Description: Fetal Alcohol Disorders are technically defined under section 300.8(c)(9) of IDEA Regulations. This states, "Other health impairment means having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that--
(i)
Is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit
hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia,
nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and
(ii)
Adversely affects a child's educational performance."
Although FAS is not specifically listed, in a discussion over FAS, IDEA said, "The list of acute or chronic health conditions
in the definition of other health impairment is not exhaustive, but
rather provides examples of problems that children have that could make
them eligible for special education and related services under the
category of other health impairment. We decline to include dysphagia,
FAS, bipolar disorders, and other organic neurological disorders in the
definition of other health impairment because these conditions are
commonly understood to be health impairments."
http://idea.ed.gov/explore/view/p/%2Croot%2Cregs%2C300%2CA%2C300%252E8%2C
On their website, the Children's Mental Health Services/REACH program states that, "Children with FASD need more intense supervision and structure than other children. They often lack a sense of boundaries for people and objects...Although they can focus their attention on the task at hand, they have multiple obstacles to learning. Since they don't understand ideas, concepts, or abstract thought, they may have verbal ability without actual understanding. Even simple tasks require intense mental effort because of their cognitive impairment. This can result in mental exhaustion, which adds to behavior problems. In addition, since their threshold for frustration is low, they may fly into rages and temper tantrums. A common impairment is with short-term memory, and in an effort to please, students often will make up an answer when they don't remember one. This practice can apply to anything, including schoolwork or behaviors. These are not intentional 'lies,' they just honestly don't remember the truth and want to have an answer. Since they live in the moment and don't connect their actions with consequences, they don't learn from experience that making up answers is not appropriate."
http://www.cmhsreach.org/disorder_fetal.html
http://idea.ed.gov/explore/view/p/%2Croot%2Cregs%2C300%2CA%2C300%252E8%2C
On their website, the Children's Mental Health Services/REACH program states that, "Children with FASD need more intense supervision and structure than other children. They often lack a sense of boundaries for people and objects...Although they can focus their attention on the task at hand, they have multiple obstacles to learning. Since they don't understand ideas, concepts, or abstract thought, they may have verbal ability without actual understanding. Even simple tasks require intense mental effort because of their cognitive impairment. This can result in mental exhaustion, which adds to behavior problems. In addition, since their threshold for frustration is low, they may fly into rages and temper tantrums. A common impairment is with short-term memory, and in an effort to please, students often will make up an answer when they don't remember one. This practice can apply to anything, including schoolwork or behaviors. These are not intentional 'lies,' they just honestly don't remember the truth and want to have an answer. Since they live in the moment and don't connect their actions with consequences, they don't learn from experience that making up answers is not appropriate."
http://www.cmhsreach.org/disorder_fetal.html
A person with an FASD might have:
Abnormal facial features, such as a smooth ridge between the nose and upper lip (this ridge is called the philtrum)
Small head size
Shorter-than-average height
Low body weight
Poor coordination
Hyperactive behavior
Poor memory
Difficulty with attention
Poor memory
Difficulty with attention
Difficulty in school (especially with math)
Learning disabilities
Speech and language delays
Intellectual disability or low IQ
Poor reasoning and judgment skills
Sleep and sucking problems as a baby
Vision or hearing problems
Problems with the heart, kidneys, or bones
http://www.cdc.gov/ncbddd/fasd/facts.html
"FASD is known as a “hidden disability” because most individuals affected by FASD are not diagnosed until adolescence, adulthood, if at all," says the National Organization on Fetal Alcohol Syndrome on their website. http://www.nofas.org/recognizing-fasd/
Accommodations (the 8 magic keys):
1. Concrete
2. Consistency
3. Repetition
4. Routine
5. Simplicity
6. Specific
7. Structure
8. Supervision
Modifications:
- Be as consistent as possible. The way something is learned the first time will have the most lasting effect. Re-learning is very difficult and therefore any change is difficult.
- Use a lot of repetition. These students need more time and more repetition than average to learn and retain information. Try using mnemonics like silly rhymes and songs. Also have them repeatedly practice basic actions and social skills like walking quietly down the hall or when to say 'thank you.' Be positive, supportive, and sympathetic during crises; these are children who 'can't' rather than 'won't.'
- Use multi-sensory instruction (visual, olfactory, kinesthetic, tactile, and auditory). More senses used in learning means more possible neurological connections to aid in memory retrieval.
- Be specific, yet brief. These students have difficulty 'filling in the blanks.' Tell them step-by-step, but not all at once. Use short sentences, simple words, and be concrete. Avoid asking 'why' questions. Instead, ask concrete who, what, where, and when questions.
- Increase supervision - it should be as constant as possible, with an emphasis on positive reinforcement of appropriate behavior so it becomes habit. Do not rely on the student's ability to 'recite' the rules or steps.
- Model appropriate behavior. Students with FASD often copycat behavior, so always try to be respectful, patient, and kind.
- Avoid long periods of deskwork (these children must move). To avoid the problem of a student becoming overloaded from mental exhaustion and/or trying to sit still, create a self-calming and respite plan.
- Post all rules and schedules. Use pictures, drawings, symbols, charts, or whatever seems to be effective at conveying the message. Repeatedly go over the rules and their meanings aloud at least once a day. Rules should be the same for all students, but you may need to alter the consequences for a child with FASD.
- Use immediate discipline. If discipline is delayed, the student with FASD will not understand why it's happening. Even if the student is told immediately that a consequence will happen the next day, he or she will likely not make the connection the next day. Never take away recess as a consequence - children with FASD need that break to move around.
- Ensure the student's attention. When talking directly to the student, be sure to say his or her name and make eye contact. Always have the student paraphrase any directions to check for understanding.
- Encourage use of positive self-talk. Recognize partially correct responses and offer positive incentives for finishing work. Try to set them up for success, and recognize successes every day! (or even every hour). Also from http://www.cmhsreach.org/disorder_fetal.html
From the view of a birth mother of a child with FAS:
