P R E S E N T E D B Y :

:

A Hands-On Approach to Supporting Students with Fetal

Alcohol Spectrum Disorder

Overview of Series

Session 1: Introduction to FASD and Universal Behavioral Strategies

Session 2: Environmental Modifications and Universal Communication Strategies

Session 3: Visual and Organizational Strategies

Session 4: Building Function into Your Program

Session 5: Supporting Inclusion in the Classroom

Session 6: Parenting Approaches for Families Caring for Children with FASD.

Parenting Approaches for Families Caring for Children with Fetal

Alcohol Spectrum Disorder (FASD).

http://child.alberta.ca/FASD/flash/FASD_Quiz.html

What are common struggles of a parent with a child with FASD?

What are parents hopes and goals?

Overview of Symptoms

Inhibitions

Problem solving

Planning

Time perception

Internal ordering

Working memory

Self-monitoring

Verbal self-regulation

Motor control

Regulation of emotion

Motivation

Judgment

Executive Functions • Highest area at risk for damage occurs in the prefrontal cortex, which controls our executive functions.

• Examples of executive functions:

Why Is Diagnosis Important?

Most people with FASD have no visible signs of alcohol exposure, their problems may be wrongly blamed on poor parenting or other disorders.

Early diagnosis and intervention contribute to positive long-term outcomes. Accurate diagnosis can:

Help the person receive appropriate services

Aid communication among clinicians, caregivers, educators, and families

Provide better self-awareness and understanding by family members

Why is Diagnosis important? Cont’d

Prevention of:

Loss of family

Increased substance use

Premature death

enables self awareness and self advocacy

.

Setting Up for Success: Environmental Strategies

Most important for all environments:

Understand characteristics and needs

Adjust expectations, build supportive environments and meet developmental needs

Parents as advocates can help with this

Try Changing How You Do Things

Give people with FASD longer to answer, develop, and achieve.

Reteach skills in every environment they will be used — don’t assume.

Think differently — use a bouncing chair.

Move from what’s wrong with them to what is going on for them.

Keys To Living With People With FASD

Rethink, reteach, respect.

Modify expectations.

Think younger or think “stage not age.”

Think perpetual innocence.

Make the world make sense.

Keys to Living Cont’d

Modify the environment

Visuals

Calm room

Timer

Keys To Living Cont’d

Be concrete and specific.

Keep things simple.

Repeat directions, rules, etc.

Have a routine and be consistent.

Use structure.

Keys to Living Cont’d

Stealing and lying

Keys to Living Cont’d

Adjust expectations to reflect the reality

of the child’s needs and capabilities.

Think “cognitive wheelchair”.

Be an interpreter, not an interrogator.

Be an investigator, not a judge.

Rethink, reteach, respect.

Environmental Strategies

The School Environment

diagnosis does not need to be shared with other students or parents

Most important is focus on creating an inclusive and supportive learning environment which respects and accommodates individual differences

Student with FASD needs opportunities to work together

Diagnosis of FASD is especially challenging because there is not always a visible sign

Must Assess the Individual

Strengths and challenges

Reactions to situations and environments

How the individual learns

What triggers anxiety, frustration, anger

Self awareness and awareness of others

Level of independence and productivity

Ability to follow directions

Ability to understand and convey information

Building Positive Relationships

Parents play critical role in helping school staff to understand child’s behaviour and needs – they provide valuable information and insights

Parents can assist with setting realistic goals and expectations and to keep a positive focus on strength and accomplishments

They can participate in the development of the Individual Program Plan which will assist with continuing learning and behaviour strategies at home – supporting students at home and in school in similar ways will be more successful

Stay in regular contact with the school ( phone calls, e-mail, communication books)

If needed use an advocate

Stay positive, show understanding and be non-judgemental even when challenging

Homework Support

Child can:

email homework assignment or leave voice mail message at home explaining homework

You can:

Model the use of visual timelines to develop time management skills

Allow regularly scheduled time at home to clean and organize bag pack, binders, etc.

keep an extra set of textbooks for home use

attention

memory

cognition

sequencing

Universal Communication Strategies

Words vs. Communication

Misperception that the only way to communicate is through words

Non-verbal communication

Facial expression

Body language

Gestures (formal and informal systems)

Object and picture exchange

Universal Communication Strategies

Remember Symptoms of FASD:

Hyperactivity and behaviour problems

Attention and memory problems

Difficulty with judgement and reasoning

Learning Disabilities (language delay)

First step for successful use of language:

Teach listening skills:

Eye contact

Quiet hands

Little distraction

Check comprehension

Understands at one/two/tree word level

Understands only with visual support

Use of Language

Make sure you have attention – establish eye contact

Give direction (2-3 words)

wait for processing at least 5-7 seconds

Repeat Direction (2-3 words)

Wait

Assist if needed – gesture, physical prompt, hand over hand

Your language should be:

Natural (voice and intonation) but slow/ pause between words

Voice should be soft but firm

Short and concrete – reduce the complexity of your language; break down instructions

Use vocabulary that is appropriate to the students comprehension capability – clarify student understanding; if needed simplify your language

Con’t

“start” versus “stop” – talk about what you want your student to do versus what not to do; use positive phrases

Questions versus directives – questions reduce compliance, if there is no choice don’t offer one (“Would you sit down now?” Versus “You need to sit now.”)

General statements versus direct requests (“It’s time to go outside” versus “ You need to put your coat on”)

Confusing versus descriptive directions (“Clean up your desk”) versus (“ Wipe off the lunch leftovers”. “Put all your pens away”.)

Con’t

shorten the distance – directing an arms length away better than from across the room

Start with easy directions before asking for the big one

Respond appropriately to communicative attempts (yelling vs. pointing)

Praise, praise, praise

maximized comprehension results in improved compliance

Success with Behaviour

"Modify the environment, not the child."

&

"Try differently, not harder“.

- Diane Malbin

Universal Behaviour Strategies

Effects of FASD:

Visual and auditory processing problems

Difficulty with reading comprehension

Memory problems

Sensitivity to sensory input

Attention deficit

Problems with social behaviours

Problems following multiple directions or rules

Difficulty with math and abstract reasoning

Inability to understand cause and effect

Difficulty organizing tasks and materials

"The greatest obstacle that our kids must overcome is the chronic frustration due to unrealistic

expectations."

- Dr. Calvin Sumner

Common Misinterpretations

© 1994-2002

Deb Evensen

Behavior Misreading Correct Interpretation

Non-compliance Willful misconduct Stubborn Attention Seeking

Difficulty translating verbal directions Doesn’t understand

Makes same mistakes

Manipulative Willful

Cannot link cause and effect

Often late Lazy poor parenting

Time Organization

Out of seat behavior

Willful Pest Sensory integration

Behavior is for a purpose…

Not on purpose…

Functions of Behaviors Answer the Question “Why.”

Tangible: To get a specific Response of item

Something Intrinsically motivation

Self-Stimulation:

Communication: To express a need

Or desire

Escape/Avoidance: To avoid Aversive stimuli

Attention Seeking: To get you to pay attention

Functions Of

Behavior

Can’t Won’t

Skill Deficit?

Global development delay

Communication skills

Attention skills

Academic skills

Self-management skills

Daily living skills

Social skills

Performance Deficit?

Lack of motivation to

perform skill (initiation)

Lack of opportunity

(environmental deficits)

Hypotheses about Behavior Challenges

Know that there is no categorical approach to

behavior supports.

Accept the fact that there is no single recipe for

handling problem behavior, because each situation

and individual is different.

Must understand/know individual and context.

Always choose your battles. Certain behaviors should be managed through planned ignoring (in conjunction with

other behavior shaping strategies).

At the very least always respond with a neutral affect and keep words to an

absolute minimum.

The actions parents and teachers take to increase student success.

PREVENTION Rules,

Routines, Arrangements

REACTION Positive and

Negative Consequences

Remember that behavior serves a purpose for the individual, and that our job is to

figure out that purpose.

The best time to address / intervene upon the behavior is when the behavior is not

happening.

Teaching Alternative Behaviors

Specific alternative or replacement behaviors / skills must be made as efficient and effective as the problem behavior(s).

•Alternative Skill Examples:

•Problem-Solving Skills •Choice-Making Ability •Anger Control •Relaxation Training •Self-Management/Control •Communication •Social Skills

Supporting Techniques

Provide visual schedules

Pictorial cues

Personal script essential rules

Cognitive Behavioral Script

Pre-teaching and rehearsal of expectations

What If? Chart (actions and consequences)

Visual Schedules

44

Personal script

essential rules

What if?

Chart

Build a system of reinforcement that reflects student’s preferences.

Continually consider how our behavior reinforces children either intentionally or unintentionally.

Rather than ignoring fixations, consider how to use areas of intense interest to increase motivation and

for reinforcement.

Activity

Explain the following misinterpretations to a teacher:

You are perceived as unsupportive because homework is hardly ever done

You are perceived as unsupportive because student is always late

Your parenting skills are perceived as poor because student presents with poor social judgement

Burnout on Both Sides of the Relationship

People with FASD

Caregivers

Feel it is better to be bad than look stupid

Consistent inconsistency in their child

Tired and anxious all the time

Negative feedback from others

Chronically fail

Have the wrong expectations for their child

Experienced a life-long ‘poor fit’

Avoiding Burnout

Remember people with FASD are not “being bad.” They have brain damage.

Look for resources, ask questions, ask for help.

Remember your strengths and the strengths of the individual with FASD.

Admit your limits and theirs.

Plan for when you both need breaks.

Stick to your plan!

See People As …

Not problems—or people with problems.

Remember that expectations have to be realistic and appropriate to each person with FASD and not a generalization about FASD.

Raise Awareness in the Community

Post FASD information in doctors’ offices, treatment centers, and community centers.

Promote FASD Awareness Day (September 9). Visit www.fasday.com for information.

Focus attention on FASD. You can help the entire community.

Resources

http://www.von.ca/fasd/ http://fasd.typepad.com/fasd_support_in_alberta/support_for_mothers/ http://www.asantecentre.org/Family_Support_Resources.html http://www.come-over.to/FAS/faslinks.htm http://www.acbr.com/fas/Bcgov/contents.htm http://www.cdc.gov/ncbddd/fasd/index.html http://www.fasalaska.com/ http://www.fasdcenter.samhsa.gov/ http://www.acbr.com/fas/ http://depts.washington.edu/fadu/ http://www.nofas.org/ http://www.psychologistsassociation.ab.ca/pages/FAS http://www.lrc.education.gov.ab.ca/pro/default.html http://www.notasingledrop.org/ www.learning.gov.ab.ca/k_12/specialneeds/resource.asphttp://pbsc

Local Programs and Services

http://www.child.alberta.ca/home/864.cfm

www.triplep.net

Damaged Angels

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