Fetal alcohol syndrome disorder
FETAL ALCOHOL SPECTRUM DISORDER:
Review of “Instructional Tips: Supporting the Educational Needs of Students with Fetal Alcohol Spectrum Disorders” by Susan Marie Ryan. The journal article was published in Teaching Exceptional Children Plus.
The purpose of this article is to equip in-class teachers with the knowledge to “meet the learning, behavioral, and social needs” of students who have FASD. The article resulted from a 4-year study that involved interviews and observations of 25 teachers in Alaska who had students with FASD.
Introduction:
The article begins with a brief introduction about the available research and statistics:
The article then proceeds to provide 8 “Instructional Tips:”
The author points out that sometimes students with FASD have extremely chaotic lives; multiple foster care, various agencies involved in child’s life and perhaps judicial/criminal agency involvement. She states that under these conditions, teachers should work hard to develop/maintain relationships with external groups in order to create cohesion and full knowledge. Ryan refers to one such system she observed: the wrap-around support system. This philosophy supports fostering collaboration with the agency on a long-term basis which would be supervised by the in-school team and inherited each year by each new teacher. The system focuses on the need for continual/long-term support between the teachers, in-school-team and various agencies.
The author states that one of the most serious and negative consequences of FASD is the student often lacks acceptable social skills. Ryan’s research showed the positive impact that teaching social skills had on students with FASD. She sites several individual teaching strategies she discovered from her research, ranging from JK to high school. Accumulatively, Ryan concluded that teaching social skills should be “embedded” through the day and must be taught within the context of day to day lived experiences, not in isolation.
Ryan’s research showed that students with FASD functioned much better in a structured, routine environment. Teachers that she interviewed also stressed the importance of consistent application of rules and consequences. One teacher stated, ““Provide enough structure to help the student with FASD stay in control, but at the same time to hold the student accountable for taking some responsibility for self-control and for setting realistic goals.”
During her research, Ryan found that all 25 teachers agreed upon the importance of repeating rules, lesson instructions and providing information in small chunks and checking for understanding. Ryan provides a number of useful strategies: create picture schedule of day or tasks, individually check for understanding by asking student to repeat back and work with parents to reaffirm task instructions.
Here are some:
Ryan states that it is important that in-class teachers work with special education teachers and in-school team. In particular, she stated that it is important to recommend interventions for students you suspect of having FASD.
Conclusion:
The author concludes by re-stating the above outlined points. She also points out the importance of continual teacher-reflection on the effectiveness/ individual response to these strategies.
Ryan, S.M. (2006). Instructional tips: Supporting the educational needs of students with fetal alcohol spectrum disorders. TEACHING Exceptional Children Plus, 3(2) Article 5. Retrieved [date] from http://escholarship.bc.edu/education/tecplus/vol3/iss2/art5
Fetal Alcohol Spectrum Disorders
The article that I researched was Students With Fetal Alcohol Syndrome: Updating Our Knowledge, Improving Their Programs by Darcy Miller.
The article begins with a case study about Jack, a 10 year old boy with FAS. It discusses how the teacher intervenes (social skills, modeling and guided practice) when Jack has negative peer interactions. The case study is a useful way for other teachers to understand how to deal with a student exhibiting associated with FAS. The article then continues to describe how FAS is not a recognized category under the Disabilities Act. Students are usually identified with another behaviour/emotional disorder related to the condition. I found this information useful because I assumed that FAS was an identifiable disability.
A chart lists some misconceptions and realities regarding students with FAS that may assist a teacher who has never taught this type of student before. For instance, a misconception that some teachers may have is that students with FAS who are talkative have good verbal skills. The reality of this misconception is that these students “don't know how to use language to negotiate everyday tasks, demands, and social interactions.”
The article also has useful strategies for intervention and teaching students with FAS. It would be beneficial for a teacher to understand how certain characteristics of FAS exhibit themselves as social/emotional, cognitive/behavioural and adaptive behaviours in the classroom. Understanding the way that students exhibit behaviours can allow the teacher to plan strategies to deal with issues as they arise.
There is also another useful chart to show teachers how to use assessments for FAS students in the areas of Language/Communication, Social/Behavioural, Adaptive/Behavioural and Academic/Cognitive to directly teach skills in these domains. Further, the chart also illustrates how to have the student practice the skills in each area and what environmental or academic supports to provide to help with success in these areas.
The article ends with sample IEP goals that are particular to students with FAS. Under the goal, the author has listed interventions to use with the IEP goal. For example, if the goal is to have the student demonstrate appropriate social skills in social situations, the author has written examples of how to intervene using Language/Communication ( role-play conversations), Social/Behavioural (chart on desk to reinforce appropriate behaviour), Academic/Cognitive (direct instructions on a task) and Adaptive/Behavioural (provide practice joining a group at lunch). This can be a very useful starting point for a teacher who needs to develop programming for a student with FAS.
A variety of online resources are offered for further research on the topic. Overall, the article gives the teacher many concrete strategies in understanding, programming, teaching a student with FAS.
Fetal Alcohol Syndrome
I decided to read an article concerning Fetal Alcohol Syndrome because I would like to learn more about it and because I suspect one of my students may have this syndrome. The title of the article is Students With Fetal Alcohol Syndrome: Updating Our Knowledge, Improving Their Programs, by Darcy Miller. I really liked how this article was laid out in that it gave a brief overview of a student in Grade 4 who exhibited the signs of Fetal Alcohol Syndrome (FAS) and then gave a very clear outline of what FAS is.
“The diagnosis of FAS is based on growth deficiencies, facial anomalies, cognitive deficits or abnormalities, and the amount of alcohol exposure during gestation”. Mr. Miller also references a 4-digit code that is used to diagnose the level of impairment or severity of the above mentioned areas. Level 1 would indicate no evidence of impairment and level 4 would indicate definite or severe evidence of impairment. “Using the four-digit code in diagnosis can result in 256 possible combinations…”.
What is interesting and challenging for educators is that FAS is not formally recognized as a category under the Individuals with Disabilities Education Act (IDEA), and that FAS is often discussed as a subset of other disabilities. I also found it interesting that there used to be a term, Fetal Alcohol Effects (FAE), that denoted students who displayed mild effects of FAS but that this term was considered too vague. The term Fetal Alcohol Spectrum Disorder (FASD) is now used more often and encompasses the full range of fetal alcohol spectrum disorders. “The characteristics associated with FAS range from mild to severe, and differentially impact language/communication, social/behavioral, academic/cognitive, and adaptive functioning”. Table 1 in the article has a good visual descriptor of this. (I tried to include it but had difficulty here).
I also found it interesting that there are many misconceptions about FAS. One being that students with FAS who have strong oral language skills have good social communication skills. “Despite being able to say a lot, many students with FAS have deficits in social communication; they don’t know how to use language to negotiate everyday tasks, demands, and social interactions. “Special education teams need to look beyond verbal fluency and vocabulary, and assess these students’ language comprehension and pragmatics, expressive and receptive understanding, as well as social communication skills”. The recommendation then, is direct instruction in social skills and language expectations.
As far as other interventions for children with FAS, it is important to address the social/behavioural component by pinpointing specific areas of concern. These students typically have anger management issues and will need positive behavioural supports which “provide accommodations for behaviours that won’t change or that change very slowly”.
Another misconception is that students with FAS are also “mentally retarded”. In reality, these students have varied academic and cognitive profiles with both strengths and weaknesses. However, these students do, in fact, tend to have overall difficulties understanding abstract concepts. It is suggested by Miller that the school resource personnel need to conduct in-depth academic and cognitive assessments in order to develop appropriate interventions.
Finally, with respect to adaptive behaviour, once again there can be a range of difficulties for the children with FAS. These can range from organization skills to having difficulty completing tasks independently and understanding basic safety rules. Through the various research and parent reports, it is clear that many students with FAS continue to require assistance and support after high school, therefore, adaptive behaviour is a very important component in the overall picture of the student with FAS. Clearly this is a very difficult and challenging condition but with ongoing new research and a collaborative team approach, these students can be helped in many positive ways.
Students With Fetal Alcohol Syndrome: Updating our Knowledge, Improving Their Programs
Review of “Instructional Tips: Supporting the Educational Needs of Students with Fetal Alcohol Spectrum Disorders” by Susan Marie Ryan. The journal article was published in Teaching Exceptional Children Plus.
The purpose of this article is to equip in-class teachers with the knowledge to “meet the learning, behavioral, and social needs” of students who have FASD. The article resulted from a 4-year study that involved interviews and observations of 25 teachers in Alaska who had students with FASD.
Introduction:
The article begins with a brief introduction about the available research and statistics:
- Fetal Alcohol Syndrome (FAS) was first proposed in 1968.
- The article focuses on Fetal Alcohol Spectrum Disorder FASD which is an umbrella term which encompasses 4 related diagnoses, including FAS
- Since 1968 there has been a progress in number of reported cases of FASD- in the USA, 10 of 1000 children are diagnosed with FASD annually.
The article then proceeds to provide 8 “Instructional Tips:”
- Think Person/Child First:
- Build a Relationship with Student’s Family
- Develop Partnerships and Build Collaboration Between Families, Schools, and Community Agencies, and Implement Wrap-Around Services.
The author points out that sometimes students with FASD have extremely chaotic lives; multiple foster care, various agencies involved in child’s life and perhaps judicial/criminal agency involvement. She states that under these conditions, teachers should work hard to develop/maintain relationships with external groups in order to create cohesion and full knowledge. Ryan refers to one such system she observed: the wrap-around support system. This philosophy supports fostering collaboration with the agency on a long-term basis which would be supervised by the in-school team and inherited each year by each new teacher. The system focuses on the need for continual/long-term support between the teachers, in-school-team and various agencies.
- Develop Social Skills
The author states that one of the most serious and negative consequences of FASD is the student often lacks acceptable social skills. Ryan’s research showed the positive impact that teaching social skills had on students with FASD. She sites several individual teaching strategies she discovered from her research, ranging from JK to high school. Accumulatively, Ryan concluded that teaching social skills should be “embedded” through the day and must be taught within the context of day to day lived experiences, not in isolation.
- Provide a Structured Environment
Ryan’s research showed that students with FASD functioned much better in a structured, routine environment. Teachers that she interviewed also stressed the importance of consistent application of rules and consequences. One teacher stated, ““Provide enough structure to help the student with FASD stay in control, but at the same time to hold the student accountable for taking some responsibility for self-control and for setting realistic goals.”
- Use Repetition and Consistency
During her research, Ryan found that all 25 teachers agreed upon the importance of repeating rules, lesson instructions and providing information in small chunks and checking for understanding. Ryan provides a number of useful strategies: create picture schedule of day or tasks, individually check for understanding by asking student to repeat back and work with parents to reaffirm task instructions.
- Modify the Classroom Environment and Modify the Curriculum
Here are some:
- Intentional seating plans (FASD student at front)
- Placing student with intentional peers to promote “good modeling.”
- Breaking tasks into segments and chunk information into smaller sections and check for understanding regularly
- Gentle reminders to focus and positive reinforcement
- Use of visual cues and pictographs
- Enlist help of parents to help student come to school organized and prepared
- Shortening time of task or give more frequent breaks
- Debrief with students and ask for student feedback on learning and understanding
- Make a Referral to Special Education and to an FAS Diagnostic Clinic
Ryan states that it is important that in-class teachers work with special education teachers and in-school team. In particular, she stated that it is important to recommend interventions for students you suspect of having FASD.
Conclusion:
The author concludes by re-stating the above outlined points. She also points out the importance of continual teacher-reflection on the effectiveness/ individual response to these strategies.
Ryan, S.M. (2006). Instructional tips: Supporting the educational needs of students with fetal alcohol spectrum disorders. TEACHING Exceptional Children Plus, 3(2) Article 5. Retrieved [date] from http://escholarship.bc.edu/education/tecplus/vol3/iss2/art5
Fetal Alcohol Spectrum Disorders
The article that I researched was Students With Fetal Alcohol Syndrome: Updating Our Knowledge, Improving Their Programs by Darcy Miller.
The article begins with a case study about Jack, a 10 year old boy with FAS. It discusses how the teacher intervenes (social skills, modeling and guided practice) when Jack has negative peer interactions. The case study is a useful way for other teachers to understand how to deal with a student exhibiting associated with FAS. The article then continues to describe how FAS is not a recognized category under the Disabilities Act. Students are usually identified with another behaviour/emotional disorder related to the condition. I found this information useful because I assumed that FAS was an identifiable disability.
A chart lists some misconceptions and realities regarding students with FAS that may assist a teacher who has never taught this type of student before. For instance, a misconception that some teachers may have is that students with FAS who are talkative have good verbal skills. The reality of this misconception is that these students “don't know how to use language to negotiate everyday tasks, demands, and social interactions.”
The article also has useful strategies for intervention and teaching students with FAS. It would be beneficial for a teacher to understand how certain characteristics of FAS exhibit themselves as social/emotional, cognitive/behavioural and adaptive behaviours in the classroom. Understanding the way that students exhibit behaviours can allow the teacher to plan strategies to deal with issues as they arise.
There is also another useful chart to show teachers how to use assessments for FAS students in the areas of Language/Communication, Social/Behavioural, Adaptive/Behavioural and Academic/Cognitive to directly teach skills in these domains. Further, the chart also illustrates how to have the student practice the skills in each area and what environmental or academic supports to provide to help with success in these areas.
The article ends with sample IEP goals that are particular to students with FAS. Under the goal, the author has listed interventions to use with the IEP goal. For example, if the goal is to have the student demonstrate appropriate social skills in social situations, the author has written examples of how to intervene using Language/Communication ( role-play conversations), Social/Behavioural (chart on desk to reinforce appropriate behaviour), Academic/Cognitive (direct instructions on a task) and Adaptive/Behavioural (provide practice joining a group at lunch). This can be a very useful starting point for a teacher who needs to develop programming for a student with FAS.
A variety of online resources are offered for further research on the topic. Overall, the article gives the teacher many concrete strategies in understanding, programming, teaching a student with FAS.
Fetal Alcohol Syndrome
I decided to read an article concerning Fetal Alcohol Syndrome because I would like to learn more about it and because I suspect one of my students may have this syndrome. The title of the article is Students With Fetal Alcohol Syndrome: Updating Our Knowledge, Improving Their Programs, by Darcy Miller. I really liked how this article was laid out in that it gave a brief overview of a student in Grade 4 who exhibited the signs of Fetal Alcohol Syndrome (FAS) and then gave a very clear outline of what FAS is.
“The diagnosis of FAS is based on growth deficiencies, facial anomalies, cognitive deficits or abnormalities, and the amount of alcohol exposure during gestation”. Mr. Miller also references a 4-digit code that is used to diagnose the level of impairment or severity of the above mentioned areas. Level 1 would indicate no evidence of impairment and level 4 would indicate definite or severe evidence of impairment. “Using the four-digit code in diagnosis can result in 256 possible combinations…”.
What is interesting and challenging for educators is that FAS is not formally recognized as a category under the Individuals with Disabilities Education Act (IDEA), and that FAS is often discussed as a subset of other disabilities. I also found it interesting that there used to be a term, Fetal Alcohol Effects (FAE), that denoted students who displayed mild effects of FAS but that this term was considered too vague. The term Fetal Alcohol Spectrum Disorder (FASD) is now used more often and encompasses the full range of fetal alcohol spectrum disorders. “The characteristics associated with FAS range from mild to severe, and differentially impact language/communication, social/behavioral, academic/cognitive, and adaptive functioning”. Table 1 in the article has a good visual descriptor of this. (I tried to include it but had difficulty here).
I also found it interesting that there are many misconceptions about FAS. One being that students with FAS who have strong oral language skills have good social communication skills. “Despite being able to say a lot, many students with FAS have deficits in social communication; they don’t know how to use language to negotiate everyday tasks, demands, and social interactions. “Special education teams need to look beyond verbal fluency and vocabulary, and assess these students’ language comprehension and pragmatics, expressive and receptive understanding, as well as social communication skills”. The recommendation then, is direct instruction in social skills and language expectations.
As far as other interventions for children with FAS, it is important to address the social/behavioural component by pinpointing specific areas of concern. These students typically have anger management issues and will need positive behavioural supports which “provide accommodations for behaviours that won’t change or that change very slowly”.
Another misconception is that students with FAS are also “mentally retarded”. In reality, these students have varied academic and cognitive profiles with both strengths and weaknesses. However, these students do, in fact, tend to have overall difficulties understanding abstract concepts. It is suggested by Miller that the school resource personnel need to conduct in-depth academic and cognitive assessments in order to develop appropriate interventions.
Finally, with respect to adaptive behaviour, once again there can be a range of difficulties for the children with FAS. These can range from organization skills to having difficulty completing tasks independently and understanding basic safety rules. Through the various research and parent reports, it is clear that many students with FAS continue to require assistance and support after high school, therefore, adaptive behaviour is a very important component in the overall picture of the student with FAS. Clearly this is a very difficult and challenging condition but with ongoing new research and a collaborative team approach, these students can be helped in many positive ways.
Students With Fetal Alcohol Syndrome: Updating our Knowledge, Improving Their Programs
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