Bereavement and Autism:A Universal Experience with Unique Challenges
22nd Annual Tri-State Psychology Conference, University of CharlestonPlenary Paper Session Presentation – Friday, April 12, 2013
Brian A. Wong ‘13 Marshall UniversityB.A. Psychology; Counseling minorFaculty MentorKeelon L. Hinton, Department of PsychologyMarshall UniversityWatch presentation @ http://www.youtube.com/watch?v=WFPU7Ksxg_M
At age 15, mom’s death to melanoma at age 54 (10/50-12/04) U.S. Army Band – Fort Myer, Virginia (1974-1998) First female Sergeant Major
Diagnosed with Asperger’s (2005-2006)
College Program for Students with Asperger’s Syndrome Sociology of Death and Dying (SOC 452/552) (Spring 2010)
Hospice of Huntington (Fall 2010) for Clinical Placement (COUN 370) class
Grief Counseling (COUN 456/556) (Fall 2011)
Wendt Center for Loss and Healing (Washington, DC)
Camp Forget-Me-Not/Camp Erin DC 2012
Attended 17 funerals and 4 weddings
Need for attention“There is very little research in this area. Suggestions for helping individuals with ASDs understand and cope with death are available. But empirical literature is scarce. Since all individuals with ASDs will face bereavement in their lives, this is an area that deserves more research attention, particularly focused on strategies and interventions.”
Barbara Becker-Cottrill, Ed.D. Executive Director, West Virginia Autism Training Center at Marshall University
Autism Society of America Panel of Professional Advisors
Ed.D. – Teachers College, Columbia University
(Personal correspondence – Wednesday, March 13, 2013)
What is out there on bereavement and autism?
Hypomania following bereavement in Asperger’s syndrome: A case study. (Berthier, 1995)
Abnormal bereavement in a 21-yr. old male with Asperger’s who became mute after death of grandfather. Possibility of exaggerated and masked grief.(Marston & Clarke, 1999)
(Peer-review search on Academic Search Premier, PsycARTICLES, PsycCRITIQUES, PsycEXTRA, and PsycINFO)
Bereavement & Support from others
Regular Theme in Psychotherapy• Often overlooked in therapy by professionals• Appears most often as underlying issue rather than presenting issue(Humphrey, 2009)
Not uncommon for members of support system to invalidate feelings. (Pomeroy & Garcia, 2009; James & Friedman, 2009)
Personal experience • After funeral. • Significant dates
Post-loss Grief Recovery Process
Tasks of Mourning• 1) Accept reality of loss; 2) process pain of grief; 3)
Adjust to life without deceased; and 4) emotionally relocate the deceased
Mediators of Mourning• Relationship to deceased and nature of attachment• Nature of death (expected, unexpected, violent?)• Historical Antecedents• Personality and social variables• Concurrent Stressors
(Worden, 2009, pp. 39-52, 57-77)
AutismPrevalence is rising• In 2009: 1 in 100 children• In 2012: 1 in 88 children (Centers for Disease and Control, 2009, 2012)
Colleges and universities supporting students (Hood, 2011; Jaslow, 2011)
Interaction with neurotypicals rise
Predicted Challenges with autism and grief
Theory of MindAffect/behavior and empathy interacting with other grievers
Concrete/Literal ThinkingMaybe cognitively in Preoperational/concrete stageDifficulty with abstract concepts relating to death (e.g. afterlife, permanence)Not seeing the body (Task 1)Difficulty with emotionally relocating deceased in life (Task 4)
Specific InterestsPreoccupy self with matters relating to circumstances surrounding death
(e.g. obituaries, funerals, cause of death,)
Complicated Grief or coping?
Executive FunctioningRigid in routines (Task 3); function best on predictabilityAdjusting to loss – anticipatory grief vs. post-loss grief.
Predicted Challenges with autism and grief (cont.)Verbal Ability
Expressing feelings, eulogies, etc.Online groups
Age of peersFriends with older/younger peopleIf older, depending on age, more future losses?
Existing network of peersWill peers remain or become a secondary loss?
Intervention“Psychological interventions do sometimes actually make people worse, usually when the intervention is unwarranted and interferes with a natural recovery process” (p. 105).
George A. Bonanno, Ph.D.Department of Counseling & Clinical PsychologyTeachers College, Columbia University
Bereavement-themed Social Stories Marc Ellison, M.A. Ed.D., Associate Director of Training, West Virginia Autism Training Center at Marshall (Personal correspondence Wednesday, March 6, 2013)
Suggested research•Social stories, pre-loss and post-loss•Approaching the topic of bereavement with birds and the bees
While not everyone will have children, everyone will face bereavement.
Bereavement & Autism
•Bereavement• Inevitable, universal • Recovery process unique to each individual• Not many are aware of how to support grieving
friends• Described as “lifelong journey” by one of my
bereavement counselors
•Autism• Diagnosis rate rising • Schools supporting students on the spectrum• Likelihood of interaction with autism at school and
work
Brian A. Wong ‘13
Marshall University
B.A. Psychology, Counseling minor
Paper and slide may be downloaded/read @
http://marshall.academia.edu/BrianWong
References Berthier, M. (1995). Hypomania following bereavement in Asperger’s syndrome: A
case study. Neuropsychiatry, Neuropsychology, & Behavioral Neurology,8(3), 222-228.
Bonanno, G.A. (2009). The other side of sadness: what the new science of bereavementtells us about life after loss. Philadelphia, PA: Basic Books.
Centers for Disease Control and Prevention. (2012, Friday March 30). “Prevalence ofautism spectrum disorders – autism and developmental disabilities
monitoring network, 14 Sites, United States, 2008.” Surveillance Summaries.Morbidity and Mortality Weekly Report 61(3). Retrieved fromcdc.gov/mmwr/pdf/ss/ss6103.pdf
Centers for Disease Control and Prevention (2009, Friday December 18). “Prevalenceof autism spectrum disorders – autism and developmental disabilities
monitoring network, United States, 2006.” Surveillance Summaries. Morbidity and Mortality Weekly Report 58(SS-10). Retrieved fromcdc.gov/mmwr/pdf/ss/ss5810.pdf
Hood, G. (2011, Wednesday April 13). “Autistic kids learn to survive, and thrive, incollege.” National Public Radio. Retrieved from
npr.org/2011/04/13/135345982/colleges-address-autistic-students-struggles.
References (cont.)Humphrey, K.M. (2009). Counseling strategies for loss and grief. Alexandria, VA:
American Counseling Association.
James, J.W. & Friedman, R. (2009). The grief recovery handbook: the action programfor moving beyond death, divorce, and other losses. (Rev. ed). New York,NY: HarperCollins.
Jaslow, R. (2011, Monday May 9). “Autism spectrum students get welcome at morecolleges.” CBS News. Retrieved from www.cbsnews.com/8301-504763_162-20061046-10391704.html
Marston, G.M., & Clarke, D.J. (1999). Making contact--bereavement and Asperger’ssyndrome. Irish Journal of Psychological Medicine, 16(1), 29-31.
Pomeroy, E.C. & Garcia, R.B. (2009). The grief assessment and interventionworkbook: a strengths perspective. Belmont, CA: Brooks/Cole, 2009.
Worden, J.W. (2009). Grief counseling and grief therapy: a handbook for the mentalhealth practitioner. (4th ed.). New York, NY: Springer Publishing.
