement involves a change of identity, from "normal"

to disabled, from accused to excused. The whole process

establishes a rationale to which the parents can cling in moments


of doubt and conflict." As though the pedagogy is unaware that

they pursue a narrative in which the system wins and bankrupts

the individuals of difference rather than tapping into the

minefield of their potential. So accordingly in our field, our

role as VR counselors is to help channel the ability of our

clientele and consumers in order to make them heroic, in costume,

in ability, in society. Yet we also have the charge to be

reformers of society and improve the institutions into better

mechanisms of community, industry and culture.

Education and pedagogical cultural reform is the hinge that

determines the success of especially individuals with Asperger’s

Syndrome, if not all people diagnosed with HFA and other ASD.

There is an historical and social responsibility for correcting

humans rights violations and maintaining national productivity.

The integration of social cues education and the “unspoken rules”

of the education system allows us to maintain industrial

competitiveness with other external national education and

economies rather than internally against one another. This

advances the USA as a culture and as a civilization. Individuals

are essentially specialized neurons and education and medicine


are like the neurosystems for vocational deployment and

individual harnessing.

In a brief interview with ID advocates who work with people

overcoming ASD diagnosis, the emphasis on inclusion and against

exclusion is paramount. In interviewing Krystle Taylor, an

adjunct instructor for the College 2 Career Program for the San

Diego Community College District, she reiterated numerous times

“They’re just like anyone else with the same hopes and dreams as

everyone else” (personal communication, 27 April 2015). In

another conversation with Ms. Kay Freeman, a mother of a child

with autism, she explained to me that there are many families

that are fighting against time in preparing their autistic family

members for autonomous living. She says that vocations that

provide competitive compensation are integral. Menial labor jobs

are not an option, but more ideally jobs that are technical,

decentralized and tailored to their personalities. The San Diego

Autism Society--a one woman operation--supports families with a

resource list rich website, support groups and community outreach

(personal communications, May 1, 2015). The more I research ASD,

the more I realise that we’re all people with a system perhaps


too focused on the bottom line rather than who’s at the line with

us when we get there. One of the most touching deliveries of this

message that I read was riding the bus to teach ESL in Japan,

which read 緒緒緒緒「」一 which translates to, “Together, we advance.”

VIII. Works Cited & Suggested Readings

Anonymous, . (2011). Autism; studies show new video game helps

children with autism learn skills for independence. Education

Letter, 224.

Ashwin C., Hietanen J., & Baron-Cohen S. (2015). Atypical

integration of social cues for orienting to gaze direction in

adults with autism. Molecular Autism, 6, 5. doi:10.1186/2040-2392-6-

5

Cederlund M, Hagberg B, Gillberg C. (March–April 2010) Asperger

syndrome in adolescent and young adult males. Interview, self -

and parent assessment of social, emotional, and cognitive

problems. Research in Developmental Disabilities, Volume 31, Issue 2, Pages 287–298.

Cohmer, S. ""Autistic Disturbances of Affective Contact" (1943),

by Leo Kanner". Embryo Project Encyclopedia (2014-05-23).


Gaus, V. (2011). Adult asperger syndrome and the utility of

cognitive-behavioral therapy. Journal of Contemporary Psychotherapy,

41(1), 47-56.

Goldstein, J. (2014, February 28) The Invention of the ‘Economy’.

Retrieved from

http://www.npr.org/blogs/money/2014/02/28/283477546/the-

invention-of-the-economy

Gotsis, M. , Piggot, J. , Hughes, D. , & Stone, W. (2010). Smart-

games: A video game intervention for children with autism

spectrum disorders. Proceedings of the 9th International Conference on

Interaction Design and Children, 194-197.

Hale, C. (2010). Privilege and the avoidance of stigma.

Disability Studies Quarterly, 30(2), no pagination.

Hill, E. (n.d.). Adults with Asperger Syndrome: Is Occupational Therapy Right

for You?. Retrieved from

http://www.aane.org/asperger_resources/articles/adults/occupation

_therapy_asperger.html

James I., Mukaetova-Ladinska E., Reichelt F., Briel R., Scully A.

(2006). Diagnosing Asperger’s syndrome in the elderly: a series


of case presentations. International Journal Of Geriatric Psychiatry. Oct;

Vol. 21 (10), pp. 951-60.

Khouzam HR, El-Gabalawi F, Pirwani N, Priest F. (May–June 2004).

Asperger’s disorder: A review of its diagnosis and treatment

Comprehensive Psychiatry, Volume 45, Issue 3, Pages 184–191.

Koenig, K. , & Rudney, S. (2010). Performance challenges for

children and adolescents with difficulty processing and

integrating sensory information: A systematic review. American

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Lawrence, D. , Alleckson, D. , & Bjorklund, P. (2010). Beyond the

roadblocks: Transitioning to adulthood with asperger's disorder.

Archives of Psychiatric Nursing, 24(4), 227-238.

Matson J. , & Wilkins J. (2008). Nosology and diagnosis of

asperger's syndrome. Research in Autism Spectrum Disorders, 2(2), 288-

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Peliciari, N. O'Donnell, L., Wagner P., Alberts, L., Niemann, G.

(2010 January). Classroom Strategies For Students With Autistic Spectrum

Disorders. Retrieved from http://www.njea.org/news-and-

publications/njea-review/january-2010/classroom-strategies-for-

students-with-autistic-spectrum-disorders.


Rhode, M. (2011). Asperger's syndrome: A mixed picture.

Psychoanalytic Inquiry,31(3), 288-302.

Shalock R. (2011, May 5). Begin with the End in Mind - Dr. Robert Shalock

[YouTube video]. Retrieved from https://www.youtube.com/watch?

v=dFQwVaFHG78

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(2012). Social competence intervention for elementary students

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World Health Organization (1992). International classification of diseases:

Diagnostic criteria for research (10th edition). Geneva, Switzerland:

Author. (pg.186-187)

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Quality of Life: Autism Spectrum Disorder

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