Monday, April 6, 2009

Western New England College's Peer Mentoring Program for Aspies, Part I

Hello,

It's April - National Autism Awareness Month.

Also, if you're a high school senior (at least in the U.S.), you've probably just gotten your college admission decisions and you're deciding where you'll go.

You don't need me to tell you that it's a tough decision. If you're an Aspie, maybe we can make your decision a little easier.

Western New England College (WNEC), like most colleges, has an Office of Student Disability Services (SDS - yes, those initials have a new meaning on today's college campuses). Unlike most colleges, it has a well-regarded Peer Mentoring Program for Students On the Autism Spectrum (there's another program, for students with AD/HD, described on the top half of the same page).

The three program leaders, SDS Director Dr. Bonni Alpert, SDS Assistant Director (and WNEC alum) Krysten Langone, MA, and Assistant Professor of Psychology (and Certified School Psychologist) Dr. Ava Kleinmann, so graciously agreed to spare a good bit of their scarce time and energy answering my questions. Their professionalism is a credit to WNEC.

Today, I'm going to present Professor Kleinmann's views. In the next part of our series, I will present Ms. Langone's perspective, and after that I will culminate the series with Dr. Alpert. Professor Kleinmann is an experienced school psychologist, and she speaks from a therapeutic perspective.

Q: What do you think are the most important challenges that NT classmates of Aspie college students face in dealing with them? What about NTs associating with Aspies in a variety of settings after graduation?

A: One of the major challenges in the college setting is communication. This can manifest in a number of ways from peer staff (eg RAs) having to repeat certain rules to working together on group projects for class. Group work is commonly cited as a challenge for college students, and this is magnified when one of the group members has difficulties with a variety of social and executive functioning skills. NT classmates have reported frustration when there is a lack of follow through from classmates on things as basic as returning a phone call or completing a simple task that was delegated to them.

There are also subtle behaviors that can be challenging for NT classmates to interpret including inappropriate eye contact or excessive politeness. A related challenge is that at our institution the students on the spectrum have chosen not to disclose their status to many peers, which can make for unrealistic expectations by NT classmates.

Assisting students on the spectrum with their transition out of postsecondary education is another important goal of the program. The first step is to support students in making it through some of the proximate challenges encountered every day from social relationships to schoolwork.

In the workplace, efforts should be made to best support the person on the spectrum, which may include setting up a job coach, to matching a job to their interests/skills, and helping the employer to see the benefit of hiring someone with an AS diagnosis. A lack of understanding of the needs and special skills of individuals on the spectrum can lead to difficulties similar to those encountered in college.

Q: What qualities have you found most important in a peer mentor?

A: Our program is comprised of highly motivated, talented and mature students seeking out the didactic and clinical experiences offered through the Asperger’s Peer Mentoring Program. Those mentors who model the same behaviors that are often goals for students with Asperger’s Syndrome are particularly well suited to be mentors.

One of the goals of the program is to teach students on the spectrum a variety of social, problem solving, and executive functioning skills critical to the college environment and beyond. This skills set should already be fairly well developed in the mentors based on successful completion of some of the college career. This in addition to consultation with doctoral level supervisors will allow them to support and serve as positive role models throughout participation in the program.

It is also expected that the mentors adhere to the highest ethical standards and we use the APA [American Psychological Association] code of conduct which is the standard for practicing psychologists. Exercising good clinical judgment, seeking assistance from the team, and utilizing problem-solving skills are all important qualities of mentors that are further cultivated through their experience in this program.

Q: How have peer mentors generally developed and challenged themselves during their service?

A: The challenges that the peer mentors have encountered have been as diverse as the opulation that’s been served. Some of the mentors have reported being challenged by altering the expectations for the nature of the interactions they have with students on the spectrum.

They have also been challenged by having dynamic goals based on changing mentees and changing circumstances in that person’s life. For example, an initial goal of having a mentee approach professors appropriately and independently may be substituted for a goal of developing prerequisitie skill of self-monitoring and problem identification.

Peer mentors have also developed a unique personal perspective on working with these peers, which has challenged their preconceived notions and at times their patience. An additional challenge has been training mentors to become student clinicians, which involves writing in clear, objective, and nonjudgmental behavioral terms while maintaining records and assisting
assessments.

Q: That's quite interesting, looking at what the peer mentors have faced. In what ways would you say peer mentors are better people at the end of their service than at the beginning?

A: Some of the mentors have reported the unexpected benefit of learning more from their mentees than perhaps they were able to share themselves. As each semester of the peer mentoring program progressed mentors expressed changing their expectations and realizing that what they got out of the experience was more than they could have ever expected.

In terms of actual skills mentors improve writing skills, develop some proficiency with the use of psychological assessments, and have a much better understanding of the autism spectrum, social skills training and clinical work in general.

Some of them have gained insight into their own behaviors by being placed in the position of describing, analyzing and assisting with the development of various behaviors in the students they work with.

Q: Do you think peer mentors should in some cases have the ability to give some rewards or even punishments, such as free tickets to events for meeting a goal, or extra required educational sessions - perhaps at some expense to the mentee - for failing to meet a goal or for some kind of inappropriate behavior? To what extent do you feel behavior modification should be a part of mentoring?

A: The peer mentors do give rewards and punishments to the mentees, but perhaps these are not as programmed as they would be in traditional applied behavior analysis.

Mentors give in vivo, natural feedback to their mentors, but this is changing as the skills and needs of the mentees change and are better understood/defined, and as the therapeutic relationship progresses. Mentors are trained to look for natural opportunities to provide social praise, which could be as simple as thanking the person for showing up on time for a scheduled meeting.

Administering natural punishment is also recommended but should be mild, direct, and should be used to teach something. For example, when a mentor lets a mentee know the consequences of starting a meeting late or missing a meeting (eg the fact that if interrupts the mentor's schedule, can be frustrating etc) they are providing that person with valuable and constructive feedback that might not otherwise be delivered in a constructive, therapeutic manner.

Of course the extent to which these consequences for behavior are delivered are carefully discussed in the context of supervision meetings and clinical judgment is something that is being cultivated in the mentors. Our program used a variety of therapeutic approached with the mentors and mentees, but behavioral technologies including both antecedent strategies and positive consequences are central to effective service delivery.

Presently contrived rewards and punishments are not part of the program. Because the program strives to provide social skills training, support etc in vivo it is delivered in as natural a way as possible. Certainly introducing more programmed consequences is an option but is not currently a component.

I could see how using rewards such as coupons to the campus center or tickets to events in the area would be helpful. However, the use of punishments might not be the best route to go because while punishment may serve to suppress undesired behavior it does not increase target behaviors or really teach any new skills.

Q: More broadly, how do peer mentors best give feedback to mentees? Do they need to be more blunt than when talking to fellow NTs?

A: As mentioned previously being direct, specific, and giving that feedback as soon as possible is likely to have the best impact. Many individuals with Asperger’s have some difficulty interpreting the subtleties of language from tone to the nonverbal aspects of communication. Mentors are instructed to be clear and direct, but also look for natural opportunities to teach about the various shades of gray that exist with language and communication.

Sometimes being “blunt” may not have the desired effect, which is why a careful balancing of the therapeutic relationship with the need to provide that feedback is something that needs to constantly be evaluated.

Q: To what extent - if any - do you feel that Aspies can be successful peer mentors? What particular challenges and assets could Aspies bring to that role?

A: Great question. Many of our mentees have been highly successful at demonstrating a broader range and more appropriate social skills in a variety of contexts. They have provided valuable feedback to the program when "debriefing" about the experience to the SDS director.

If a student is motivated, interested, and willing to put in the work they would certainly be in a unique position to work with peers and share their own experiences if necessary. Certainly many of the same challenges that exist when working with NT mentors would also potentially be present with Aspie mentors, particularly since this is a new experience.

In particular, navigating the unclear areas of the therapeutic relationship as a mentor - but not officially a clinician - would be challenging since it’s impossible to anticipate every possible judgment issue to preteach problem solving strategies.

Q: What should mentees be prepared to do to make the mentoring relationship work?

A: That’s a tough question because it depends on so many factors, including what the mentor and mentee each bring to the table and what their expectations might be. Because these expectations can change throughout the course of the relationship communication about changing needs, challenges, etc is crucial.

Of course the complexity of this task is compounded by the existence of communication differences that already exist. Having realistic, achievable goals and being flexible in those goals is certainly an important component. Getting those out in the open early on is also important instead of making assumptions about what is important to each party.

This might be accomplished by creating a written yet dynamic “contract” about each party’s responsibility. Being able to make the time commitment to meet regularly and stay in touch is also important and this is where the mentors take the lead to get everyone on the same page.





Dr. Kleinmann made some notable points. I will just highlight a few:


  • In particular, while Dr. Kleinmann is not categorically against "artificial" incentives in a mentoring program, she feels that the best approach relies on natural consequences, including natural, real-time opportunities to reinforce desired behaviors. She believes that teaching general social skills and ways of thinking, not narrowly conceived behaviors, is most important, and that contrived punishments are ineffective because they only discourage undesired behaviors without pointing the way to better ones.

  • Dr. Kleinmann also believes that the peer mentoring relationship is to some extent also therapeutic. While doubtlessly she would not hesitate to have a peer mentor refer, say, a suicidal mentee to appropriate professionals, she does hold mentors to the standards of ethics expected of therapists. Also, while on the one hand Aspies may need to be told things more directly, even bluntly, than do NTs, she also believes that therapeutic considerations require limits on how mentors get their points across.

  • Aspies can certainly be peer mentors, too, as long as they can put in the time and effort. Aspie mentors will need to be able to exercise enough judgment to work well in a therapeutic setting, since not everything can be pre-taught. Scripts will only go so far.

  • For NT and Aspie mentors, the experience can be quite rewarding. For example, mentors can improve their communication and clinical skills and even learn more about themselves. While Dr. Kleinmann does not mention career implications, her views suggest that the experience can be especially good for future teachers, therapists and others - especially (but not only) if they might like to work with people on the autism spectrum.

  • Dr. Kleinmann also makes clear both that (1) NTs need to understand AS so as not to misinterpret unusual behavior on Aspies' part and (2) Aspie behavior, such as showing up late or even not at all for scheduled meetings, can be legitimately frustrating to NTs.

What do you think?

2 comments:

Anonymous said...

The interviewee who talks about "punishments" for adult college students sounds pretty sick. Since when should a "Doctor" (who throws around psuedoscience terms like "NT" and "Aspie") talk about punishing students? I'd never let my kid anywhere near this person. My kid needs services in college, not become a lab rat for this behaviorist extremist.

People with Asperger's suffer enough without needing this person playing God and giving them "rewards" or "punishments" -- those come on their own with life.

The condescension this person has towards people (yes, they're PEOPLE, Dr. Alpert) with Asperger's is disturbingly palpable. She buys into stereotypes of the inferior, irresponsible, barely-human, and asocial "Aspie" who should learn to be just like the superior "popular kids." Nevermind that plenty of the "NT" students at her institution probably have similar if not more self-destructive habits.

I can't imagine that a responsible institution lets someone with such repulsive views interact with this "vulnerable population."

Jeff Deutsch said...

Hello,

I can definitely understand your strong views about rewards and punishments.

From discussing Dr. Kleinmann's responses with her, it seems to me that she agrees with you that contriving punishments does less good than harm. In fact, she does not seem enthusiastic about contriving rewards either, though she may feel that it could be acceptable under some circumstances.

Dr. Kleinmann seems to agree with you that rewards and punishments come on their own with life, as you put it, and she said that mentors should restrict themselves to showing the natural consequences of different kinds of actions.

I have no doubt there are some Aspies who do quite well without mentoring. On the other hand, others find that explicit introduction to various social and executive functioning skills - which many NTs have already been able to learn implicitly - can really make the difference in regard to getting along better with their roommates and RAs, having friends and dates and even doing better in class.

Speaking only for myself, I know it would have made all the difference. That's a major reason why I've profiled this program.

What do you think?

Jeff Deutsch

PS: "NT" and "Aspie" are lay terms, and while no doubt professionals who work with Aspies may also understand them, those terms are not intended to convey any scientific meaning.