Fostering Social Emotional Skills & Academic Success

for Students with FASDCheryl A. Wissick, Ph.D. University of South Carolina

Trainer, SC FASD CollaborativePresentation Youth at Risk, Savannah GA, 3-4-13

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.org

Scfasd.weebly.com

Resources for Presentation

Wikispaces

Behaviorsolutions

Webtoolboxes

Objectives

• What do you know? Pre evaluation

• What do you want to know?

• Establish a goal for today

• FASD: overview and misconceptions

• Social Emotional Solutions

• Academic 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 & DD in Western World

New Research

Scientists identify molecular events:1- Alcohol inhibits critical L1 cell adhesion form the brain & spinal cord2- Certain compounds can block alcohol’s inhibition

YEA

1st TrimesterAlcohol

interferes with organization of

brain cells

2nd Trimester

Alcohol causes clinical

features of FAS

3rd TrimesterAlcohol leads to

problems encoding visual

& auditory information

Prevalence of Any Alcohol Use among Women

Aged 18-44 Years – United States, 1991-2005

• High-risk drinking among women has not declined in the past decade

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

0

10

20

30

40

50

60

Not pregnant Pregnant

Pre

vale

nce

(%

)

Behavioral Risk Factor Surveillance System, 1991-2005, United States

High School girls 2011 data

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Black

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nic

Hispan

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Other

, non

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nic† 9 10 11 12

0

10

20

30

40

50

60

70

CurrentBingeBinge/alcohol

Binge Drinking

18–2

4

25–3

4

35–4

4

45–6

4≥65

Whi

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Binge Drinking Prevalence %

Age Ethnicity Education Income

How much is too much alcohol

• What is a standard drink:• 12 oz. of beer• 5 oz. of wine• 4 oz. sherry• 1 ½ oz. of liquor • 12 oz wine spritzer

• NO alcohol in any form is safe during pregnancy.

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.

Person First language• FASD is what a person has not what

a person is.

• Teenager with fetal alcohol spectrum disorders

• Student with a learning disability

• Man with red hat

• Can you think of one?

Misconception #1You 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

Misconception #2Students with 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

• Estimates are that 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.

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 & have a low SES 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 when to consider a FASD &

try other techniques?

• Students or clients who do not respond to Research & Evidence based strategies

• Students or clients do not respond to typical rewards and consequences

• Students or clients who appear to be unmotivated and unresponsive

Why? Brain disorder creates gaps

Source:

Chart of age level functioning

Consider FASD as the umbrella

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

“Typical” strengths

• Friendly

• Likeable

• Verbal

• Helpful

• Caring

• Hard Worker

• Determined

• Have points of insight

• Good with younger children or elderly

Barriers

Do not learn by experiencing consequences of their behavior.• Act oppositional & have

outbursts . • Keep breaking the rules.• Problems with lying or filling in the

truth.• Only respond to immediate

rewards and consequences.• Difficulty with social situations &

friends

Techniques: Consequences

• Do not use natural consequences and make all consequence short term – (1 day max)

• USE positive reinforcement – immediately

• Do not take away what they like to do as a consequence for their behavior.

Techniques: Lying

• 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.

Techniques: Social

• Provide Social skills training & model with peers. Keep them actively involved

• Work on Strengths and help foster relationships with positive peers.

• Provide positive mentors• Social skill training so that others do

not see them as weird, strange, being inappropriate

• Do better in 1-to-1 situation

Techniques: Rules

• Make sure rules are simple, be positive 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

• Provide reasons for rules

Techniques: Outbursts

• Look for signs of stress• Provide quiet environments for chill

out• Ask if they need help • Be there to provide assistance• Provide second chances• Check our expectations • Be consistent & calm

Barriers to Learning

Attention• Coming to attention

• Filtering out other distractions

• Staying on task for long periods

•Shifting attention

Barriers to learning

Verbal Reception • Verbal expressive ability is much more

advanced than verbal receptive skills or ability to produce written products.

• Can’t process several directions at once • Can SAY what they need to do but they

cannot show they can do it

Barriers to Learning

Working memory• Problems with Storage and

retrieval• Inability to hold information in

memory while performing a mental operation Cannot keep track of multiple plans to remember what they were supposed to do when

Barriers to Learning

Impaired Number Sense• Difficulty with concepts*:

telling time, money, measurement• Difficulty with time as a function of

retelling events, Impaired sense of timeline

• Difficulty planning and mental manipulation

Barrier to learning

Abstract Concepts• Slow Processing rate• Difficulty with prediction• Difficulty making links or forming

associations• Problems making generalizations • Literal thinking

Overall Strategies• Simplify & structure the

environment• Use a lot of repetition & rephrasing• Provide one direction or rule at a

time.• De-stress situations as it creates

cortisol in their brain. • Be consistent!!

Take home information

• We can’t change behavior of the damaged brain but we can change our approach or environment.

• Consider their point of view as they learn and see things differently

Remember

LISTEN… when they tell you that they cannot do something but they are trying as they do get frustrated: like trying to put together something from IKEA every day!

Other resources from ScFASD.weebly.com

Do2Learn

http://edmontonfetalalcoholnetwork.org

Resources to teach students

Help spread the word

with the FASD Knot

Can you follow the picture directions to make an FASD knot?Cheryl Wissick cwissick@sc.eduOr Drwissickusc@gmail.comhttp://behaviorsolutions.wikispaces.com

• All images of Lego from the Morgue File

• http://www.morguefile.com/