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Fetal Alcohol Intervention Misconceptions
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Got Academic or Behavior Problems: What’s FASD got
to do with it?
Cheryl A. Wissick, Ph.D. University of South Carolina
Presentation adapted from information fromDan Dubovsky, FASD Specialist, FASD Center CFE, SAMHSA
Roger Zoorob, M.D., Meharry Medical College& Support from
South Carolina Collaborative FASD
Resources
FASD Center: FASDsoutheast.org Center for Excellence in FASD:
FASDcenter.samsha.orgSimulation:
http://www.come-over.to/FAS/SimTest.htm
Scfasd.weebly.com
Resources for Technology
Wikispaces
Behaviorsolutions
Webtoolboxes
Objectives
What do you know? Pre evaluationWhat do you want to know?Establish a goal for today
FASD: overview and misconceptionsAcademic SolutionsBehavioral Solutions
FASD: Fast Facts
FASD – 100% preventable, 0% curable
If you are pregnant, don’t drink.If you drink, don’t get pregnant.Exposure to alcohol can affect
the brain development at any time during pregnancy.
FASD leading preventable cause of ID in Western World
FASD
Fetal Alcohol Spectrum Disorders is not a diagnostic category, but rather an umbrella term describing the effects that can occur in a person whose mother drank alcohol during pregnancy.
FASD is what a person has not what a person is.
Misconception #1
You know a child has been affected by alcohol by the way he/she looks.
Facial effects decrease as children ageFull facial effects are only required for a
diagnosis if one cannot substantiate that the mother drank during pregnancy.
FASD is much broader than just FASFAS has dysmorphic facial features,
growth deficit and CNS abnormality
Misconception #2Students with a FASD all have severe
intellectual disabilities
Students with a FASD can have a range of abilities from severe intellectual disabilities to learning disabilities (IQ range 20-110)
Students with a FASD can be labeled as having ADHD, ODD, Personality disorder, Learning Disability, Depression but FASD is the umbrella
Leading cause of ID but only 25% have ID
Misconception #3FASD is not as prevalent as Autism
More children are affected by alcohol than the number of students identified as having autism spectrum disorders
FASD is not as publicized due to stigmaGood data are not collected on the
incidence of FASD – only birth records of mothers “known” to drink are recorded.
Misconception #4
Alcohol does not cause as much damage as cocaine or heroin.
Alcohol has long range effects on behavior and brain functioning.
FASD is a lifelong disorder.
Misconception #5
If there is no cure, then why bother with identification.
Early identification helps provide structure and a stable environment.
Early identification can assist with strategies for instruction
Misconception #6
Only women who are alcoholics give birth to babies with a FASD.
We cannot predict how much alcohol exposure will lead to a FASD.
What constitutes one drink is much smaller than what we usually consider.
FASD is more prevalent in middle to upper class situations than lower class.
Misconception #7
If I use evidence based practices the student will respond, otherwise the student is not trying.
Students do not respond to typical language-based approaches.
We have to shift thinking to what is wrong with the curriculum and not what what is wrong with the student.
So how do we know or when to consider a FASD?Students who do not respond to
Research & Evidence based strategies
Students do not respond to typical rewards and consequences
Students who appear to be unmotivated and unresponsive
Why? Brain disorder creates gaps
Source:
Chart of age level functioning
Consider FASD as the umbrella
Use Strengths Based Approach
What do they do well?What do they like to do?What are their best qualities?What are your funniest experiences
with them?Identify strengths in family,
teachers, community, schoolAlways focus on the individual first
“Typical” strengths
FriendlyLikeableVerbalHelpfulCaringHard Worker
DeterminedHave points of
insightGood with
younger children or elderly
UDL* Model
Paradigm shift: Move from viewing the individual as failing to viewing the program as not providing what the individuals need. (Dubovsky)
Identify Barriers to learning and then list possible solutions to those barriers.
Identify specific barriers in your classroom
Link technology tools to assist students
* Universal Design for Learning
Barrier to learningVerbal expressive ability is much more advanced than verbal receptive skills or ability to produce written products.
Students can talk the talk but not walk the walk. Do not assume that what they say is indicative of
what they knowAllow them to provide verbal explanation and
interpretation of what something means or have them demonstrate
Barrier to learning
Can’t process several directions at once
Provide one direction at a time.Student with ODD still won’t comply
but a child with FASD will complete task.
Create visual task analysis charts -Interactive Excel chart
Provide a checklist
Barrier to learningCannot keep track of multiple plans, each with several goals and a number of steps per goals
Students take part in IEP but they do not understand all the aspects, provide positive feedback, provide checklist.
Students cannot be responsible to follow their own behavior plan
Work on one goal at a time.
Barrier to learning
Can’t remember what they were supposed to do when (whether its an hour, day or week after being told)
Working and short term memory ideas
Reduce Cognitive LoadUse of texting to remind young
adults.Set alarms or reminders
Barrier to learningCannot understand abstract concepts
Teach underlying skills Provide manipulativesUse concrete examplesRole play to act out conceptsProvide Examples & NOT-examples of
concepts
Barrier to learningCannot filter what they are thinking
Support points of insightFoster their creative ideas, Model journaling without censorship or
gradingThey don’t mean to be rude or
intrusive, just say what they think. Model good ways to speak your mind
Barrier to learning
Say they know what they need to do but they cannot show they can do it
Have them act out what to do Have them complete an example Provide guided practice
Barrier to learning
Literal thinkingBe careful of specific directions, they
will do what they are told.Do not use sarcasm, joking, similes,
metaphors, proverbs, idiomatic expressions.
Do a task analysis of a skill, do not assume that the students will fill in a step
Explain & consider misinterpretations of words
Barrier to learning
Difficulty with number concepts: time, money, measurement
Provide direct instruction for time & money
Provide schedules for month, mark off each day.
Provide support for shopping with a peer to help with money
Set alarms or timer
Barrier to Behavior Management
Try to “go along with the crowd” so that they have friends.
Model their peers, so provide positive ones
Provide Social skills training Work on StrengthsIdentify positive role models and
foster those relationships as they won’t thrive on their own
Do better in 1-to-1 situation
Barrier to Behavior Management
Does not learn by experiencing consequences of their behaviorShort term consequences –no more than
1 dayDo not use natural consequencesUSE positive reinforcement -
immediatelyUse repeated role playingDo not take away what they like to do as
a consequence for their behavior.
Act oppositional or angryBrain might be overloadedTry using fewer directions or only
oneFind out if student knows what to
doFind out if student understands the
directions and can do the academic task
Provide a chill-out space when they start to get frustrated.
Barrier to Behavior Management
Keep breaking the rulesRather be bad, instead of be stupid.Make sure rules are simple, in a
positive formHave students explain what the rule
means and not just repeat the ruleAct out the rules or see if they can
provide a Not-Example
Barrier to Behavior Management
Barrier to Behavior Management
Problems with lying.
Students do not have a good sense of a timeline, so they fill in the gaps
Discover the “purpose” of the lying, a behavior analysis
Verify the person’s story from credible sources, not always peers.
Not always a connect between what they feel to how they act so they might “look” like lying.
Barrier to Behavior
Problems with Adaptive Behavior
Direct instruction for daily living skillsIncrease support for older students by
providing relevance of academic skills to daily living
Understand that supporting typical organization skills is not enabling
Barrier to Behavior Management
Difficulty making & maintaining friends.Provide positive mentorsFoster relationships through strengths &
interestsSocial skill training so that others do not
see them as weird, strange, being inappropriate
Find something that student likes to do and let them do that regardless of their behavior
Be careful about their attitudes about death (people who die get lots of attention, death be at peace)
People I can hang around with are in my circle
People who are on the fence.
People who are on the other side of the fence, who are not good friends.
Overall StrategiesSimplify the individual’s
environmentUse of a lot of repetition, more
than what we think based on their intellect & verbal behavior.
Provide one direction or rule at a time.
De-stress situations as it creates cortisol in their brain.
Do not use ZERO Tolerance policies- add in the IEP considerations
Technology Tools: Organization
Start with tools EARLY so by middle school they are automatic and not an add on
Livescribe PenTodo lists:Jing: video and screenshotsExcel interactive chartVisual models
Take home informationModify approaches to meet needs
based on brain damageSimplify the environment and add
structure.Listen when they tell you that they
cannot do something but they are trying as they learn differently
They do get frustrated: like trying to put together something from IKEA daily
Resource Reminders
Wikispaces for Technology toolsSCFASD Collaborative Weebly
Prevention, Intervention & Videos
Consider joining the Collaborative
Contact speakers
Do2Learn
Resources to teach students