Clients with Asperger’s Disorder Blossom in Wilderness

By Jesse Quam, LCSW and Leah Madamba, MS, NCC, LPC

David was overwhelmed.

That morning, his parents woke him up earlier than usual in order to bring him to his new therapeutic wilderness program, where he would live and learn for the next six to eight weeks.

This change in his daily routine, compounded with the bothersome tag in his new long underwear and his itchy new polypropylene socks, made him feel anxious and scared.

Shortly after arriving at the wilderness program, David found himself amid six peers who were frenetically sorting through the week's food supply. The program's field staff, while being very kind, misunderstand his questions about how they are going to eat dinner without a kitchen to cook in and how they will wash their hands without a sink and running water.

Exacerbating his reaction to this over-stimulation, he was desperately missing his regular updates to his baseball scores, especially since the season just started.

Without a savvy, creative intervention, David could have quickly spiraled out of control -- yelling, screaming, and threatening to hurt himself or others because he does not feel like he has control over anything. His parents and teachers had experienced these outbursts many times over the years -- but neither his parents nor his teachers were there.

In other words, David was on the verge of a meltdown.

Diagnosing David

During David's early years, his parents had struggled to understand why their son was acting in what, to them, was such a confusing (and occasionally confounding) manner. At first, doctors thought he had Attention Deficit Hyperactivity Disorder. Later, they theorized that he might be suffering from a childhood form of bipolar disorder. But nothing seemed to explain (or help with) his behavior problems

Finally, when he was six years old, David was diagnosed with Asperger’s Disorder.

According to information Dr. R. Kaan Ozbayrak has posted on his website, www.aspergers.com, Asperger’s Disorder is a milder version of Autistic Disorder. Both Asperger's Disorder and Autistic Disorder fit into the larger category of Pervasive Developmental Disorders (PDD).

While David's parents felt relief at having a diagnosis, they were also overwhelmed by the complexity of his daily needs.

About Asperger's Disorder

Asperger’s Disorder is often characterized by social isolation and eccentric behavior during one's younger years:

  • Children and adolescents who have Asperger's Disorder often experience challenges with their social skills due to impairments with two-sided social interaction and non-verbal communication.
  • Their speech may be marked by repetitive patterns or odd inflections.
  • They tend to be clumsy and usually have a specific area of interest (for example American Revolutionary History, trains, technology, or astronomy) that precludes interest in other age-appropriate topics.

While researchers have made considerable advances in their efforts to understand Asperger’s Disorder, there is still no “cure” or specific treatment for the disorder.

Typical interventions are focused on addressing the particular symptoms or rehabilitating the person so they can function in society. For example, with psychosocial interventions, individual therapy can help the client talk about how difficult it is to be socially different. Other routes involve social skills training, parent education, behavior modification, and educational interventions.

Another option involves the use of psychopharmacological interventions. This means taking medications to address different symptoms such as hyperactivity and impulsivity, irritability and aggression, preoccupations and compulsions, and anxiety.

The Benefits of Wilderness

Given the apprehension that David demonstrated upon his arrival -- and considering the many challenges facing all children who have Asperger's Disorder -- some might question the appropriateness of enrolling in a therapeutic wilderness program. But wilderness programs have proved to be particularly beneficial for adolescents and teens who have Asperger's Disorder.

In the unique environment of a therapeutic wilderness program, there is the opportunity to be creative and flexible in combining all of these typical interventions as well as incorporating some new ones.

For example, when David felt over-stimulated by the frenetic energy of the group and the apparent lack of structure in the daily routine, the field staff pulled him aside and asked him questions to find out more about the stressors. David compared it to feeling like a balloon that keeps expanding on its way to popping. This metaphor gave David a way to express his feelings and gave field staff a way to assess his anxiety level. The staff then explained the evening routine to him and answered all of his questions about how the group would last without any modern conveniences.

Making Progress

Over the course of his first two weeks in the therapeutic wilderness program, David began to feel much more comfortable living outdoors. He trusted the daily routine, and had faith in the adults who were supervising his activities.

As he became more comfortable and trusting in his wilderness environment, David began to work on his social skills. His training began with one-on-one sessions with his therapist. As they talked together, the therapist explained the facial expressions he gave in response to David’s stories.

The next step was bringing in a trusted peer to have a discussion about what it means to be a friend. David also learned how to make and keep friends by living in a small group of peers where feedback was immediate. Eventually, with the support of the staff, David was able to lead an evening meeting with his peers.

The wilderness program even addressed David's fixation on baseball, and used this passion to encourage his progress. David's therapist incorporated baseball metaphors into daily teachings, and he was also allowed to earn baseball updates as he progressed through the program’s levels. This helped David to manage his anxiety and recognize what things he could control.

As a back-up plan for times when David felt overly frustrated, a plan was put in place in which David agreed to break sticks and burn them in the fire, or talk to staff about his feelings, before threatening himself or others.

Experiencing Success

At the end of his seven week stay, David was proud of his accomplishments.

During the Trail’s End experience that marked the completion of the wilderness program, his parents were impressed to see the leadership skills that he had developed with his peers. They also noticed that David was less rigid, more flexible, and better at staying in the moment.

Thanks to this useful wilderness intervention, David was able to experience successes that he can use as benchmarks for continued progress in future experiences.