A parent was introducing her child's FASD to us and recommended Diane Malbin's book, Fetal Alcohol Spectrum Disorders: Trying Differently Rather Than Harder. Being the reader that I am, I went to Amazon and obtained my very own copy and read. The book has a couple of basic premises. One, any amount of alcohol during pregnancy runs the risk of FASD and the more that is drunk, the higher the risk. Two, FASD is the result of brain damage and should be treated like other more visible disabilities. We don't tell the blind person to try harder to read, we give him Braille or audiobooks. Similarly we should not expect individuals with FASD to be able to do tasks they cannot do. Three, we need to modify the environment to meet their needs. Interestingly, I find these last two principles similar to those we recommend with autism spectrum disorder.
The author identifies some primary behavioral characteristics. If these characteristics are not met appropriately, they result in secondary behaviors as the individual deals with the frustration of not having their needs met and being presented with unrealistic expectations. These primary characteristics include:
- dysmaturity
- slow processing speed
- impulsivity and distractibility
- memory problems
- difficulty generalizing
- difficulty abstracting and predicting
- over and under sensitivity
- limited ability to identify cause and effect.
Secondary behaviors include anxiety, fatigue, rigidity, shutting down, poor self-concept, social isolation, aggression, avoidance and depression. Unaddressed, these behaviors may result in trouble with authorities, self-injury, and addiction problems.
As a result of these children's lack of cause and effect understanding, poor generalization skills and memory issues, behavior modification techniques often are unsuccessful. Consequently, modifying the environment becomes the humanizing choice. Specific instructions and verbal and visual cues may become essential. Becoming extra aware of links between physical states (such as hunger or tiredness) and behavior is important. I remember realizing my son did not recognize hunger, but when he was hungry he was impossible. That meant I needed to get him to eat so that he could control his behavior. This sort of link is common in children with FASD as well.
We need to understand that when they learn something, it may not generalize. I knew how to use the graphic organizer for that assignment but need explicit instruction on how to use it on the next. What they were able to produce one day, may not be reproducible another, especially if the setting is different (school v. home; ELA room v. social studies room). Too much input is overwhelming. All those anchor charts around the room may help many students, but distract and result in brain freeze for the child with FASD. The average kindergartener learns three step directions, but for a child with FASD that may not be possible until middle school and beyond.
The best businesses thrive because of managers. The best managers identify the strengths and talents of their teams and find ways for people to spend their time doing the things they do best. We need to emulate this behavior in schools and homes. We need to find the things our children do best and work to ensure that those things are the things they have time to do. This allows them to find flow and success. When a person spends the majority of their time doing things that are super hard and stressful, they cannot be their best. When they capitalize on those things they do well, they can excel. Creating this sort of environment is essential to our children with FASD's success
