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Tips for Caregivers of Children with FASD

FOR MORE INFORMATION: 633 Wellington Crescent Winnipeg, MB R3M 0A8 PHONE: (204) 235-8874 EMAIL: [email protected]

TIPS FOR USE• Useearmuffsorheadphonesthatcompletelycoverthe child’sears.

• Useearprotectorsinnoisyenvironmentstolowerthe noiselevels.

• Useearprotectorsduringquiettimestoincreaseyourchild’sconcentrationandtoshutoutambientsounds.

• Trydifferentearprotectorsbeforedecidingonwhichonetochoose.Yourchild’sreactionswillshowyoutheonestheyprefer.

What Are They?

Earprotectorsareanyearcoveringthatprotectsyourchild’searsfromsound.Theyhelptolessenauditorystimulithatmaybeoverwhelmingordistractingforyourchild.

How Will Ear Protectors Benefit Your Child?

ChildrenwithFASDmayhavedifficultyfilteringoutenvironmentalnoise.It’seasyforustoignorenon-essentialsoundsbutsomeofourkidswithFASDmaynotbeabletodeterminewhatisimportantandwhatisnot.Theymaylosefocusandbecomeoverloadedwithsensorystimulationinaloudsetting.Theymayexperienceanxietywhentheyhearunexpectednoisessuchasafiretruckpassingby.Reducingauditorystimuliwithearprotectorscanbeusefulinthesesituations.

Why Use Ear Protectors?Earprotectorscanbecalmingforchildren.Iftheycandealwithmost environmentalinformation,theirabilitytofocus,reactappropriatelyandorganizethemselvesmaybeimprovedaswell.Earprotectorscanalsoreduceauditoryself-stimulationincludingactionssuchashumming orself-talk.

Where Can My Child Use His/Her Ear Protectors?

At school •Recess •Lunchtime •Quiettime

Outings: •Atrestaurants •Themall

At home: •Whenyour childneedsto dohomework •Atmealtimes

Where Can I Purchase Ear Protectors? (2012)

Earprotectorsareavailable atlocalautomotiveand hardwarestores–specializedchildsizedprotectorsarealsoavailableonline.

For More Questions, Ask Your Occupational Therapist!

Ear Protectors Sensory Organizing Tool



TIPS FOR USE• Tobeeffective,parents mustfirstassistandreinforcetheuseofvisualscheduleswiththeirchild.Overtime, lesssupervisionwillbeneeded.

• Useinitiallywithafewfavoriteactivitiesandslowlyexpanduseofvisualschedulestootherless-favouredactivities.

• Visualschedulescanbe inexpensive,simpletodo, andeasilytransportable. Justbecreative!

• Parentscancreatevisual schedulesbydrawing images,takingcomputer imagesfromclipartorthe Internetorcuttingthemoutfrommagazines.

• Thebestwaytoensure visualschedulescanhelp yourchildistokeepthem consistentandeasy tounderstand.

Visual SchedulesWhat Are They?

ChildrenwithFASDoftenhavestrengthsinunderstanding visualinformation.

Visualschedulesareaseriesof imagesthatrepresentaseriesof activitiesorstepsofanactivity. TheyareusedtohelpchildrenwithFASDanticipateeventsintheirday andlearnaboutandunderstandtheirenvironment.Visualschedulesusepictorialcuesandminimalwordstoprovidestructuretoanactivity,routineortheentireday.Photographs,symbolsorphysicalobjectsmaybeused.

Visualschedulesoutlineexpectationsforchildreninawaythatis easytounderstand.Childrenshouldbeginusingthescheduleswithadultassistance,andslowly,withguidance,theylearntointerprettheschedulesindependently. Why Use It?

• Visualschedulesallowchildrentogainindependenceand focusontasksinthehome andatschool.

• Inyoungerchildren,thismeansthatplayskillsmayimproveandbehavioroutburstslessen.

• Olderchildrenmaybecomemoreindependentincarryingouteverydayskillsforliving.

Useful Websites:www.connectability.ca/visuals-engine/

www.boardmakershare.com/ You/Home

www.visualaidsforlearning.com

www.do2learn.com/sitemap/index

Visual Schedules Can Help Your Child with the Following

• Transitioningintoanother activityornewsituation (e.g.summertoschool)

• Rememberingthesteps toanactivityoraseries oftasks

• Anticipatingthenextactivity ornextstep

• Lesseningbehavioral outbursts

• Planningwithintheir environment

• Payingattentiontotasks• Attendingtoandunderstandingverbalinstructions



TIPS FOR USESpecial equipment may be purchased to help your child with deep pressure. Ask your occupational therapist about equipment that would be best suited for your child. Examples of deep pressure equipment are illustrated on the side panel of this sheet.Herearesomesimple,funandsafeactivities youcandowithyourchildathomethatinvolve deeppressure!1.Giveyourchildlotsofbigbearhugs!2.Youcanplaysquishinggameswithyourchildthat useconstantfirmpressure(makesuretoavoid restrictingairflow!).

• The Hot Dog Game:Getyourchildtoliedownonthefloorandplaceabodypillowontopofthem,

pretendingit’sthebun.Useyourarms tosmotherandsquishontheketchupand othercondiments.Makesureyouapply pressureonyourchildfromshouldertotoe! Donotcoverthenoseandmouthatanytime.

• Forolderchildren,anexerciseballmaywork better.Whilethechildliesonthesoftgroundontheirstomach,slowlyandfirmlyrolltheballup anddownthebodyfromshouldertotoe.Youcanalsocountslowly“1...2...3...”orusetheword“Steeeam...Rolleeerrr...”

• Useabeanbagchairoranoverfilledarmchairtoprovideaspacewheretheycanreceiveall-overdeeppressure.

Deep PressureWhat Is It?DeeppressureisatypeoftouchusedtoprovidecalminginformationtothebodyandhelpchildrenwithFASDrelaxwhentheyfeel “over-excited“duetotoomuchstimulationfromtheirenvironment. Itisoftenseenasprovidingconsistent,firmtouchtothebodyor byusingstretchymaterialsormoldablematerialstoimitatedeep pressuresensations.ManyresearchersonchildrenwithFASDindicatethatsensoryinput,suchasdeeppressureandfirmbutgentletouch, arebeneficialtowardscalmingthesensorysystem.Thesensationsprovideanoverallcalmingsensationtothebodyandthebrain,whichpositivelyaffectsthewaychildreninteractwiththemselvesandothers.Askyouroccupationaltherapistifthisisagoodfitforyourchild.

When Would Your Child Benefit from Deep Pressure?•Whenyourchildisanxious(e.g.newsituations,newexperiences)•Whenyourchildisoverstimulatedorover-excited(e.g.whenyourchildisrunningaroundandunabletofocusatschooloratthemall)

•Whenyourchildseemsdisorganizedorlessgrounded.

Warnings and Precautions• Providingdeeppressureshouldalwaysbemonitoredbya responsibleadult.

• Thereisariskofairwayconstrictionwhenusingdeeppressure materials.Ensurethenoseandmoutharefreeandclearfor breathingandpressuretothebodydoesnotrestrictrespiration.

• DeeppressuretoolsMUSTNOTbeusedtorestrictmovements.

Ask Your Occupational Therapist About Deep Pressure. It Works!

Firm Hugs

Deep Pressure Vest

Body Sock



TIPS FOR USE1. Useverbaland/orvisualcuestowarnthechildthata transitioniscoming.

2. Showyourchildthetimerandsetitwhileheorsheiswatching.

3. Leavethetimerinaplacewhereyourchildcanseeit.

4. Ifthechild...

– AsksformoretimeOR

– Isimpatient(howmuchlonger?)

–>...Remindthemtolookatthetimer.

Visual TimersWhat Are They?

Visualtimersletyouseehowmuchtimeisleft.

Who Would Benefit From Using a Visual Timer?

ChildrenwithFASDoftenhavedifficultywithunderstandingthe conceptoftimeandbeingawareoftimepassing.Theyareoften concretethinkerswhoarefocusedonwhattheycansee,taste,touch,smell,orhear.Visualtimershelpmaketimeeasiertounderstandby allowingthemtousetheirsenseofsight.

Children Who Have Difficulty Understanding Time May Also Have Difficulty With...

• Transitionsbetweenactivities• Sharingortakingturns•Waitingpatiently.

Why Use a Visual Timer?

Helpingchildrenseetimehelpsthemunderstandhowmuchtimeisleftforagivenactivity.Thisprovidesavisualcluetofinishanactivityandstarttransitioningtoanewactivity.Avisualtimeralsohelpsthechildwaitpatientlyandtaketurnsbygivingavisualpictureofhowmuchlonger is left.

Time Timer (timetimer.com)

• Appsandsoftwareavailable

Sand Timer

Free app available for iPads and iPhones

For More Suggestions, Ask Your Occupational Therapist!



Movement Break Suggestions• Pushorpullfurniture

• Shovelsnow

• Putawaythedishes

• Carrythingsaroundthehouse(e.g.laundry)

• Getaforgottenitemfrom anotherroom

• Pushtheshoppingcartorcarrythegroceries

• Putgroceriesawayinto thecupboards

• Usearockingchair

• Dowallorchairpush-ups

• Playanactivegametogetherlike‘SimonSays’

• Goforawalk

• Playoutside

What Are They?Theyareshortbreakstoletthechildmovearoundbeforegoingbacktoaprevioustask oractivity.

Who Would Benefit from a Movement Break?Everyone!Movementbreaksgiveusa chancetomovesowecanfocusduring activitiesthatrequire:

• Maintainingfocus/attention

• Sittingstill

• Maintainingappropriateenergylevels.

Why are Movement Breaks Effective?Itishardworktofocusononetaskforalongtime.Ourbodiesaremadetomove,interactandfeeltheenvironmentaroundthem. Thinkabouthowtiredyoufeelaftersittingalldayatyourdesk, studyingalengthybook,orlisteningtoalongtalk.Ourbodiesneedabreak!Bymovingaround,thebodygetsachancetore-energizeandrefocusattention.Thishelpsusimproveourconcentrationtogetthejobdone.

Movement Breaks

TIPS FOR USE• Movementbreaksareagreattooltouse:

–Afterschool–Beforeperiodsofconcentration(dinner,whilewatchingTV, carrides)

– Whenyourchildishavingdifficultyfocusing.• Atthebeginning,youcanhelpyourchildbyactingastheir ‘externalbrain’.Youcanhelpthemknowwhentotakea movementbreakandteachthemovertimehowtoaskforone.

• Movementbreaksdonotneedtobeastructuredsportor exerciseprogram.Simplechoresorerrandsaroundthehouseworktogivechildrenthebreakstheyneed.Teachyourchildhowtoaskforamovementbreaksothatovertimetheycanbecomemoreindependent. For More

Suggestions, Ask Your Occupational Therapist!



TIPS FOR USE• Rememberthatyour expectationsshouldmatchyourchild’scapabilitiesduringthattime.Whatyouexpectandwhatyourchildcansuccessfullydomaybe differentthings!

• Beconsistent–makeittrue foreveryoneinthefamily.

• Bespecific–makeiteasytoapplytosituationsbytalkingaboutwhatactionsyoumeanandwhen.

• Beconcise–useshort, simplereminders.

• Betimely–trytoreview before,coachduringand praise after.

• Donotusetoomuch language.Visualsand gesturesarealsoeffectiveasreminders.

• Remindthechildof pastexperienceswith theactivitytorefresh theirmemory.

• Reviewexpectationswiththechildbeforestartinganewactivity,andhelpthemrememberthesteps tosuccess.

• Ifaproblembehaviorstarts, remindthechildofyour expectationsbeforeitgets outofhand–makeiteasy tosucceed.

What Are They?Expectationreviewsareremindersofwhatspecificbehaviorsare appropriateandacceptableandmayincludealistofrules,stepstodo orevenadescriptionofwhatsuccesslookslike.

Who Would Benefit from Expectation Reviews?Childrenwhohavedifficultywith:• Applyingoneruletodifferentsituations• Rememberingrulesandhowtoact• Engaginginanewactivity,event,orsituation.

Why Remind the Child of Expectations for a Situation?SomechildrenwithFASDmayhavedifficultieswithmemoryand generalization.Reviewingexpectationscanjogtheirmemoriesandletthemknowwhatappropriatebehaviorslookliketohelpthechildfocusonbeingsuccessful.

Some Strategies for Reviewing Expectations • ReviewexpectationsBEFOREgoingintotheactivity;coachDURINGtheactivity;andpraiseyourchildAFTERtheactivity.

• Breakyourexpectationsintosmallersteps.Forexample,insteadofsaying“Eatyourdinnerproperly,”talkabouthowyouwanttoseehim/hersitstill,waitatthetableuntileveryoneisfinished,ORcleartheirplate.Thisgivesthechildanunderstandingoftheirjob.Focusononestepatatime!

• Examplejobsinclude:eatingdinneratthetable,goingforacarride,doinghomework,goingtobed.

• Usevisualreminders.Visualaidsmaybecreatedtorefreshthechild’smemory.Thisalsoprovidesaquickreferenceandallowsforquickerrecognition.

• Usefewerwordsandmorevisuals!• Reinforcegoodbehaviorsbypraisingpeerswhoaremodelling goodbehavior.

Example: Whenvisitingfriends,youmayusethefollowing:

SitUse Inside Voice

Hands to Self

Reviewing Expectations Shaping Positive Behaviour



Social Stories

For More Questions, Ask Your Occupational Therapist or Speech Language Pathologist!

Here’s a Brief Example of a Social Story about SharingMynameisJeremy.

Iliketoplayvideogames.

Thomaslikestoplayvideo gamestoo.

IfThomasaskstoplayvideogameswithme,Icansay,“Yes, youcanplaywithme”.

ThomaswillbehappyifIsharewithhim.Wecanplaymoreoften.

SharingmyvideogameswithThomasmakesmehappy.

IcansharemyvideogameswithThomasagainwhenIseehim nexttime.

Sharingmakesmehappy.

What Are They?Socialstoriesareuniquestoriescreatedforchildrentopreparethemfornewordifficultsituationsorevents.Thesestoriesmaybeintheformofpicturebooksorintextonlyandareusefulinhelpingchildrenbetterunderstandeventsandexpectations,whichmayleadtomoresuccess.Thisapproachhasbeensuccessfulwithchildren,adolescents,andadultswithsocialandcommunicationschallenges.(Gray,2010)

When Should You Use Social Stories? • Fornewsituations

• Fortransitionsandchangesindailyroutines

• Foranysituationthatmaycauseanxiety(fears,etc)

• Forsocialinteractionsthatneedtobeprocessedinaconcreteway.

Why Use Them?Thesestoriesaddresssocialdifficultiesbygivingchildrenaperspectiveonthethoughts,emotions,andbehavioursofothers.Theyalsohelpchildrentobetterpredicttheactionsandbeliefsofothers.Socialstoriesgivechildrendirectcontactwithsocialinformationthroughtextand picturesratherthanthroughspeechandobservation.Thesestoriesprovidesomeseparationbetweenteachingandexperiencingthesocialsituation,whichgiveschildrenchancestopracticetheskillsontheir ownterms.

Social Stories

TIPS FOR USE• Socialstoriescanbeuseddailywithyourchild.Practicingthesocialstorybeforetheactualeventoccurswillhelptobetterprepareyourchild.

• Pairingplayactivitiesalongwithsocialstorieswillhelpwithreal-lifesituations.Forexample,ifyourchildisgoingtothemovietheatre,createa“theatre-like”scenarioathomebyputtingonaDVDandmakingthempopcornandsnacks.

• Ifthestoryisnotworking,itmayhavetobechanged.Itisbettertoconsultanoccupationaltherapistorspeech-language pathologistforhelptodevelopsocialstoriestosuityourchild.

Formoreinformationaboutsocialstories,visitTheGrayCenterwebsiteat:http://www.thegraycenter.org/social-stories



Warning and Precautions • Ensureadultsupervisionwhenusingbodysocks.

• Bodysocksshouldnotbeusedasarestrictioninanyway.

• Bodysocksalsoposefallingandtrippinghazards.Becarefulwhenusingonsmooth surfacestoavoidinjury.

Purchasing InformationSchoolSpecialty Phone:1-866-519-2816 www.schoolspecialty.ca

TFHSpecialNeedsToysCanadaInc Phone:1-877-509-7524 www.specialneedstoys.com/can

SouthpawEnterprisesInc. Phone:1-800-228-1698 www.southpawenterprises.com

FDMT Phone:1-866-465-0559 http://www.fdmt.ca

What Are They?Bodysocksarestretchy,breathablefabricbagsmadeofalycra/spandexmaterial.Theycanfitoverachild’sbodyorbewornwiththechild’sheadoutside.Thestretchymaterialprovidesmovementresistanceaswellasfirm,gentlepressureduringplay.

When Would Your Child Benefit from a Body Sock?ChildrenwithFASDareofteneasilyoverwhelmedby environmentalsensoryinput.Theymaybecomeoverlyalertand appearanxious,overly-excited,confused,disorganized,hyperactive oroutofcontrol.Useabodysockwhenyourchildisshowingsigns ofrestlessnessandoverexcitement.Itisalsoagoodtimetouseabodysockwhenyouwantyourchildtocalmdownforatask.

Why Are They Useful? • Theyprovidecalmingandreorganizinginformationthrough resistanceanddeeppressureinput.

• Theyprovideincreasedfeedbackandawarenessofmovements.• Theymayprovideavisualbreakwhenusedtocovertheheadaswell.• Theyhelpchildrenlearnhowtocoordinatetheirbodiesandfeel themmoving.

Body Socks Sensory Organizing Tool

TIPS FOR USE• Yourchildcaneitherclimbcompletelyintoasockorleavetheirheadoutside.

• Haveyourchildstandinfrontofamirrorandstretchtomake asmanydifferentshapesaspossible,usingdifferentpartsof theirbody.

• Holdeachposefor10-15secondstoincreasebodyawareness,balance,andawarenessoftherelationshipofonebodypart toanother.

• Haveyourchildpretendtobedifferentanimals,suchasa:– Caterpillar–crawlingalongtheground– Butterfly–flappingit’swings– Fish–swimmingthroughanocean– Monkey–swingingthroughtrees

Ask Your Occupational Therapist if This is a Good Match For Your Child or if You Have Any Questions!



TIPS FOR USE• Trytofindoutwhatwordsoractivitiesworkbesttoreinforcethepositivebehavior.“Awesome,youhungupyourcoatallbyyourself!”

• Timingandfrequencyofreinforcementshouldbeconsistent. Initially,reinforcementshouldoccuraftereveryincidentof positivebehavior.Asthebehaviorbecomeswelllearned, starttodecreasetheamountofreinforcementsothechild doesnotcometoexpectreinforcementeverytimethebehavior isperformedcorrectly.

• Makesurenon-verbalreinforcementsmatchtheverbal.Inotherwords,whenyouaretellingthechildhowgreattheydidduring soccerpractice,makesuretosaythiswithasmileandapaton theback.

• Becautiousnottousethesamewordsorphrasestoooftenorthechildmayloseinterestwiththistypeofpraise.

• Knowingthedifferencebetweenbriberyandreinforcementisimportant.BriberyisoftenusedasastrategytorewardthechildBEFOREthepositivebehaviourwhentheparentexperiences resistance.ReinforcementisusedAFTERtheyhavealready performedthepositivebehaviour.

What Are They?Verbalreinforcementsarepositivecuesgivenverballytoaffectchildren’sresponsestospecifictasksoractivities.Wordsratherthanrewardsemphasizegoodwork. Forexample,ifyourchilddoesagoodjobontheirchores,youmaysay“Goodjobondoingthedishes!Theyarereallyclean!” Thisencouragesthemtodojustaswellnexttime.Verbalreinforcementscanalsobepairedwithrewardssuchasfree-playtimeorafavouritesnack.Compliments,encour-agementsandrewardsarelikelytoincreasethechancesdesirablebehaviorwill happenagain.

Why Use Verbal Reinforcements?Verbalreinforcementsare usefulinmotivatingchildrenand shapingbehavior.Usingverbal praisecanhelpmaintainor strengthenexistingbehaviours andhelpdevelopnewbehaviours.

When Do You Use Verbal Reinforcements?Verbalreinforcementscanbe usedimmediatelyafterthe childhasperformedpositive behaviorsorwhentheyneed moreencouragementtoperformbetter.Whenthechildisaware theyaredoingwell,theywillbe motivatedtocontinuepracticing.Verbalreinforcementscanalsobe usedtocorrectnegativebehaviors. Forexample,insteadofsaying “Stoprunninginthehallway!” youcansay,“Trywalkinginthe hallway”.Positivelyphrasingwhatyouactuallywantthechildto dowillcuethemtoperform thebehaviorratherthanusing negativephrasing.

Verbal Reinforcements Shaping Positive Behaviour



TIPS FOR USE• Usesmall,quiet,safeobjectsasfidgets.

• Fidgetscomeindifferenttextures,shapes,andsizes.Ask your occupational therapist for suggestions on fidgets that may work for your child.

• Atthebeginning,keepfidgetswithyoutogiveyourchild whentheyarehavingtroublefocusingorkeepingtheirhands tothemselves.Teachthemhowtousethemcorrectly.Overtime,childrenwillbecomemoreindependentwiththeiruseandlearntoaskforoneorfindonethemselves.

• Remindyourchildthatfidgetsaretoolstohelpthemlisten andfocus,andnottoystobeusedforthrowingandbouncing.

• Makesurefidgetsyouandyourchildchoosearenotdistracting toothers.

• Keepfidgetsinaneasilyaccessiblearea.

Hand FidgetsWhat Are They?

Fidgetsusethesenseoftouchforthehandsandareoftensmallobjects childrenholdandfidgetwithusingtheirhands.Examplesarestressballs, kooshballsorhairelastics.FidgetsforchildrenwithFASDareoftenreferredtoas“ListeningHelpers”.

Who Would Benefit from Using Hand Fidgets?

• Childrenwithattentionandfocusdifficulties.Usingfidgetsmayhelpduringactivitiesrequiringalotofconcentrationsuchaswaitinginline,watchingamovie,listeningtoalectureorsittingduringavisit.

• Childrenwithastrongneedtotoucheverything.

Why Use Hand Fidgets?

Handfidgetshelpkeepyourchild’shandsbusyandoutoftrouble. Theyprovideasmall,quietobjecttomeetyourchild’sneedfor touchingwithoutharmingordistractingothers.Givingyourchild somethingtoholdintheirhandsallowsthemtofocusontheactivitywhilemeetingtheirneedtotouch.

For More Suggestions and to Ask if it Matches Your Child’s Needs, Ask Your Occupational Therapist!

TipFidgets are not expensive!

Manycanbepurchasedatdollarstoresormadeathome.

Make fidgets at home:Tryfillinga balloonwithsandorflourto makeastressball.

Elastics Koosh Ball


SleepissuesamongchildrenwithFASDarecommon.Manychildren experience“disturbedsleep”,whichcanlooklike:

• Troublefallingasleepatbedtime(takingmorethan20minutes to fall asleep)

• Frequentlywakingupatnight (forminutesorhours)

• Earlymorningawakenings

• Difficultygettingoutofbed inthemorning

• Tired,hyperactiveorirritable duringtheday

• Sleep-walkingorsleep-talking• Restlesssleep(tossing andturning)

FASD and Sleep

What Can I Do? Strategies and Solutions

One of the first steps for helping children with sleep issues involves promoting good sleep habits through sleep hygiene.

Sleep Hygieneisthepromotion ofgoodsleeproutinesbyimprovingthesleepenvironment,usingsleeppromotingactivitiesandschedulingsleep.Itisthefirststrategytotry, andtheseneedtobetrialed consistentlyfor2-4weekstoseeiftheyarehelping.Keepingasleeprecordduringthisperiodhelps determinesuccess.

According to medical literature, the first step in the treatment of sleep disorders is sleep hygiene.

Without treatment, sleep problems can continue into adulthood.

Why is Sleep Important?

• Poorsleepatnightcanleadtoproblemswithlearning,memory, attention,mood,andbehavioursincludinghyperactivity,aggression, andimpulsivity.

• Sleepisalsoimportantfordevelopment,andifsleepissuesarelong lasting,theymaypreventchildrenfromreachingtheirpotentialsin cognitiveandmotordevelopment.

• Poorsleepforachildmeanspoorsleepfortheirparents/caregivers! Thiscanleadtostressandfrustrationforthewholefamily.

• Withoutaddressingandtreatingsleepissues,theeffectofallother treatmentsmightbereduced.

What Might Be Causing Poor Sleep?

• ChildrenwithFASDmighthavedifficultysleepingthroughthenightduetovariousfactors,withperhapsmorethanonefactoractingatthesametime.Thesefactorsinclude:braindifferences,healthproblems,poorsleeproutines,andemotionalorsocialissues.

• ChildrenwithFASDoftenhavedifferencesintheprocessingofsensoryinformationfromtheirbodiesthatareinchargeofseeing,listening,tasting,touching,smelling,alongwithsensesinchargeofknowingwheretheir bodiesareinspace,howfasttheirbodiesaremoving,andgivingfeedbackfromjointandmuscles.

• Thesedifferencescanaffecthowsensoryinformationfromthe environmentandthebodyisorganizedinthebrain.Forexample, softnoisescanseemloudandirritating,smallamountsoflightcan seemoverwhelmingorthefeelingofpajamasorblanketscan beuncomfortable.

•EachchildwithFASDhasindividualsensoryprocessingneedsthatareuniquetothemandmayaffectsleepinadifferentway.

• ChildrenwithFASDmayhaveabnormalsecretionsofthehormone melatonin.Melatoninisreleasedbythebrainandresponsibleforwhen wesleep,how longwesleep,andhow wellwesleep.Whenchildrendon’tsecreteenoughmelatoninatnight,theyhavetroublefallingasleep,stayingasleepandwakingupearlyinthemorning.

Children with FASD are up to 5 times more likely than typically developing children to have sleep issues.



SIGHT• Usedimmerlightstodecreasebrightness.

• Usesimplesheets(nopattern)andneutralroomcolourstoreducevisualstimuli.

• Uselight-blockingwindowshades.

• Ifpossible,abedroomshouldbetotallydark(evenlowlightlevelscaninhibit melatoninsecretion).

SOUND• Useearplugs,sleepmachinesorwhitenoisemachinestoblockoutnoise.

• Listentosoothingmusic(meditationsongsorsongswith60-80beatsperminute).

• Carpetingonfloorscanabsorbnoise.

TOUCH• Cuttagsoffpyjamasorbeddingsince itmayirritatetheskin.

• Useplainorsoft-texturedbedding todecreasestimulationand/orirritation toskin.

• Beawareofchild’smaterialpreferencesforpajamasandbedding,e.g.flannelvs.lycraorloose-fittingvs.snug.

SMELL• Donotuselaundrydetergents, soaps/shampoosortoothpasteswith strong scents.

• Trycalmingscents(e.g.vanilla,lavender,banana).

• Bedtimesnackideassuchaswarmfoods,suckingliquidsthroughastraw,andfoodsthatneedtobechewedarehelpful.

JOINTSENSE ANDMOVEMENT

• Usedeeppressure/massageatbedtimetohelpkidssettledown(canbedonewithhandsoritemssuchasasleepingbag). Trythisonlyasmuchaschildwilltolerate.

• Useslowback-and-forth,rhythmicalrockingtohelpwithsettling(e.g.rockingchair).

• Useoversizedquiltsorheavyblankets– theweightcanprovideaddeddeep pressureandcanbecomforting.

OTHER• Donotusethebedroomforpunishment.Thisroomshouldbeaplacethatis comfortable,familiarandnotexciting.

• Keepthebedroomlayoutconsistent anduncluttered.

• Avoidco-sleepingasthisincreasestheriskofsleepissues.

• AvoidTVinthebedroom.

Sleep Environment

Followingaresolutionsandstrategiesforthebedroomtohelpwithsleep:

Sleep-promoting Activities

Followingareactivitiestohelpwithsleepsuccess:

• Useregularlyscheduled movementbreaksand“heavywork”(pushing/liftingactivities)duringthedaytohelpthechildbecomemoresettledatbedtime.Itisbetterforthecaregivertostructureandorganizethisactivity.

• Avoidscreentime(e.g.TV,videogames,computergames)1to2hoursbeforebedtime.Studiessaypre-bedscreentimeisrelatedtodelayedonsetofsleep.

• Noroughhousingbeforebed.• Pre-warnthechildatleast30-60minutesbeforebedtime.

• Avoidfoodswithsugarorcaffeineclosetobedtime.

• Usecalmingactivitiesbefore bedtimetoreducethetimeit

takestosettleforsleep (e.g.rocking,warmbath,massage).

• Useasoftvoiceandsimple instructionsatbedtime.

• Usevisualschedulesasapromptforbedtimeroutine.Thismayincludepicturesofhavingabath,thenbrushingteeth,thenputtingonpyjamas,etc.

• Readage-appropriatestories, avoidbooksthatstimulatethemindorsenses(e.g.scarybooks,touchbooksorbookswithsound).

•Provideopportunitiesforexposuretonaturallightingduringtheday(e.g.outdoorplayinsunshine).Daylightaidsintheproductionofnocturnalmelatoninwhichhelpsimprovesleep.

Sleep Schedule

Schedules,routinesandstructureareimportantnotjustatbedtimebutalldaylong.

• Enforceroutines,rulesandconsistency.

• Maintainthesamescheduleonweekendsandholidays.

• Includeascheduled“winddown”time(30-60minutes)beforebedtime.

Medication

•Ifsleepstrategiesarenot working,youmaywantto discussatrialofmedication withyourchild’sdoctor.

• Melatoninmaybehelpfulto establishasleepschedule. Talktoyourdoctorabout whetherthisisagoodoption foryouandyourchild.

• Discusstheeffectsofyourchild’scurrentmedicationsonsleep.

Consult With Your Occupational Therapist For More Information.


Homework TipsWhy Is Doing Homework Difficult for a Child with FASD?

ThebrainsofchildrenwithFASDaredeveloped atypically,whichmayresultinvariousbehavioral symptomsincluding:

• Hyperactivity• Distractibility• Lackofinhibition• Learningdifficulties• Difficulties withroutines

• Poormotorskills• Socialand languagedelays

• Impairedinformationprocessingabilities

• Difficultyself-regulating

Thesesymptomscanmakesittingdowntodo homeworkhardtodo.

Here Are Some Tips to Help Your Child with Homework:

• Keepintouchwithyourchild’sschool:Ahome-schoolcommunicationsbookmaybethebestwaytodothis.Thisway,youwillknowtheteacher’sexpectations;youcancommunicatewiththeteacheraboutwhatisrealisticforyourchild;andtheteacherorstaffcanlogyourchild’sbehavioratschool.Also,theteachersmaybeusingadifferentinstructionalstyleorprocessthanwhatyouarefamiliarwith.Ifyouknowhowtheschoolisteachingaskill,youcanbemoreconsistentandaccuratewithreinforcingitathome!

– Remindschoolstafftokeepcommentspositive.

– Ifthecommunicationsbookfrequentlydoes notmakeithome,findanalternatewayto communicate.Aphonecallattheendofthe dayorevenemailmaybethewaytogo.

• Createahomeworkenvironmentthatisfreeof distractionsandonethatlimitsyourchild’sneedtogetup:

– Setupadeskortableinaroomthatisrelativelyemptyandfreeofclutter.

– Iftheroomhasawindow,facethedesktowardsthewallsoyourchildisnotdistractedbywhatisgoingonoutside.

– Trytohaveallpotentiallyneededsuppliesincloseproximity(i.e.pencils,pens,sharpeners,erasers,etc.,andmaybeaglassofjuicewithastraworwaterbottleforsucking,incasetheyneedadrink).

– Strategiesthathelpkeepyourchildcalmandfocusedshouldalsobereadilyavailableinthe

environment(suchasfidgettoys,wobblecushions,wobblestools,rockingchairs,pressurewraps orvestsand/orcalmingmusic).

• Trytoestablisha“homeworkroutine”withyourchild.Herearetipstohelpyoucreatethisroutine:

– Usevisualsupports,suchasvisualtimersand/orvisualschedules.Usingavisualtimermayenableyourchildto‘see’howmuchtimeisleftfora certainactivity.Then,ifyourchildgetsofftrack, youcanpointtothevisualscheduleandremindthem“firsthomework,then...”.

– Italsohelpstobreakdownthetaskintosmaller,moremanageableparts(i.e.15minutesspent onhomeworkfollowedby10minutebreak). Continuetodothetaskinshortintervalsuntil allhomeworkiscomplete.Thisway,overtime yourchildwilllearnwhattoexpect.

– Alsokeepinmindwhensettingupaschedulethatyourchildmayneedtimetounwindwhentheygethomefromschool.Forexample:Oncehomefromschool,givethem20minutestounwind;followedbytimespentonhomework.Asageneralrule,childrenwithFASDwillhandle10-20minutesofhomeworkpernight.Ifyourchildhashadaroughday,reduceyourexpectationsforhomework.Youmightwanttojustreadthehomeworktoyourchildratherthanpushingtocompleteit.Besuretoincludebreaksinbetweenhomeworkperiods.Youcanusestrategiessuchasincorporatingmove-mentbreaksandheavyworkintothisroutinetohelpyourchildfocus.



Homework Tips (Continued)

• Betheir“externalbrain”:

– Evenafteryouhavesetuptheenvironmentandbuiltstrong routines,don’tforgetyouwillstillneedtobearoundtohelporga-nizeandmonitorthemwhilethey areworking.

– Teachthemtoaskforhelpandprovideassistanceasneeded. BecausechildrenwithFASDtendtothinkin“blackandwhite”terms,youwillneedtobetheretohelpthemunderstand “greyareas”.

– Discussproblem-solving strategiesoutloud,andmakesuretheyunderstandthem.

– Bethereregularlytoprovideencouragementandimmediatefeedbackforpositivebehaviors.

– Giveyourchildcuestocheck-inwiththeiremotions,provide supportandredirectthem whenneeded.

– Manychildrenkeepit togetherforalongschoolday.Unwindingathomewillbeveryimportant.Sometimes,playtimeorengaginginheavyworkormovementactivitieslikebiking,swimmingorrunningisjustwhattheyneedtorelax.Afterall,yourchild’sbiggestlearningtoolrightnowisplay!

ChildrenwithFASDarealldifferentsincetheirbrainsdevelopsindividually.Sometipsmaywork foryourchild;somemaynot. Trydifferentcombinationsandkeeplookingfornewstrategies.

SummaryHelpyourchilddevelopapositivestateforthinkingandfocusingonwhattheyneedtodo.

TOUCH• Ensuretheyarenotwearinganyclothingthatdistractsthem.

• Fidgetsorlisteninghelpersareagreatwaytoextendfocus.Theycanbeanysmallobjectsthatcanbeheldinthehand.Somelikemouthtoolslikechewytubesorstirsticks,whileothersusegum.

SOUND• Workinaquieterarea.AvoidTVs,radios,phones,orotherpeopleintheroomtoavoiddistractions.

• Yourvoiceisagreattoolwhenteaching.Useitsvolume,speedandpitchto giveinformation.

• Whitenoise(suchassoftmusicwith nolyrics)issometimeshelpfultoblockoutothernoisesinthehome.

SIGHT• Keeptheareaasbareaspossible, todecreasedistractions.Youcanuseasmalldeskareaoravoter’sboothtocreateanofficetosetthemood.

• Limittheamountofhangingsonceilings,wallsandevenfridges.

• Naturallightisbetterthanartificial, butmakesureyouhaveenough, nottoomuch.

• Visualtimerscangiveamoreconcreteideaofhowmuchtimeyouhavelefttowork,eliminatefrequentquestionsandincrease cooperation.

• Visualschedulesclearlyshowwhattasksarelefttobedone,andallowforbettertransitioningsinceyourchildwillknowwhatiscomingnext.

JOINTSENSE ANDMOVEMENT

• Useacomfortablechairforhomework–experimenttofindthebestonein thehouse. Somestudentsliketobeonahighstool,whileothersliketobesquishedbetweenpillowsonanarmchair.

• Useshortandstructuredmovementbreakswhenyounoticetheirattentionfailing.Goingtothewashroomtowashtheirface,holdingayogaposeforafewseconds,orevendoing10jumpingjacksareexamplesofmovementbreaks. Allthesemusthaveadefiniteending soitiseasytogobacktowork.

• Useapairofoldsockssewn togetherandfilledwithbeanstomake aweightedsnake.Youcandrapeitaroundyourchild’sshouldersorontheirlaptoprovidedeeppressureandincreasefocus.

SMELL&TASTE• Citrusscentsarestimulatingwhile vanillaandlavenderarecalmingscents.Bemindfulofhowyourchildis affectedbyanyscent,anduseitto youradvantage.

• Haveaglassofwaterwithastrawhandyforaquickbreak.

• Crunchyandchewysnackslikecelerysticks,pretzels,orgummycandymayhelpwithextendingfocusontask.

OTHER• Itisalwayshelpfultohaveopen communicationwiththeschoolabouttheamountofhomeworkgivenandyourchild’scapabilitiestocompleteit.

• Breakupthetaskintosmallermoremanageablechunks.Onlygiveyourchildwhatyouknowtheycando!

• Setagoalandtalkaboutsolutionswhenyougettoadifficultpart.

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