10/10/2017
There is a fine line…
Bianca Hynes, M.A., Eszter Kiss, M.A., LPC WV Autism Training Center, Marshall University
LEARNING OBJECTIVES
Participants who attend this presentation will be able to:
Identify how social communicational deficits affect the ability of individuals with Autism Spectrum Disorder to form and maintain healthy relationships.
(Through case study presentations) Learn how to best assess and differentiate between situations that involve behaviors defined as stalking or sexual harassment, and behaviors unique to individuals with ASD due to the challenges in the area of social communication and social interaction.
Create an individualized plan to address cases involving inappropriate behaviors in relationships.
Common myth and misconception
“Individuals living with ASD are not interested in romantic relationships…”
How do you feel about Romantic Relationships?
Are romantic relationships something you have desired or picture for yourself?
1 10/10/2017
What we know about ASD and romantic relationships…
Individuals with Autism Spectrum Disorder desire and seek relationships.
Social communicational deficits often affect and pose challenges to individuals with Autism Spectrum Disorder to form and maintain healthy relationships.
Due to social ineptness, caused by social communication and social interaction deficits, individuals with ASD may engage in inappropriate or intrusive dating behavior as an attempt to initiate interpersonal relationships, which can lead to serious consequences (Stoke & Newton,2004).
The rules of dating… how do you know them?
We learn about dating and gain our knowledge and skills about social and romantic relationships from engaging with, and observing peers, friends, as well as from different sources of media.
Due to core deficits of ASD, such as impairment in communication and social reciprocity, which leads to difficulty with socialization and development of meaningful social relationships; individuals with ASD often have less access to peers and friends as a source of learning to acquire social and romantic skills and knowledge.
Stalking, and Social and Romantic Functioning Among Adolescents and Adults with Autism Spectrum Disorder by Stokes, Newton and Kaur, 2007
Challenges due to Unrealistic expectations
Information learned from media can often be misinterpreted and/or misused, that lead to frustration, anger, and inappropriate behaviors.
College = sex
Media Influences (animal house)
Understanding concepts such as “Friends with benefits”
Ability to judge (“Bad”) advice from peers
Goals vs. understanding limitations
Age vs. Developmental Age (why am I not ready)
Why is this not happening for me?
2 10/10/2017
There is a fine line…
“In society, there is a blurry distinction between what constitutes acceptable and inappropriate relationship behaviors. To initiate a relationship, it is not unusual for a person to ask the target of their interest out on a date, telephone them, send them letters, wait for them outside work, or make other attempts to initiate social contact. There is a subtle distinction between these appropriate and inappropriate forms of these behaviors. Persistent unwanted attention via any of these behaviors is typically utilized to distinguish between harassment and appropriate courting (Ravensberg & Miller, 2003). Stalking involves repeated or persistent unwanted attempts to communicate with or associate with another (Mullen, Pathe´ , Purcell, & Stuart, 1999). The fine line between these two is not often clearly drawn. Most particularly, it may be unclear to a person who has experienced considerable social rejection and exclusion over their whole life, learning that associations with others are only available with persistence. Confusion, or lack of awareness, of what is and is not regarded as appropriate courtship behavior, together with the desire for intimate relationships, limited socialization, and inadequate overall social and sexual functioning, may likely lead to what is considered as stalking.”
As cited in Stokes & Newton, 2004.
What is stalking?
Stalking is illegal in all 50 United States (California was the first state to make stalking illegal in 1990) but each state defines stalking differently (Snow 1998). Stalking is defined as a continuum of behavior that can range from harassment to threatening behavior to assault and homicide (Snow 1998). It is often a fine line between acceptable and unacceptable behavior (e.g., sending flowers to someone at work may be interpreted differently by the receiver depending upon their own intentions and their assessment of the context).
There are three main elements of a stalking crime (Proctor 2003). These are
(1) harassment involving repetitive, annoying and disturbing behavior directed towards a person that has no positive or legitimate reason other than to harm the person,
(2) a credible threat toward a person that causes the person to become fearful of their safety or causes emotional distress, and
(3) a course of conduct involving a series of acts over time towards a person that causes emotional stress and/or concern with safety.
(Understanding Stalking Behaviors by Individuals with Autism Spectrum Disorders and Recommended Prevention Strategies for School Settings by Post, Haymes, Storey,
Loughrey and Campbell, 2012)
Lack of skills and social communication and interaction deficits are NOT stalking
Social skill deficits can present challenges with, but not limited to: Understanding appropriate relationship timelines Understanding the nature of relationships (professional vs personal) Unrealistic expectations Understanding and displaying courtship behaviors - Flirting vs. Friendship Theory of mind, specifically understanding other’s intentions and perspectives Relying on assumptions Appropriately expressing and processing emotions Age vs. Developmental age Hidden rules and expectations of relationships Hidden rules and expectations of the use of technology Concept confusion Literal/Concrete thought process
3 10/10/2017
Consequences of these behaviors…
As stated earlier “confusion, or lack of awareness, of what is and is not regarded as appropriate courtship behavior, together with the desire for intimate relationships, limited socialization, and inadequate overall social and sexual functioning” can often lead to serious consequences such as (Stoke & Newton,2004):
Legal Issues (probation, jail time, permanent record, sex offender list)
Problems with Judicial Affairs
Damaged Reputation
Damage/change of Self-esteem and self-concept
Negative Impact on Future relationships
View of society and the world, creates a false concept (globalization, “all girls are the same” “relationships will never work out for me”)
JUDICIARY VIEWS ON CRIMINAL BEHAVIOUR AND INTENTION OF OFFENDERS WITH HIGH-FUNCTIONING AUTISM (COLLEEN M. BERRYESSA, 2014)
As previous literature has reported (Freckelton and List, 2009; Freckelton, 2013), judges are limited in their ability to effectively and properly understand the disorders, their symptoms, and how to factor this information into their decisions in order to ensure they are fair and just.
“…although each diagnosed offender and his actions should be assessed individually, the majority of individuals with hfASDs that exhibit criminal behaviour are thought to do so because of the characteristics of their disorders (Murrie et al., 2002; Barry-Walsh and Mullen, 2004; Howlin, 2004; Haskins and Silva, 2006; Attwood, 2006; Kristiansson and Sorman, 2008; Browning and Caulfield, 2011), which presents a complex set of issues for judges when handling diagnosed offenders.”
“Regarding the sentencing of an offender with an hfASD diagnosis, one respondent with hfASD case experience stated, “I think it’s [hfASD disorder] an important factor. I mean if somebody is […] in front of me and we’re trying to figure out how they should be punished for something that they did, the question […] has to start with why did they do it? If they’re predisposed to doing it then, you know, that’s a problem”
While we are by no means state that no one with a diagnosis of ASD have true criminal intent, we believe that they are often misunderstood, and/or mistreateddue toa lackof awareness and understanding what isASD and how it effectstheirbehavior.
Consequences of these behaviors… Case study 1 Background
Accepted into the College Program in the The judged ruled to drop all charges but Spring of 2011 after attempting to attend placed the client on probation for 10 years independently in Fall, 2010. During that first and asked that he be placed on the sexual semester attended the program’s skill building offenders list. group Due to the final decision of the judge he was While home in the Winter of 2010, was accused of a crime that resulted from his social unable to return to Marshall in the Fall 2011. communication-related challenges; was Returned to Marshall University in Spring of placed in jail for a short period of time. 2012 Returned for the Spring 2011 semester but was unsuccessful in all of his courses due to the Began counseling with a WV ATC intern due stress and anxiety of his on going court case. to high levels of anxiety about his charges back at home.
4 10/10/2017
Case study 1: Needs assessment
Strengths that will help the client thrive: What needs to be in place for the client to thrive? • Friendliness and a genuine want to be • Overcome extreme level of anxiety about past experiences involved on campus and with peers following him to college • Loves to listen to and be there for others. • Building his reputation at school • Ability to communicate his emotional • Improve ability to communicate effectively with others feelings and needs • Improve ability to recognize body language and verbal cues • Willingness to work on making himself of others better and move forward from past • Reduce obsessive thoughts about relationships and the effect events they have on him emotionally • Strong interest in Journalism and a vast • Develop a plan to become more socially involved. knowledge in the area.
The client expressed that he sometimes becomes angry that people have trouble understanding where he is coming from, and when they don’t understand why he doesn’t look them in the eye when talking.
Case study 1: Identifying personal communication factors that negatively influence relationships
Identified factors making it difficult for others to We also focused on the factors that make others understand where he is coming when he feel he is ‘creepy’ or a ‘jerk’. Developed the communicates with them following list:
The client felt that others may be more • texting someone too much understanding of him if they knew about his • not being aware of physical space between you diagnosis. We talked about the right times and and another person, wrong times for disclosure. • continuing to talk to someone when their body language or verbal cues suggest that they no Reenacted a real-life situation in which the client longer want to talk spoke to a classmate after class and the classmate • touching people you barely know and giving used sarcasm but the client didn’t laugh. The them pet names like “hun” or “cutie,” classmate was offended and ignored him the next class. Role-played the client’s explanation to the • speaking in an aggressive tone of voice and holding eye contact too long. classmate that he has Asperger’s Syndrome and that’s the reason he may not have understood. He did a great job of self advocating during the conversation.
Talking about the factors related to social communication helped him realize what exactly he should be working on. To this point, the client had never been given literal descriptions as to why people felt he was creepy so being direct helped clarify what he needed to change.
Homework: The following week, he was asked to prepared a list of 5 verbal or non-verbal cues he caught and understood during social situations he was involved in and 5 verbal or non-verbal cues he did not catch during a social situation but realized later.
Overuse or inappropriate use of technology
The hidden rules of social media
The hidden rules of texting, instant messaging ect...
New age - new communication, apps, programs, chats (snap chat, yik-yak, tinder…etc)
Appropriate vs. Inappropriate processing
5 10/10/2017
Case study 1: Body language and verbal cues
Results from last weeks homework: Did recognize- A female in class that he had been placed in a group with had been avoiding him after a week of texting him. He “Girl in class I was talking to wasn’t looking at me that decided to ask if he had done something wrong. means she’s not listening” When her response was “No,” but her body language said “Girl in dorm lobby was fiddling with her stuff while I ‘get away from me,’ John did not notice. Later in the day tried to talk she didn’t want to talk to me” he saw that the same girl had posted “Get away from me “My dad had a stern voice when I called. I knew he creeper!” on her Twitter page around the same time as was angry about something” their discussion.
“Someone I thought was my friend was acting strange When asked what could have made her feel that way like not talking to me when I talked to her and avoiding about him we referred back to the list of factors from our last me in the dorm I knew something was wrong but I session. didn’t know what.” The client reported that in the first few days of knowing her started calling her “cutie.” He was texting her almost constantly without response most of the time, and when he Didn’t recognize- saw her he would invade her space and any other conversations she might be having to talk to her. The last “Girl was fiddling with her hair while I was talking to her time she didn’t completely avoid him he asked her for a in dorm lobby. I kept talking and didn’t see she was hug before he left and stated that it was an awkward ‘ass bored or not listening.” out hug’. I asked him to elaborate and he described it as a “My friend’s reaction to a question was nice but her hug you give to someone of the opposite sex when you’re body language was weird. She kept her distance from in ‘the friend zone.’ We discussed how this could be a me, didn’t look me in the eye and crossed her arms” complete turn off to her.
Session 6: Relationship traits and timeline
During this session the client and I discussed the stages of a romantic relationship using the hand out.
We discussed some traits that are not on the handout that might fit into some of the categories:
Strangers- He felt this stage is where you exchange phone numbers. We discussed why that might not be appropriate upon the very first introductions.
Casual Dating- He felt this is where you develop pet names for one another and flirt a lot. We discussed why the use of pet names could turn people off if used too soon.
Session 6: Relationship traits and timeline
The client explained that he had hung out with a girl 3 times since our last session.
I asked him to rate where he felt they were on the romantic relationship scale: “5” (Casual Dating)
I then had him rate where he thought she probably felt their relationship was: “4” on the Friendship scale! (see to right)
6 10/10/2017
Session 6: Relationship traits and timeline
The client and I discussed some ways he could help get her to the romantic relationship scale. He had some great ideas: Don’t call too much Don’t hang out every day Take things slowly Build trust with one another
At the end of our session the client and I both filled out a personal time line of relationships and compared our individual results.
He was shocked to see the differences in our time lines. I required a lot more time between the friends and dating stages then he did and we spoke about why we both felt that way. At the end of our session he understood that taking things too fast can push people away.
Session 6: Relationship traits and timeline
7 10/10/2017
What we can take away?
1. Individuals with Autism Spectrum Disorder desire and seek relationships however, the desire for intimate relationships, paired with limited socialization, inadequate overall social and sexual functioning, and reoccurring negative experiences will often have a negative impact on (the possibility of) future relationships.
2. Challenges related to theory of mind, deficits in pragmatic language and non-verbal communication often leads to confusion, then frustration, and possibly anger.
3. Individuals with ASD often display a Literal/Concrete thought process. Abstract, unclear answers with hidden meaning often imbedded in non-verbal cues can be extremely difficult to decode, and once again lead to confusion, then frustration, and possibly anger.
I’d love to “Maybe” Possibly… but…
What we can take away?
4. Honesty, open communication and self-advocacy is key to a successful, positive relationship. “Be persistent” – knowing and accepting that relationships, and dating is challenging for all, and while difficult, rejection is part of the experience.
5. “People with Autism are still people at the end of the day…we are not any more different then you are.” Advice: Be honest, if we a person is doing something unusual for a relationship, off-putting, strange, or something you are not comfortable with, let them know. Chances are, they did not know, or were not aware.
“Honesty is key, and it goes both ways”
UNDERSTANDING AND DISPLAYING COURTSHIP BEHAVIORS - FLIRTING VS. FRIENDSHIP
THEORY OF MIND, SPECIFICALLY UNDERSTANDING OTHER’S INTENTIONS AND PERSPECTIVES
1. As discussed earlier, challenges related to theory of mind, deficits in pragmatic language and non-verbal communication often leads to confusion, and inappropriate courtship behavior during an attempt to initiate interpersonal relationships.
2. Next we will discuss a case study that shows, how challenges with abstract, unclear answers, and hidden cues imbedded in non-verbal language can lead to confusion, and possible serious consequences.
8 10/10/2017
Case study #2: Background
Accepted into the College Program in the Refused one on one therapy but talked openly Summer of 2012. During that first semester to support staff attended the program’s skill building Disclosed a similar situation of “unclear answers” groups from females at home over the summer creating In sophomore/junior years began pursuing aggressive behavior such as; over texting and different romantic relationships at home contacting on social media and while at school Spring of 2016 a similar situation reported by In Fall of 2015 a professor reported to another professor; a female classmate reported support staff that a female student aggressive/ stalker-like behavior in a single reported to him stalker-like behaviors of the closed incident student
Case study 2: Incident 1
In Fall of 2015 a professor reported to support staff that a female student reported to him stalker-like behaviors of the student
• Student reported that he asked a o Once support staff was informed the classmate out on a date after feeling student sat down with us to explain his they had built an acquaintanceship actions. • The female replied with “Maybe, o Clearly outlined his behaviors and why sometime” they seemed ‘creepy’ or aggressive to the • The student became anxious waiting young lady for a clear response and after a week o Advocated for student with Professor in of being in a classroom setting with order to give an understanding and with the young lady without one began student consent disclosed diagnosis showing classically aggressive o Professor then reached out to female behavior such as; student to explain that the student was • Hanging ‘around’ his romantic interest simply waiting for a response and how his without talking diagnosis played into those behaviors • Following her after class • Pacing outside the restroom she was using o Continued conversations about past All in hopes of a clear answer to his invitation attempts that ended the same way
Case study 3: Incident 2
Spring of 2016 a similar situation reported by another professor; a female classmate reported aggressive/ stalker-like behavior in a single closed incident.
• Student reported that he had no clue o Once support staff was informed the student sat down what we were talking about nor did he with us to explain his actions. know the female students. He was simply o Clearly outlined his behaviors and why they seemed waiting to enter the classroom for his class ‘creepy’ or aggressive to the young ladies but there were other people in the room o Discussed reputation and how previous incidents may from the last class have led these ladies to believe he was being aggressive toward them • The female students reported they had o Advocated for student with Professor in order to give had no interaction with him outside of the an understanding of the situation classroom but that he was showing o Professor then reached out to female students to classically aggressive behavior such as; explain that the student was simply waiting to enter • Pacing outside the empty classroom they the classroom and how his diagnosis played into those were in • Self-talk that sounded disgruntled behaviors • Hanging ‘around’ without talking directly to them
9 10/10/2017
Case study 3: Client Perspective
What challenges do individuals with ASD “The biggest challenge, I think, is just getting off the ground with one…we all seem to think that there's some kind of script face concerning to it all that we just don't have a copy of. I know from personal experience. It's frustrating. In fact, I've had some of my romantic most successful hookups when I've had a few beers in me because I just decide to throw out the damn rulebook and play relationships? it by ear. And unfortunately a lot of people with ASD never make that leap. For some it could be lack of confidence. Others probably feel like they need to feel in control and end up taking too much control over their lives. Then they end up screwing everything up for themselves because of it. At least that's the way it seems to me. Awkwardness and inexperience definitely plays a part. So does fear of rejection. And this is all just scratching the surface. Sometimes the biggest problems arise after the first date. If getting a date is one impossible challenge, taking a relationship to the next level is two and a half.
Also, and this is a big problem that affects a lot of people with ASD, is that they might have certain behaviors or mannerisms which strike others as creepy. And if you're already embittered about previous missed chances, failed relationships and the like, getting treated like a creep WILL only push you closer to the edge.”
What advice would you give to others about dating someone with ASD?
The unclear mind… Ever feel alone in a crowd of people? Trying to be cool…
Over drinking (people think I am funny)
Engaging in dangerous/ illegal activities (drugs, DUI, paying for sex)
This round is on me (open tab) “Girls want to be around me” Client Perspective:
Why might this be a dangerous perspective?
10 10/10/2017
How can you help!
Being clear about expectations, wants and hopes
Being a mentor
Clearly defining roles
Socials Skills Support Individualized support in both areas concurrently lead to well- balanced and most successful outcomes
Mental Health Support
Conclusion
“In summary, while every person has the innate basis for developing sexuality in a multitude of expressions and experiences, individuals with disabilities (and especially individuals with an Autism Spectrum Disorder) most often require additional education and help to become able to express their sexuality in a socially appropriate way. While most neurotipically developing peers form intimate relationships beginning in adolescence and into adulthood, along a variety of experiences from dating to partnering in committed relationships, many individuals with an Autism Spectrum Disorder remain living with their family of origin into their adulthood and have significant difficulty navigating the social expectations surrounding relationships. Their difficulty may pertain to recognizing their own needs and wants, as well as to recognizing their partner’s wishes coupled with more inexperience than their peers in this arena. Sexuality and relationship education in a supportive format that includes the individual’s values and background will be most effective. Interventions need to be individualized with a long-range goal that matches the cognitive, social, and emotional developmental level of the person with ASD. As the prevalence of persons with ASD increases in our society, we are more than ever called to support their ability to mature into adults capable of functioning in all areas of life, including sexuality and intimacy.”
Relationships, Sexuality, and Intimacy in Autism Spectrum Disorders by Urbano, Hartmann, Deutsch, Polychronopoulos and Dorbin, 2013.
Thank you!
Any Questions?
11 10/10/2017
References
Maria R. Urbano, Kathrin Hartmann, Stephen I. Deutsch, Gina M. Bondi Polychronopoulos and Vanessa Dorbin (2013). Relationships, Sexuality, and Intimacy in Autism Spectrum Disorders, Recent Advances in Autism Spectrum Disorders - Volume I, Prof. Michael Fitzgerald (Ed.), InTech, DOI: 10.5772/53954. Available from: http://www.intechopen.com/books/recent-advances-in-autism-spectrum-disorders-volume-i/relationships- sexuality-and-intimacy-in-autism-spectrum-disorders
Stokes, M., Newton, N., & Kaur, A. (2007, September). Stalking, and Social and Romantic Functioning Among Adolescents and Adults with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 37(10), 1969-1986. doi:10.1007/s10803-006-0344-2
Post, M., Haymes, L., Storey, K., Loughrey, T., & Campbell, C. (2012, December). Understanding Stalking Behaviors by Individuals with Autism Spectrum Disorders and Recommended Prevention Strategies for School Settings. Journal of Autism and Developmental Disorders, 44(11), 2698-2706. doi:10.1007/s10803-012-1712-8
Berryessa, C. (2014). Judiciary views on criminal behaviour and intention of offenders with high-functioning autism. Journal of Learning Disabilities and Offending Behaviour, 5(2), 97-106. http://dx.doi.org/10.1108/JIDOB-02-2014-0002
Intimate Relationships and Sexual Health: A The Autism Spectrum, Sexuality and the Curriculum for Teaching Adolescents/adults with Law: What Every Parent and professional High-functioning Autism Spectrum Disorders and needs to know Other Social Challenges Book by Isabelle Hénault, Nick Dubin, and Tony Attwood Book by Catherine Davies and Melissa Dubie
12