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Peer support
Tuesday January 8, 2013
By Barbara Luborsky, OT


Bullying often is in the news these days, and our pediatric clients with Aspergerís syndrome often are targeted. In fact, according to Tony Attwood, author of "The Complete Guide to Aspergerís Syndrome," these children are least four times more likely than their neurotypical counterparts to be targeted by bullies, with shunning the top reported form of bullying. He goes on to say one in 10 teens with AS will experience a peer gang attack. These statistics are chilling.

As reported in Today in OTís News & Trends Oct. 15, a recent study by researchers at Washington University, St. Louis, corroborates Attwoodís statistics, finding an estimated 46.3% of adolescents with autism spectrum disorders have been victims of bullying, versus about 10.6% of the general adolescent population. The study, which appeared Sept. 3 on the website of the Archives of Pediatrics & Adolescent Medicine (now JAMA Pediatrics), concluded one important way to address the situation is for schools to "incorporate strategies that address conversational difficulties and the unique challenges of those with comorbid conditions."

What the Kids Need to Know is a new tool designed to address this recommendation. This PowerPoint presentation originally was developed by Ruth Bielobocky, whose son, Evan, has AS. It features clear and direct information about AS and instructions for leading a discussion with classmates to develop strategies for increasing social interactions and including the student in the classroom community. The presentation can be customized to include user-specific information.

This project initially was developed when Evanís anxiety about school became so severe that he was making himself vomit to be sent home. Bielobocky realized Evanís classmates might be nicer to him and more forgiving of his odd behaviors if they had information about his diagnosis and some strategies for interacting with him. She put together the presentation, previewed it with Evanís teacher and principal, and made arrangements to present it to the class.

After witnessing Bielobocky deliver the initial presentation to Evanís sixth-grade class, I was sure this tool could be useful to many other families. She and I worked together to write a script and parent guide and to document research validating this approach. The parent guide explains each step in the process of preparing the presentation, and the script provides dialog to use with each slide. The package includes a section about how to lead a productive peer discussion after presenting the PowerPoint. The best way to develop strategies the children will use to improve the social climate for the student with AS is to work collaboratively with the class. This includes promoting positive interactions among classmates that facilitate inclusion of the student.

Here is Evanís description of the experience: "On the day of the PowerPoint, I was nervous. What if everybody teased me more, or started acting like I had a disease? When the time came for my mom to present it, I left the room.

"When I came back into the room, it was like a light had turned on. Right away, everyone was much more open in general, and they seemed more understanding. They invited me to play games on the playground, and saw me for who I really was. Nobody mentioned my disability, but came forward with an open mind. Even though their behavior toward me was different, because they knew about my Aspergerís syndrome, I still felt a little 'different.í Over time, that feeling of being different really did fade away. A year later, I was one of the select few that received an invitation to go to a Halloween party, and after that, I truly felt like a normal kid. Being included in these social interactions really helped me learn those unwritten rules that you canít learn unless you are hanging out with other kids."

After the success Evan experienced with the What the Kids Need to Know presentation, several other families in our community used the presentation with good results. Children, and in some cases even teachers, are better able to include a student with AS in classroom communities after learning more about the diagnosis and the individual. When students participate in a problem-solving discussion about ways to help integrate their classmate into social activities, the resulting strategies improve life for the child with AS in the classroom setting. Helping children understand their peers with AS really does decrease bullying and increase positive interactions.

The What the Kids Need to Know package can be purchased for $47.99 at

Barbara Luborsky, OTR/L, is owner of Way to Grow LLC, a pediatric occupational therapy and speech practice in Frederick, Md.

Tuesday January 8, 2013
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