FASD and Education An Ontario Perspective

1
FASD and Education An Ontario Perspective

• FASEout Presentations
• February 17, 2006 - Ottawa
• Mary K. Cunningham B.Ed. P.H.Ec.

2
Acknowledgements

• Mary Cunningham is a parent of a young adult with
  ARND. She has been learning about FASD from her
  daughter and her students since 1998.
• Diane Malbin, (Oregon) Donna Debolt (Lethbridge),
  Chris Margetson (Guelph), Bonnie Buxton (FASworld
  Toronto), Cheryl Duquette (Ottawa), Laura
  Spero(London)
• Alberta Government Education ministry

3
Presenter Information

• Parenting consultant and FASD advocate
• Retired from 30 years in education system as a
  teacher, department head and consultant
• Has two young adult children, one with ARND
• Is married to another retired educator
• Co-author of Parenting in Canada, 2003
• Co-founder of ON Coalition for Parenting Ed.
• Lives in Kitchener, ON cunninghammary_at_rogers.com

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FASD and Education An Ontario Perspective

• 1-Educational Success for
• Students Affected by FASD
• 2-Advocating Successfully
• within the School System

5
Educational Success for Students with FASD

• 1- Introduction
• 2- FASD 101 for Educators
• 3- What FASD Looks Like at School
• 4- Brain Damage Behaviour
• 5- How Secondary Effects Develop
• 6- Success for Students with FASD

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FASD is an umbrella term for

• Fetal Alcohol Syndrome (FAS) (obvious to all)
• Partial Fetal Alcohol
• Syndrome (pFAS)
• Alcohol Related Neurodevelopmental
• Disorder (ARND)
• ARBD, Static Encephalopathy

7
FASD and Education?Have I seen FASD yet?
8
Alcohol Use In Pregnancy

• 50 of pregnancies are unplanned
• 17 to 25 of women reported drinking alcohol
  during their last pregnancy
• 7 to 9 reported drinking alcohol throughout
  their last pregnancy
• Canadian National Survey

9
What about Dad?

• A fathers drinking does not cause FASDBUT
• Drinking and drug use can damage sperm causing
  subtle neurological damage such as
  impulsivity,learning disabilities, attentional
  problems (lower birth weight)
• When a father drinks he influences the mothers
  drinking

10
Co-occurring Mental Illnesses

• ADD/ADHD is often diagnosed
• (Reactive) Attachment Disorder (R-AD)
• Bi-Polar Disorder/Depression
• Conduct Disorder (CD)
• Oppositional Defiant Disorder (ODD)
• Obsessive Compulsive Disorder (OCD)
• Borderline Personality Disorder (BPD)
• (Kathryn Page 2002- Ctr. For Families, Children
  Courts)

11
FASD in Education Facts

• Health Canada notes that 1 of live births are
  FASD-affected. (This is probably low). This means
  at least 300,000 Canadians are living with FASD
• FASD is one of the most common birth defects in
  North America
• FASD is the most common cause of developmental
  delay in North America
• IF YOU ARE AN EDUCATOR YOU HAVE DEALT WITH FASD

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Most Students with FASD are Invisible
13
The Usual FASD Story

• JK/SK unduly quiet or aggressive and unruly
  (ADD/ADHD-like)
• May slip through cracks at first
• Level 2 C evaluations
• By 4-6 serious learning problems are obvious
  reading, math, science
• May be a Safe School nightmare with
• frequent suspensions

14
The Usual FASD Story

• By grade 7 or 8 is dropped by achieving friends
  who can see disabilities
• Picks up with peers with similar problems
• School skipping, no homework, school failure
• Petty crime, drugs, alcohol use, early sexual
  activities
• Early school dropout or expulsion first sign of
  marginalized adulthood

15
If you are an educator

• You have dealt with students who have FASD
• You will deal with students who have FASD for the
  rest of your career
• So, whats to be done?

16
Reframe The Behaviour

• IT IS NOT THAT THEY WONT,
• THEY CANT

17
Brain Damage Behaviour Change (Donna Debolt)
18
FASD Information Processing Disabilities

• FASD is an extremely serious and debilitating
  information processing learning disability
• A student could have any or all of these
  deficits
• 1.    Input- recording of information from the
  senses
• 2. Integration- process of interpreting the
  input
• 3. Memory- storage of information for later
  use
• 4. Output- producing answers, responses,
  completion of work

19
Two Common Reactions Processing Difficulties

• 1- Total shut down and turn off
• May be confused with ADD
• 2- Hyperactive acting out
• May be confused with ADHD
• ADHD is frequently misdiagnosed!

20
Brain Damage Behaviour

• Our brain is like a computer CPU and it
  controls our behaviour
• When the CPU gets the wrong data or processes
  data incorrectly dysfunctional behaviour results
• A FASD-affected brain will not recover so those
  around it must adapt and serve as
• external brains

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What might an information processing disorder
feel like?

• Imagine loud music is blaring, the lights are
  buzzing and you are wearing a scratchy wool
  sweater over your bare skin, (Dorothy Shwab,
  Manitoba)
• This is how it feels for a student with FASD,
• Exactly what would you actually learn under these
  circumstances?
• How would you act under these conditions?

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Primary Effects a Teacher Might See(A-L-A-R-M)

• Adaptation - trouble stopping or starting
  activities
• Language - talk a great line, but dont get
  it when people try to talk to them
• Attention ADD/ADHD frequently misdiagnosed
• Reasoning dont understand abstract ideas, eg.
  math
• Memory - sketchy-on and off, has big gaps,
  dont learn from experiencesame mistakes over
  and over
• IT IS NOT THAT THEY WONTTHEY CANT

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Brain Damage Causes Dysmaturity

• A confounding but classic sign of FASD
• Student appears to be functioning at different,
  inconsistent ages, for example
• Chronologically 18 Socially 12
• Emotionally 8 Cognitively 9
• Research is starting to show that individuals
  with FASD tend to get as mature as they are going
  to, or get caught up by age 35, too late for
  the school system, but still a ray of hope for
  parents

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Dysmaturity Concept Students with FASD
Frequently Show Many Different Ages
SKILLS
Expressiveness (Talking)
Understanding Ideas
Money Time Concepts
Emotional Maturity
Physical Maturity
Reading ability
Social Skills
Living (Life) Skills
How Old He/She MAY act in each skill area
Adapted from research findings of Streissguth,
Clarren et al by D. Malbin 94
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Will Students Outgrow FASD?NO

• They may have life-long problems with
• - Learning
• - Remembering
• - Thinking things through
• - Getting along with others
• Brain damage is permanent!

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The Worst Case ScenarioSecondary Effects Develop
27
Students With FASD Often

• Are bullied and stigmatized
• Have trouble finding friends
• Do not achieve at school
• Disappoint people around them
• Are disappointed in themselves
• Develop very poor self esteem

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Then FASD creates Secondary Behaviours (Malbin,
2004)

• Primary FASD behaviours are those that most
  clearly reflect underlying damage to brain
  structure and function (slides 29 ff)
• Secondary FASD behaviours are defensive and
  develop over time in response to a non-supportive
  environment, the individual suffers from a
  chronic inability to fit in

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Secondary BehavioursAn Educator Might See at
School

• Bullied, Teased
• Fighting, Outbursts
• Running away, Avoidance
• Sexually inappropriate to point of being
• dangerous
• Depressed, Suicidal
• Co-occurring Diagnoses
• School Failure, Expulsion grade 9/10

• Inappropriate humour
• Class clown
• Isolated, Few friends
• Pseudo-sophisticated- trying to pass as OK
• Irritability,Resistance, Fatigue, Arguments
• Anxious,Fearful,
• Overwhelmed
• Poor Self Esteem
• Unrealistic Goals

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Secondary Effects of FASD (1996-Washington State)
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Review

• Alcohol in utero can cause both physical and
  neurological damage to the fetus
• Neurological (brain) damage is the root of most
  FASD problems faced by schools
• Brain damage causes very serious learning
  disabilities which lead to primary behaviours
• If left untreated primary behaviours turn into
  serious secondary behaviours and a marginalized
  adulthood (see Streissguth, 1996)

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The Best Case ScenarioSuccess for Students with
FASD
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Change the Paradigm

• If they could they would -It is not that
  students with FASD wont, they cant
• Understanding this will change your attitude and
  they will notice your support Behaviour Brain
  Damage
• Diabetics need insulin, paraplegics need wheel
  chairs, students with FASD have permanent brain
  damage and need you to deal with this
  irreversible fact
• Learn to love the student you got, not the one
  you wanted

34
There IS a silver lining

• ALL STUDENTS WITH FASD
• HAVE INNATE STRENGTHS
• AND COMPETENCIES

35
Recognize ability not disability!

• ALL people with FASD excel in some or all of the
  following areas
• ART MUSIC POETRY
• MECHANICS HANDS-ON SKILLS
• WORKING WITH CHILDREN ANIMALS
• COMPUTERS TECHNOLOGY
• COMPETITIVE SPORTS

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Multiple Intelligences

• Howard Gardner is the theorist behind MI, this
  is especially useful for students with FASD
• Everybody has some of each of the 9 intelligence
• groups. Find out what you are good at and work
  at getting better. Dont beat yourself up about
  your weaknesses.
• Multiple Intelligence development is especially
  important for students with FASD. Good for self
  esteem development too
• Google Howard Gardner Multiple Intelligences

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Multiple Intelligences

• Verbal Interpersonal Visual
• Kinesthetic - Musical Naturalistic
• Intrapersonal - Mathematical Existential
• Every student has some of each. Discover and
  develop your best ones!

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Typical Strengths and Abilities

• Hands on learners
• Kinesthetic, energetic
• Learn by doing and repeatedly shown
• Good long term visual memory
• Value fairness and
• can be rigidly moral,
• comforted by rules
• and orderliness

• Express themselves
• well verbally
• Good with animals, children, mechanics,
  computers, and the arts
• Friendly, affectionate,
• loving, loyal, gentle,
• determined, sensitive
• and compassionate

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Teaching Students with FASD

• FASD strategies will not hurt students so when in
  doubt or waiting for diagnosis go ahead and use
  these strategies
• The ideas in this presentation are an
  introduction only and teachers should be aware
  that an endless repertoire can be developed.
  There is no magic formula.
• All these Special Education strategies are just
  good teaching. They work for almost any student
  with learning disabilities.

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In General

• Head off trouble, nip escalating stimulus
  overload before the child explodes
• Provide constant supervision, preventing a crisis
  is easier than cleaning it up
• These students need external brains
• All the expectations in curriculum wont be met,
  teach life skills and blend in academics
• Teaching life skills that others learn by osmosis
  must be multimodal,repeated and compelling
  (ESSENTIAL)

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Some Starter Strategies

• Reduce stimulation, provide quiet places for them
  to de-stress as needed
• Go slowly-10 s children in a 1 s world
• Hands on learning, focus on strengths
• Foster interdependence not independence
• Repeat, re-teach, repeat, re-teach, repeat
• Carpe diem- Enjoy today, do a day at a time

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More Starter Strategies

• Do not ask why they dont know
• If things go wrong try differently, not harder
• Make transitions as easy as possible
• Use visuals as often as possible
• Break everything into steps, do 1 at a time
• Remember that students with impairments teach
  life lessons to everybody else

43
External Brains (S. Clarren)

• Help the child reframe their world
• Provide crutches for an invisible disability
• Provide pro-active and intervention strategies
• Assist the child to process information and to
  respond more appropriately
• If you are physically disabled you need a
  wheelchair.
• If you are blind you need a seeing eye dog.
• If you are a child with FASD you need an external
  brain.

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People Who Understand
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Teaching Students with FASDBuilding Strengths,
Creating Hope

• The following website is INVALUABLE
• www.education.gov.ab.ca/k_12/specialneeds/fasd.asp
  
• Western Canada is light years ahead of us in
  all aspects of FASD understanding, prevention and
  intervention (education)
• Do not try to re-invent the wheel, go to the
  above Alberta website for the newest and best
  resource on successful education for students
  with FASD
• You may print for free 165 pages in length

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Teaching Students with FASDBuilding Strengths,
Creating Hope

• Introduction
• Chapter 1 What is FASD?
• Chapter 2 Key Program Planning Concepts
• Chapter 3 Positive Classroom Climate
• Chapter 4 Students Needs
• Appendices A, B C (excellent resources)
• Bibliography and Index

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Ideally..

• We will substantially reduce the incidence
• of FASD in the future.How?
• By spreading the Zero 4 Nine message

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Zero 4 Nine Messages

• No known amount of alcohol can be consumed safely
  during pregnancy.
• There is no known safe time to drink alcohol in a
  pregnancy
• A pregnant woman has a choice, her baby does not.
• A pregnant woman may need help from her spouse
  and peers not to drink.
• Avoid alcohol when planning a pregnancy or breast
  feeding

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FASD Prevention in Education

• The place to get the 0 for 9 message out so it
  will stick is to students before can drink
  legally
• OCMPE The Ontario Coalition for Mandatory
  Parenting Education wants all high school
  students take and pass a parenting course before
  graduation FASD messaging will be embedded.
• Fewer babies in the stream!

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For More Information

• Please feel free to contact the presenter at
• cunninghammary_at_rogers.com
• or 519-893-7393 (Kitchener, Ontario)
• The internet is a valuable source of information,
  search under fetal alcohol spectrum disorder
• www.education.gov.ab.ca/k_12/
• specialneeds/fasd.asp (excellent resource)

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The End of Part OneRECESS!
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FASD and Education An Ontario Perspective

• 2-Advocating Successfully
• within the School System

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Successful Advocacy inthe School System

• 1-Advocacy and Advocates
• 2-Parent and School Relationships
• 3-Getting a Diagnosis of FASD
• 4-FASD Has NO Special Ed category!
• 5-Emphasize the Positive
• 6-Strategies for Successful Education

54
FASD Advocacy?

• Advocacy is active support especially
• the act of pleading or arguing for
• something
• An advocate is a person who pleads
• for a cause or promotes ideas
• Students with FASD need advocacy and
• advocates to have any success in todays
• schools

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Who Can Advocate for Students?

• Teachers
• Parents and/or caregivers
• Anyone else who works with students in a school
  professionals, paraprofessionals
• - others working in the school
• Anyone who understands schools and FASD has the
  potential to be a good advocate for a student
  with FASD

56
Involve the Whole School

• Ideally ALL the people who work in
• a school from the administrators
• and teaching staff to the custodians,
• community coaches and lunch room
• supervisors will understand the
• realities of FASD and be prepared
• to recognize and properly support
• students who may have (or just look
• like they might have) FASD.

57
Whole School Efforts

• FASD 101 professional development
• for everybody
• Use of whole school programs like TRIBES
• With All Due Respect Ronald Morrish (Font Hill,
  ON)

58
Involve the Whole Community

• Establish an FASD Task Force and Support Team at
  the board level
• Educate all school staff personnel about FASD.
• Build community awareness about FASD.
• Be prepared to support parents and teachers
  caring for FASD children.
• Implement changes in the school environment and
  academic programming
• Get diagnostic facilities in the community.
• Refer children for FASD testing.
• Revisit administrative procedures regarding safe
  schools.
• Set up a personal advocate for each child with
  FASD

59
A Delicate Balancing Act

• The squeaky wheel gets the grease?
• OR
• The squeaky wheel gets changed?
• One always catches more flies with sugar than
  vinegar
• Each school will have different limits

60
Most FASD experts such as Malbin or Debolt
acknowledge that many parents of children with
FASD give the impression of being crazyMost
parents will obsess to get their children served
61
Parent/School Relationship

• FASD parents are the ultimate, 24 hour
  front-line workers and desperately need your
  support
• These parents only appear to be crazy they are
  almost overwhelmed and super stressed
• Professionals are often tempted to assume that
  (undiagnosed) FASD is the result of ineffective
  parenting and family dysfunction.
• The family with FASD is often dysfunctional
  because of FASD not the other way around

62
Duquette et al Research

• School Experiences of Students with Fetal
  Alcohol Spectrum Disorder Duquette, Cheryll and
  Emma J. Stodel (U of Ottawa) in Exceptionality
  Education Canada, vol 15, 2, 2005, pp.51-75
• Examined factors leading to persistence in
  school among students with FASD from perspectives
  of the students their parents
• Relatively small sample (24), all children
  adopted
• The high maintenance parent appeared to foster
  success parental advocacy is strongly linked
  with persistence and graduation among students
  with FASD
• Parents studied FASD then educated teachers

63
Elements Related to School Success (Duquette et
al)

• Caring teachers who understood FASD and made
  accomodations led to more success
• Parents obtained psychological testing and used
  diagnoses to access services and to provide an
  underlying reason for student difficulties
• Specialized programs and paraprofessionals,
• when needed, were related to success
• Most parents advocated strongly and provided
  encouragement at home

64
Parent Advocates

• Need to remember that teaching has been
  designated as just slightly less stressful than
  air traffic control the most stressful
  occupation in that study
• Teachers are responsible for all the students in
  their classes not just your child who may be
  taking a lot more energy than the others

65
Summer holidays DO NOT make up for 10 months of
extremely stressful teaching. They merely allow
most teachers to continue teaching the next
September
66
Educators on the other hand will do well to
remember that every student has parents and/or
caregivers who understand their individual needs
better than anyone else
67
An involved parent or caregiver for a child with
FASD is generally going to know a lot about FASD
and should be considered as an expert
68
It should never come to this
69
Parents, schools fight 1.8 Billion special needs
war Dec. 5/05 (Star) HELEN HENDERSON LIFE
COLUMNIST (THE STAR)   Gordon Martin is 9 years
old. Over the past two years, he has arrived home
from school on several occasions with feces in
his lunch bag and disturbing marks on his skin.
In October, he was expelled for disruptive
behaviour.   His mother has been banned from all
school board properties and accused of uttering
profanities and making false allegations against
staff and students. The Martins moved to a
smaller house, cashed in their retirement savings
and got help from community garage sales to pay
for a specially trained support therapist to help
in class with their son, who is autistic. The
school asked the therapist to stay out of the
classroom.   Gordon's mother says his behaviour
at school X School in X was a response to how
he was treated there. The school calls her
complaints "baseless."   Welcome to the war zone
that is special education in Ontario As
in many cases examined by the Star, communication
between family and school board broke down
completely, an issue the working committee
intends to address. "We have to do better at
communicating," says co-chair Kathleen Wynne,
parliamentary assistant to (Gerrard) Kennedy.
  "Maybe we need a third party who knows how to
get past the emotion, because common sense gets
lost in emotion" parents whose children have
gone through the system or retired teachers, for
example.      
70
Does my Student have FASD?

• Teachers should only assess and NOT diagnose
• All of the primary behaviours related to FASD can
  have other causes and every problem student
  does not have FASD - this is a critical concept
• FASD can be picked up even in ECE settings
• If you see several or all behaviours request an
  immediate psycho-educational assessment
• While you are waiting use FASD strategies. They
  will help almost all learning disabled students

71
Most Students with FASD are Invisible
72
Physical Birth Defect IndicatorsMost can be also
caused by factors other than alcohol

• Brain damage
• Heart defects
• Blood vessel defects
• Hearing/ear problems
• Kidney deformities
• Uro-genital defects
• Small head size
• Scoliosis (skeletal)

• Long, smooth philtrum
• Short palpebral fissures
• Thinned upper lip
• Skeletal (eg.clinodactyly)
• Club foot
• Cleft lip and palate
• Dental abnormalities
• Growth abnormalities

73
Primary Behaviours Related to Neurological Damage

• Learning
• Attention
• Judgment
• Memory
• Performance (varies)
• Impulsivity
• Abstract Concepts
• Communication
• Lack of Conscience
• (A-L-A-R-M

• Cognition/aural slow
• Inability to generalize
• Executive Functioning
• Social Perception
• Boundaries (touching)
• Sleeping Problems
• Eating Problems
• Learning is affected
• PLUS)

74
Getting A Diagnosis

• Psycho-educational testing is the first step
• If psych testing suggests major learning
  disabilities the next step is medical testing
• FASD diagnostic testing is done by a full
  interdisciplinary medical team
• A medical diagnosis of FASD diagnoses the child
  but the mother is also included so a diagnosis of
  FASD is a diagnosis for two.

75
Diagnosis The Earlier the Better!

• Diagnosis should bring special programs for a
  child (and disability support for an adult)
• Labelling may bring some understanding of self
• and helps stop self-blame
• Demonstrates that the individual needs special
  treatment. Intervention MUST follow diagnosis
• Increases social awareness of FASD which may
  eventually reduce the stigma associated with it
• Individuals diagnosed early get fewer secondary
  behaviours related to chronic frustration

76
Missing an Early Diagnosis

• Unless they have serious behaviour problems
  pre-school and primary students with FASD will
  often be missed because their cognitive
  limitations have not yet been challenged
• Parents MUST be believed when they describe what
  is going on at home the earliest clues will be
  found there

77
Psycho-educational Testing

• Average IQ for full FAS is 74
• IQ range for full FAS is 20-130
• Average IQ score for FASD is 90
• However, an IQ score in the normal range is
  misleading as many people with FASD are unable to
  perform at levels indicated by their IQ scores.
  (Streissguth, 1996)
• Educational success is more than just IQ

78
Psycho-educational Testing

• A full battery of psycho-educational tests is
  needed, Verbal and Peformance IQ testing will be
  part of this testing
• Full battery psycho-educational testing will
  reveal very obvious skewing if FASD exists
• If possible, testing which tests two functions at
  the same time will often reveal highly useful
  results
• Plan an IEP which maximizes strengths and
  minimizes weaknesses

79
The Ideal Situation

• Ideally the child with FASD will get early
  diagnosis and his/her Parents/Caretakers,
  Physician, Educators, Therapists, Social Support
  Workers and mentors will meet at the school level
  and begin to develop a realistic, life-long plan
  of communication and care to minimize the
  development of secondary disabilities
• We all need to work towards this situation

80
FASD as a Learning Disability

• In Ontario FASD is not recognized as a specific
  learning disability
• Many parents feel their children would be better
  served if FASD was treated as a
• specific learning disability
• In light of the Auton decision (June 2004) in the
  Supreme Court of Canada it is unlikely to be
  recognized as a specific learning disability any
  time soon

81
FASD as a Learning Disability

• Governments are beginning to realize they
  definitely can not afford to recognize FASD which
  is almost twice as common as ASD and far more
  costly in the long run
• Recognizing FASD as a specific learning
  disability would open a Pandoras Box

82
FASD as a Learning Disability

• Recognizing FASD as a Special Education category
  could open the door to recognition as a
  disability and Sections 7 and 15(i) of the CCRF
  could kick in
• Your child or student needs help NOW not when the
  right thing finally happens.
• You child cant wait while you lobby!

83
Then Why Diagnose FASD?

• A students educators MUST know they are dealing
  with FASD
• USE EXISTING Ontario Special Education categories
  with FASD in mind They will work
• An advocate must help teachers to understand how
  to deal with the behaviour caused by brain
  damage. Be prepared to teach educators about FASD

84
WE CAN EFFECTIVELY SERVE STUDENTS WITH FASD IN
ONTARIO!
85
Celebrate Strengths, Minimize Weaknesses

• This is the good news and reason to hope a basis
  for intervention and educational success exists
• Fostering innate strengths and minimizing
  weaknesses is the basis of success for students
  with FASD
• Success has been shown to prevent defensive
  secondary behaviours in affected students

86
Individual Education Plans

• Plan an IEP from the psych test results,
• if possible plan it WITH the teacher(s)and
• caregivers
• Teachers, who are mere mortals, must be able to
  follow this plan without jeopardizing their other
  20 students or their own health
• Re-assess IEP frequently and fine tune if
  possible
• Include others for support caregivers, EA,
  mentors, buddies, anyone in circle of support
  (external brains)

87
Learning Styles

• Most students with FASD are first and foremost
  tactile or hands-on learners. This helps with
  their need to move. Learning in context is
  easiest and most efficient for most of them
• Visual learning is the next easiest style for
  most students with FASD. A picture is worth a
  1000 words has a whole new meaning for FASD!
• Least of all, students with FASD are auditory
  learners. This does not work well for most of
  them (but teachers will still have to talk.)

88
Typical Strengths and Abilities

• Hands on learners
• Kinesthetic, energetic
• Learn by doing and repeatedly shown
• Good long term visual memory
• Value fairness and
• can be rigidly moral,
• comforted by rules
• and orderliness

• Express themselves
• well verbally
• Good with animals, children, mechanics,
  computers, and the arts
• Friendly, affectionate,
• loving, loyal, gentle,
• determined, sensitive
• and compassionate

89
Educational Environments for Students with FASD

• 1- Special class or school just for students
  with diagnosed FASD (David Livingston in
  Winnipeg)
• (video available, profiled on The National)
• 2- Home Schooling www.edu.gov.on.ca/extra/eng/ppm
  /131.html
• 3- Regular Classroom with integrated special
  education and withdrawal where necessary
• With proper planning most students with FASD
  can be accommodated in a regular classroom
  (challenging but doable)

90
Most Important Reframe the Behaviour you see

• If they could they would -It is not that
  students with FASD wont, they cant
• Understanding this will change your attitude and
  they will notice you support them
• Behaviour Brain Damage
• Diabetics need insulin, paraplegics need wheel
  chairs
• Students with FASD have permanent brain damage
  and need you to respect them for what they are,
  they cant survive without this

91
Interventions for SuccessDealing with FASD
Information Processing Deficits

• Structure is critical- structure with clear and
  predictable routines is paramount,gentle
  transition
• Supervision/Monitoring external brain may be
  needed 24/7- or be a telephone call away
• Simplicity-simple, brief directions repeat them
• Steps- break everything down, written/visuals
• Context- if teaching a skill do it where it will
  happen generalization is often difficult

92
Start with the Classroom Environment

• The classroom learning environment has the
  most effect on students abilities to learn
  within the settings we provide. This includes
  its organization, its management, and its
  emotional components.
• Use the acronym
• S-C-O-R-E-S

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Scores

• Supervision
• Close supervision to keep students safe
• and out of trouble - 24/7 (Recess too!)
• Structure
• Teach students that every day has a consistent
  and routine structure to it
• Simplicity
• Keep rules, routines and directions simple
• Give directions orally and in visual form

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SCores

• Communication
• -Regular and frequent communication
• between home and school
• -Students are taught and reminded how to
  communicate feelings and needs to teacher, peers
  and others
• Consistency
• -Routines, rules and consequences are
• consistent
• -Steps to complete a task are given in the
• same way every time

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ScOres

• Organization
• The school helps students to become organized
  by teaching and reinforcing sequential
  organization strategies repeat, repeat, repeat
• Classroom is organized a place for
  everything and everything in its place
• The lessons and the day are organized

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ScoRes

• Rules
• - Simple, concrete and easy to follow
• eg. Dont hit rather than abstract
• eg. Be kind or Stay safe
• - All staff use the same words for each rule and
  follow the same rules
• - Check to see whether students know and
  understand what the rules mean
• - Consequences are followed up
• - Consequences applied immediately and
  consistently taking into consideration students
  disabilities

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ScorEs

• Expectations
• -Focus on life skills/social skills vs
  academics
• -Realistic, attainable, and easily understood
• -Modified/take into consideration the special
  needs of students
• -Clearly specify what is to be expected and
  accomplished on any given assignment
• -Limit the amount of work, including homework

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ScoreS

• Self Esteem
• -Students feel accepted, valued and safe
• -Positive encouragement is given in a
• consistent way each day
• -Students strengths are explored to help
• them cope with the frustration of things
• they cannot do
• -Students are reassured that they are not
• bad even though their behaviour is
• unacceptable and needs improvement

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More Classroom Strategies

• Minimize visual/sensory overload
• Tone down colors paint walls light blue/grey
• Reduce/remove clutter
• Clearly define areas- use lines on floor or
  colored tiles
• Provide visual cues sequencing
• Keep classroom as simple as you can

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Attention Strategies

• Use as few words as you can
• Use auditory/visual cues and prompts
• Focused teaching areas (One activity only)
• Use separate seating/carrels/dividers
• Repeat/Reteach/Repeat
• Reinforce, Recognize, Encourage and Support
• Vary background sounds and activities soft
  music or silent activity followed by physical
  activity

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Strategies for Transitions

• Prepare for transitions use visual and/or
  auditory cues
• Have an agenda for the day on the board for the
  students to see
• Routine!!
• If you are aware of a change in routine, alert
  ahead of time and practice new steps
• Practice Repeat Re-teach
• Have a digital clock visible
• Warn or remove before fire drills

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Discipline Strategies

• Focus on solutions not problems
• Positive incentives
• Reinforce the value of failure
• Recognize and celebrate little successes
• Firm, consistent, clear rules
• Consistent follow through
• Emphasize responsibility for own choices
• Encourage positive self-talk
• De-emphasize cause/effect

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Strategies for Dealing with Hyperactivity

• Recognize triggers read body language nip
  outbursts in the bud
• Brain Gym
• Provide regular breaks and allow cocooning in a
  quiet place
• Provide clay, kushy balls or anything soft to be
  held and manipulated by hand for the child to
  keep at his desk so that he/she may sit a little
  longer
• Make use of weighted vests (dentist)

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Teaching Students with FASDBuilding Strengths,
Creating Hope

• The following website is INVALUABLE
  www.education.gov.ab.ca/k_12/specialneeds/
• fasd.asp
• Western Canada is light years ahead of us in
  all aspects of FASD understanding, prevention and
  intervention (education)
• Do not try to re-invent the wheel, go to the
  above Alberta website for the newest and best
  resource on successful education for students
  with FASD
• You may print for free 165 pages in length

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Whats Next for FASD?

• Current Trends in FASD
• Intervention - Understanding FASD and helping
  individuals with FASD and their care-givers to be
  Successful
• Prevention Messaging Zero 4 Nine, There is
  no safe level of alcohol in pregnancy, etc.
• Research- FASD is quickly becoming a
• hot research topic early times as yet

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For More Information

• Please feel free to contact the presenter at
• cunninghammary_at_rogers.com
• or 519-893-7393 (Kitchener, Ontario)
• The internet is a valuable source of information,
  search under fetal alcohol spectrum disorder
• www.education.gov.ab.ca/k_12/
• specialneeds/fasd.asp (excellent resource)

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Thank you for your attentionto and interest
in helping to understand, prevent and intervene
in the lives of those living with FASD Mary
K. Cunningham