Abstract
There have been very few reports about social skills training for patients with Asperger's syndrome. There have also been very few reports about the savant syndrome, a variant of Asperger's syndrome. We report a case of Asperger's syndrome, a 14-year-old male, for whom social skills training was successfully carried out. He had a savant syndrome's outstanding talent.
At 3 years of age he was assessed as developing normally. When he entered elementary school, he had few friends and spent most of his time at home. When he was in the third term of grade 8, he was first observed following around his favourite female classmate, even ‘ambushing’ her as she entered the classroom. The patient satisfied Gillberg and Gillberg's [1] diagnostic criteria for Asperger's syndrome.
Darold [2] listed calculation, mathematics, painting and music, and added the factor of memorising maps, as characteristic talents of ‘savant syndrome’. The reports so far on the savant syndrome's outstanding talents in Asperger's syndrome have been those of Mottron and Belleville [3] on three-dimensional drawing of inanimate objects and Dowker et al. [4] on poems. The present patient was characterised by his memory of maps and his role as a navigator on drives, and was regarded as a case of savant syndrome.
In the course of treatment, he was observed to have low self-esteem, a lack of confidence and poor communication with others. A therapeutic companion (TC) was in charge of his treatment. She recognised his outstanding ability and encouraged him to draw maps. As he spent more time communicating with the TC on a one-on-one basis, he began to gradually regain his confidence. We thought he would become more confident as his unique talent was evaluated, and he had time to draw maps and take pride in them. He was given social skills training for the interview part of his upcoming high school entrance exam. Interview tests were conducted to determine if such social skills had been acquired. After he had been allowed to freely answer the questions, inappropriate points (his attitude, behaviour, responses and inability to speak politely) were pointed out. He responded with the phrases ‘nothing’ or ‘nothing in particular.’ He was advised to make more appropriate responses. He was also trained in basic manners for interview tests: knocking at the door, excusing himself before doing something and standing until the interviewer offered him a chair. After repeated exercises of the social skills training, he was able to speak in the way the TC wanted him to. At last he was accepted by three private high schools. He attends high school without being late or absent. He has even joined athletic club activities. He made friends. So far he has not been seen following girls around. Although there have been very few reports about social skills training for Asperger's syndrome, Marriage et al. [5] reported that children with Asperger's syndrome had normal IQs, and that the most serious functional disability was the lack of sociability. Thus, social skills training has been effective for this patient.