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Supporting and Teaching Learners with FASD

Supporting and Teaching Learners with FASD. ________, 2010 (2011) ________, B.C. SD No. __. Purpose. • To increase understanding of how the brain with FASD functions To explain an effective approach and strategies To practice the use of a collaborative planning tool

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Supporting and Teaching Learners with FASD

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  1. Supporting and Teaching Learners with FASD ________, 2010 (2011) ________, B.C. SD No. __

  2. Purpose • To increase understanding of how the brain with FASD functions To explain an effective approach and strategies To practice the use of a collaborative planning tool To share current research and resources

  3. Agenda Introductions FASD Foundation “Shift” / Primary Disabilities/ “Fit” Accommodations LEIC Planning Page - Case Study Resources Handouts and Questions

  4. Fetal Alcohol Spectrum Disorder FASD describes a spectrum of disorders caused by prenatal exposure to alcohol.

  5. History • Biblical (“Judges”) • 471 BC - Socrates • 384 BC - Aristotle • 1968 - Lemoine (France) • 1973 - diagnostic criteria for FAS • 1996 - ARND replaces FAE; Dr. Streissguth’s study re primary and secondary disabilities • 2004 - FASD; 4 digit code for diagnoses • 2005/6 - B.C.: MCFD, Health, Education

  6. FASD: Diagnostic categories

  7. FASD: Facial Features

  8. FAS: Facial Features http://depts.washington.edu/fasdpn/htmls/fas-face.htm

  9. “Tip of the Iceberg”

  10. FASD: Diagnostic categories Fetal Alcohol Syndrome (“Tip of the Iceberg”) Alcohol-Related Neurodevelopmental Disorder (ARND) Partial Fetal Alcohol Syndrome (pFAS) *Static Encephalopathy

  11. Who’s at Risk? Everyone! FASD is an equal opportunity disability. Dr. Sterling Clarren

  12. Known Facts About Alcohol • No known safe level of alcohol consumption during pregnancy. • Alcohol crosses the placenta freely. • No woman sets out to hurt her baby.

  13. Neurons Cell body Axons Myelin sheath Dendrites Synapses Neurotransmitters

  14. Photo from C. Shurtleff Children’s Hospital and Medical Center Seattle, Washington

  15. Photo from C. Shurtleff Children’s Hospital and Medical Center Seattle, Washington

  16. Neuron

  17. 9. Primary Motor Cortex 10. Supplementary Motor Area 11. Premotor Cortex Area 12. Cingulate Motor Cortex 13. Wernicke’s Area 14. Supramarginal and Angular Gyri 15. Broca’s Area 1. Dorsolateral Prefrontal Circuit 2. Orbitofrontal Circuit 3. Anterior Cingulate Circuit 4. Thalamus 5. Hypothalamus 6. Hippocampus 7. Amygdala 8. Cingulate Gyrus

  18. Executive Functioning A set of abilities required to attain goals efficiently in nonroutine situations. Kodituwakku

  19. Brain Activity An fMRI study comparing the amount of activity required by the brain to complete a task (example: using working memory). a- alcohol affected b - neurotypical www.nrc-cnrc.gc.ca/eng/ projects/ibd/functional2.html a b

  20. adapted from: http://www.cerebralpalsychildren.com/CPFetal.html

  21. Example of Uneven Maturation (Dysmaturity) Tony (LJS) Actual Age: 15 Developmental Age Expressive Language------------9 Receptive Language-------------9 Writing----------------------------8 Reading (decoding) ability-----------------11 Comprehension ------------------------------11 (spoken/written) Physical maturity------------------------------------------------15 Emotional maturity----------------9 Social skills--------------------------9 Money, time concepts------------9 Living skills---------------------------------10 Fine motor--------------------------------------11 Gross motor--------------------------------------------------14 ___________________________________________________________ 0 5 10 15 20 Adapted from D. Malbin (1999) and FAS/E Support Network of BC

  22. Tony: LEIC Wheel

  23. Every Brain is Different

  24. Paternal Use: Findings of effects on pregnancy outcome(page 2 of POPFASD handout package) Low birth weight Impaired cognitive skills, increased hyperactivity in sons of alcoholic fathers Changes in behaviours of sons of alcoholic fathers Low count and altered structure of sperm Lower rates of pregnancies; sons were less fertile Decreased activity of sperm and lower testosterone levels Diane Malbin

  25. Prevalence • Exact rates are not known and prevalence varies from community to community • Health Canada: 9/1000 are affected by FASD • 2 to 5 percent of younger school children: FASD (2009: P. May)

  26. Cognitive Functioning • The average IQ for full FAS is 74; the IQ range for full FAS is 20 – 130 (Streissguth et al, 1996). • The average IQ for FASD is 90. • But …

  27. Theory to Practice • FASD State of the Evidence Review (Premji et al, 2004) • FASCETS study • Changes in theory

  28. Shift in Thinking • View FASD as a physical disability • IS problem to HAS problem • Won’t to Can’t • Non-compliance to non-competence

  29. Need for “Shift” • De-personalizes difficulties • Reduces stress and frustration • Builds a shared framework • Encourages reflection • Fosters a proactive approach

  30. FASD Approach • FASD = physical, brain-based disability • Know your learner well (relationship) • Observe closely and try different strategies • Set up the environment for learner success • Plan and interact proactively • Be visible • Identify what the learner needs and provide the supports

  31. Primary Disability A functional deficit that is the result of permanent brain injury.

  32. Impulsivity Linking actions to outcomes Predicting outcomes Generalizing information Abstracting Staying still Paying attention Memory Processing pace Sequencing Over stimulation Sensory issues Perseveration Language Dysmaturity or “uneven maturation” Primary Disabilities

  33. Sentence Activity • Requirements of your brain • process quickly • remember, utilize prior information, formulate • Possible Primary Disabilities • slow processing • memory difficulties Expectations in the Environment - give a quick response • provide a related, descriptive sentence

  34. Poor Fit Good Fit Exists when there is a gap between the expectations and the learner’s abilities Exists when accommodations are provided that support the suspected primary disabilities

  35. Accommodations=creating a “good fit”) To Accommodate means to make fit or suitable Strategies and/or adaptations that address the brain disability and may reduce the likelihood of some secondary disabilities

  36. “Secondary Disabilities” / Behaviours • The feelings / behaviours that develop over time when the primary disabilities are not supported (Streissguth, 1996)but….might be other manifestations of the primary brain alterations (Clarren, 2009)

  37. Frustration Anxiety Shutdown Anger Fatigue Isolation Poor self esteem Depression School problems Trouble with law Drug and alcohol issues Independent living challenges Mental health issues Parenting difficulties “Secondary” Disabilities / Behaviours

  38. Accommodations = Good Fit Environment Instruction/ Curriculum/ Communication Resources

  39. Secondary Impacts Statistics Streissguth, 1997

  40. Other Research on Mental Health and Prenatal Alcohol Exposure Astley, 2010; O’Conner, 2009*

  41. Physical Medical Concerns Heart Murmur/Defects Craniofacial Defects Spina Bifida Brain Defects Eye Problems Kidney Problems Embryonal Tumors Liver Defects Hernias Skeletal Abnormalities Skin Abnormalities Genitalia Abnormalities

  42. Video Clip “FAS: When the Children Grow Up” • National Film Board, 2002 • www.nfb.ca

  43. Linking Behaviour to Brain Normal Developmental Process: Orderly, organized, sequential. Many opportunities for links and interconnections. FASD: Inconsistent growth, undergrowth, overgrowth, disorganized gaps and clusters. Clusters can appear as areas of tremendous strength, such as superior ability in art, music, spelling or writing.

  44. Poor Fit? • Expectations of learner in the Environment • Follow rules • Act age • Requirements of learner’s brain to meet expectations • Think ahead • Think at an age- appropriate level • Suspected • Primary Disability • Cause-effect • Dysmaturity

  45. Creating a Good Fit Know and understand the learner well Build on strengths Identify the poor fit between expectations and the suspected primary disabilities Provide accommodations

  46. Good Fit Poor Fit Slow processor in a fast paced class Developmentally younger Rigid thought / perseveration • Accommodation • Give more time/ • simplify language • Think “younger” when planning • Consistent routines/ • transition warnings

  47. Accommodations = Good Fit Environment Instruction/ Curriculum/ Communication Resources

  48. What are the strengths of your learner? Is your learner… Creative? • Artistic? Athletic? • Helpful? Caring? • Generous? Determined? • Willing? Friendly? • Etc. Etc. Etc. Strengths Based Approach

  49. Attachment Early stressors Culture Nutrition Living situation Transitions Religious/Spiritual Medications Dislocation Peer supports/ mentors Family relations Wellness/Mental Health Complex trauma Financial situation Current community/world events “Time of month” Weather Other …

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