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FASD and Education An Ontario Perspective

Authored by Mary K. Cunningham B.Ed. P.H.Ec.

Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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@rogers.com
Cunningham www.faseout.ca 2008

FASD and Education An Ontario Perspective


Part I-Educational Success for Students Affected by FASD

Part II-Advocating Successfully within the School System

Cunningham www.faseout.ca 2008

FASD and Education An Ontario Perspective Part I


Educational Success for Students with FASD

Cunningham www.faseout.ca 2008

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


Cunningham www.faseout.ca 2008

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
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FASD and Education? Have I seen FASD yet?

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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

Cunningham www.faseout.ca 2008

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

Cunningham www.faseout.ca 2008

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)

Cunningham www.faseout.ca 2008

FASD in Education Facts


Health Canada notes that 1% of live births are FASDaffected. (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

Cunningham www.faseout.ca 2008

Most Students with FASD are Invisible

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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
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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?

Cunningham www.faseout.ca 2008

Reframe The Behaviour IT IS NOT THAT THEY WONT,


THEY CANT

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Brain Damage = Behaviour Change (Donna Malbin with permission)


Prenatal Exposure to Alcohol Causes Permanent Damage to the Brain

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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. 2. 3. 4. Input- recording of information from the senses Integration- process of interpreting the input Memory- storage of information for later use Output- producing answers, responses, completion of work
Cunningham www.faseout.ca 2008

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!

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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
Cunningham www.faseout.ca 2008

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?
Cunningham www.faseout.ca 2008

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 WONT;


THEY CANT
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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 Cunningham www.faseout.ca of Streissguth, Clarren et al by D. Malbin 94 Adapted from research findings 2008

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!


Cunningham www.faseout.ca 2008

The Worst Case Scenario: Secondary Effects Develop

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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

Cunningham www.faseout.ca 2008

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 nonsupportive environment, the individual suffers from a chronic inability to fit in

Cunningham www.faseout.ca 2008

Secondary Behaviours
An Educator Might See at School

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

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

Cunningham www.faseout.ca 2008

Secondary Effects of FASD


(1996-Washington State)
Alcohol/Drug Problems Innappropriate Sexual Behaviour Trouble with the Law Suspended/Expelled from School Employement Difficulties Dependent Living Arrangements Mental Health

Percentage of Adults with Fetal Alcohol Spectrum Disorder who have specific Secondary Disabilities

20

40

60

80

100

Cunningham www.faseout.ca 2008

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)
Cunningham www.faseout.ca 2008

The Best Case Scenario: Success for Students with FASD

Cunningham www.faseout.ca 2008

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 Cunningham www.faseout.ca you wanted
2008

There IS a silver lining

ALL STUDENTS WITH FASD HAVE INNATE STRENGTHS AND COMPETENCIES

Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

Multiple Intelligences
Verbal Interpersonal Visual Kinesthetic - Musical Naturalistic Intrapersonal - Mathematical Existential Every student has some of each. Discover and develop your best ones!
Cunningham www.faseout.ca 2008

Typical Strengths and Abilities


Hands on learners

Kinesthetic, energetic
Learn by doing and repeatedly shown

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

Good long term visual memory


Value fairness and can be rigidly moral, comforted by rules and orderliness

Cunningham www.faseout.ca 2008

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.
Cunningham www.faseout.ca 2008

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)
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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 one at a time

Remember that students with impairments teach life lessons to everybody else
Cunningham www.faseout.ca 2008

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.

Cunningham www.faseout.ca 2008

Teaching Students with FASD Building 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
Cunningham www.faseout.ca 2008

Teaching Students with FASD Building 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*
Cunningham www.faseout.ca 2008

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!
Cunningham www.faseout.ca 2008

For More Information


Please feel free to contact the presenter at cunninghammary@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)

Cunningham www.faseout.ca 2008

The End of Part One RECESS!

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FASD and Education An Ontario Perspective Part II Advocating Successfully within the School System

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Successful Advocacy in the 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


Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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.
Cunningham www.faseout.ca 2008

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)

Cunningham www.faseout.ca 2008

Involve the Whole Community


1. 2. 3. 4. 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

5.
6. 7. 8. 9.

Cunningham www.faseout.ca 2008

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

Cunningham www.faseout.ca 2008

Most FASD experts such as Diane Malbin or Donna Debolt acknowledge that many parents of children with FASD give the impression of being crazy Most parents will obsess to get their children served

Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

Elements Related to School Success (Duquette et al)


Caring teachers who understood FASD and made accommodations 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

Cunningham www.faseout.ca 2008

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

Cunningham www.faseout.ca 2008

Summer holidays DO NOT make up for 10 months of extremely stressful teaching. They merely allow most teachers to continue teaching the next September

Cunningham www.faseout.ca 2008

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

Cunningham www.faseout.ca 2008

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

Cunningham www.faseout.ca 2008

It should never come to this

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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,

down completely, an issue the working committee intends to address.


Kathleen Wynne, parliamentary assistant to (Gerrard) Kennedy. "Maybe we need a

communication between family and school board broke


"We have to do better at communicating," says co-chair

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.

Cunningham www.faseout.ca 2008

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

Cunningham www.faseout.ca 2008

Most Students with FASD are Invisible

Cunningham www.faseout.ca 2008

Physical Birth Defect Indicators


Most can be also caused by factors other than alcohol Brain damage Heart defects Blood vessel defects
Long, smooth philtrum

Short palpebral fissures


Thinned upper lip

Skeletal (eg.clinodactyly)

Hearing/ear problems Kidney deformities


Uro-genital defects

Club foot
Cleft lip and palate Dental abnormalities Growth abnormalities

Small head size


Scoliosis (skeletal)

Cunningham www.faseout.ca 2008

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)

Cunningham www.faseout.ca 2008

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.
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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

Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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

Cunningham www.faseout.ca 2008

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!

Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

WE CAN EFFECTIVELY SERVE STUDENTS WITH FASD IN ONTARIO!

Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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)

Cunningham www.faseout.ca 2008

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.)

Cunningham www.faseout.ca 2008

Typical Strengths and Abilities


Hands on learners

Kinesthetic, energetic
Learn by doing and repeatedly shown

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

Good long term visual memory


Value fairness and can be rigidly moral, comforted by rules and orderliness

Cunningham www.faseout.ca 2008

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)
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

Interventions for Success


Dealing 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


Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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

Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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

Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

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)
Cunningham www.faseout.ca 2008

Teaching Students with FASD Building 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
Cunningham www.faseout.ca 2008

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
Cunningham www.faseout.ca 2008

For More Information


Please feel free to contact the presenter at cunninghammary@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)
Cunningham www.faseout.ca 2008

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

Cunningham www.faseout.ca 2008