Fetal Alcohol Intervention Misconceptions

1. 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 from
Dan Dubovsky, FASD Specialist, FASD Center CFE, SAMHSA
Roger Zoorob, M.D., Meharry Medical College
& Support from
South Carolina Collaborative FASD

2. Resources
 FASD Center: FASDsoutheast.org
 Center for Excellence in FASD:
FASDcenter.samsha.org
 Simulation: http://www.come-
over.to/FAS/SimTest.htm

3. Scfasd.weebly.com

4. Resources for Technology
Wikispaces
Behaviorsolutions
Webtoolboxes

5. Objectives
 What do you know? Pre evaluation
 What do you want to know?
 Establish a goal for today
 FASD: overview and misconceptions
 Academic Solutions
 Behavioral Solutions

6. 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

7. 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.

8. Misconception #1
You know a child has been affected by
alcohol by the way he/she looks.
 Facial effects decrease as children age
 Full facial effects are only required for a
diagnosis if one cannot substantiate that
the mother drank during pregnancy.
 FASD is much broader than just FAS
 FAS has dysmorphic facial features, growth
deficit and CNS abnormality

9. Misconception #2
Students 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

10. Misconception #3
FASD 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 stigma
 Good data are not collected on the
incidence of FASD – only birth records of
mothers “known” to drink are recorded.

11. 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.

12. 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

13. 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.

14. 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.

15. 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

16. Why? Brain disorder creates gaps
Chart of age level functioning
Source:

17. Consider FASD as the umbrella

18. 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, school
 Always focus on the individual first

19. “Typical” strengths
 Friendly  Determined
 Likeable  Have points of
 Verbal insight
 Helpful  Good with younger
children or elderly
 Caring
 Hard Worker

20. 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

21. Barrier to learning
Verbal 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 know
 Allow them to provide verbal explanation
and interpretation of what something
means or have them demonstrate

22. 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

23. Barrier to learning
Cannot 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.

24. 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 Load
 Use of texting to remind young adults.
 Set alarms or reminders

25. Barrier to learning
Cannot understand abstract concepts
 Teach underlying skills
 Provide manipulatives
 Use concrete examples
 Role play to act out concepts
 Provide Examples & NOT-examples of
concepts

26. Barrier to learning
Cannot filter what they are thinking
 Support points of insight
 Foster their creative ideas,
 Model journaling without censorship or
grading
 They don’t mean to be rude or intrusive,
just say what they think.
 Model good ways to speak your mind

27. 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

28. Barrier to learning
Literal thinking
 Be 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

29. 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

30. 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 Strengths
 Identify positive role models and foster
those relationships as they won’t thrive on
their own
 Do better in 1-to-1 situation

31. Barrier to Behavior Management
Does not learn by experiencing
consequences of their behavior
 Short term consequences –no more than 1 day
 Do not use natural consequences
 USE positive reinforcement - immediately
 Use repeated role playing
 Do not take away what they like to do as a
consequence for their behavior.

32. Barrier to Behavior Management
Act oppositional or angry
 Brain might be overloaded
 Try using fewer directions or only one
 Find out if student knows what to do
 Find out if student understands the
directions and can do the academic task
 Provide a chill-out space when they start
to get frustrated.

33. Barrier to Behavior Management
Keep breaking the rules
 Rather be bad, instead of be stupid.
 Make sure rules are simple, in a positive
form
 Have students explain what the rule
means and not just repeat the rule
 Act out the rules or see if they can
provide a Not-Example

34. 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.

35. Barrier to Behavior
Problems with Adaptive Behavior
 Direct instruction for daily living skills
 Increase support for older students by
providing relevance of academic skills to
daily living
 Understand that supporting typical
organization skills is not enabling

36. Barrier to Behavior Management
Difficulty making & maintaining friends.
 Provide positive mentors
 Foster relationships through strengths &
interests
 Social 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)

37. People who
are on the
other side of People I can
the fence,
who are not
hang around
good friends. with are in
my circle
People who are on the
fence.

38. Overall Strategies
 Simplify the individual’s environment
 Use 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

39. Technology Tools: Organization
 Start with tools EARLY so by middle
school they are automatic and not
an add on
 Livescribe Pen
 Todo lists:
 Jing: video and screenshots
 Excel interactive chart
 Visual models

40. Take home information
 Modify approaches to meet needs based
on brain damage
 Simplify 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

41. Resource Reminders
 Wikispaces for Technology tools
 SCFASD Collaborative Weebly
 Prevention, Intervention & Videos
 Consider joining the Collaborative
 Contact speakers

42. Do2Learn

46. Resources to teach students