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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.
http://child.alberta.ca/FASD/flash/FASD_Quiz.html
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
Be concrete and specific.
Keep things simple.
Repeat directions, rules, etc.
Have a routine and be consistent.
Use structure.
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
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
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)
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