What is Fetal Alcohol Syndrome?
Fetal Alcohol Syndrome (FAS) results from maternal consumption of alcohol during pregnancy, and is on a spectrum of Fetal Alcohol Spectrum Disorders (FASD), which ranges from mild to severe (Miller, 2006). FAS is considered to be a nervous system impairment, and is categorized as a low-incidence exceptionality (Hutchinson & Martin, 2012). There are several different categories on this spectrum, including static encephalopathy and neurobehavioural disorders (Miller, 2006). FAS is on the more severe end of this spectrum (Dybdahl & Ryan, 2009). There are four categories used to diagnose FAS and FASD:
The level of severity for each category is determined individually, and given a number from 1 (no evidence of impairment) to 4 (definite/severe evidence of impairment). This results in a 4-digit code that is used to diagnose the individual (Miller, 2006). In addition to the above categories, fetal alcohol syndrome is associated with several medical problems related to the heart, liver, urogenital tracts, and kidneys (Dybdahl & Ryan, 2009).
How does FAS Affect Learning?
FAS impacts four areas of functioning that may affect learning to various degrees:
Language/Communication:
Students with FAS may present as normal on achievement tests due to strong vocabulary and verbal fluency, but still have communication deficits. These deficits tend to be with the social use of language. Students may struggle with using language to solve problems, and understanding pragmatic uses of language. This ultimately leads to difficulty communicating socially Miller, 2006).
Social/Behavioural:
Social and behavioural functioning is usually the area in which students with FAS experience the most difficulty. Students with FAS tend to have difficulty with impulse, aggression, and anger control. This often leads to negative relationships with peers and teachers, as well as frequent disciplinary actions at school including expulsions and suspensions. These students often exhibit attention problems, similar to those with ADHD, as well as mood swings, problems with lying and stealing, and acting immaturely. All of these challenges often lead to low social competence and poor social and interpersonal skills (Miller, 2006).
Academic/Cognitive:
Professionals used to believe that all individuals with FAS were mentally retarded, however we now know that this is not the case. Students with FAS have cognitive profiles that resemble those of students with learning disabilities. Some cognitive areas students with FAS struggle with include “understanding abstract concepts, reasoning, memory and organization problems” (Miller, 2006, p. 15). This results in difficulty with reading, math, and writing (Miller, 2006).
Adaptive Behaviour:
Students with FAS may have adaptive behaviour deficits that range in severity. Less severe adaptive behaviour deficits may include things like difficulty understanding time and sequence, and poor organization. More severe adaptive behaviour deficits include things like difficulty making everyday decisions, understanding basic safety routines in a variety of settings, and independent task completion. Students with FAS may also have difficulty with remembering information and following multistep directions (Miller, 2006).
How can I Differentiate Instruction for Students with FAS?
The majority of students with FAS are educated in regular classrooms (Dybdahl & Ryan, 2009), so it is important that educators know how to differentiate instruction and accommodate educational programs for such students. Due to the wide range of needs between students with FAS, special education programs should be developed on a student-by-student basis. Functional behaviour assessments should be completed to determine specific areas of student need (Miller, 2006).
Despite the range of educational needs, students with FAS will benefit from direct instruction, and consistency of intervention strategies across situations. This includes consistency in personnel and environmental supports as well (Miller, 2006). Like students with other exceptionalities, students with FAS will benefit from extra time and repeated practice of new skills (Dybdahl & Ryan, 2009; Miller, 2006).
It is important to remember that all students have strengths, no matter what their exceptionality is. Students with FAS tend to be excellent at visualizing things, and physical education. They tend to excel in mathematics to a greater degree than other subject areas (Dybdahl & Ryan, 2009). Teachers should pay close attention to their students’ strengths, not just their weaknesses, when developing IEPs and special education programs.
Fetal Alcohol Syndrome (FAS) results from maternal consumption of alcohol during pregnancy, and is on a spectrum of Fetal Alcohol Spectrum Disorders (FASD), which ranges from mild to severe (Miller, 2006). FAS is considered to be a nervous system impairment, and is categorized as a low-incidence exceptionality (Hutchinson & Martin, 2012). There are several different categories on this spectrum, including static encephalopathy and neurobehavioural disorders (Miller, 2006). FAS is on the more severe end of this spectrum (Dybdahl & Ryan, 2009). There are four categories used to diagnose FAS and FASD:
- Growth deficiencies
- Facial anomalies
- Cognitive deficits/abnormalities
- Amount of alcohol exposure during pregnancy
The level of severity for each category is determined individually, and given a number from 1 (no evidence of impairment) to 4 (definite/severe evidence of impairment). This results in a 4-digit code that is used to diagnose the individual (Miller, 2006). In addition to the above categories, fetal alcohol syndrome is associated with several medical problems related to the heart, liver, urogenital tracts, and kidneys (Dybdahl & Ryan, 2009).
How does FAS Affect Learning?
FAS impacts four areas of functioning that may affect learning to various degrees:
- Language/communication
- Social/behavioural
- Academic/cognitive
- Adaptive behaviour
Language/Communication:
Students with FAS may present as normal on achievement tests due to strong vocabulary and verbal fluency, but still have communication deficits. These deficits tend to be with the social use of language. Students may struggle with using language to solve problems, and understanding pragmatic uses of language. This ultimately leads to difficulty communicating socially Miller, 2006).
Social/Behavioural:
Social and behavioural functioning is usually the area in which students with FAS experience the most difficulty. Students with FAS tend to have difficulty with impulse, aggression, and anger control. This often leads to negative relationships with peers and teachers, as well as frequent disciplinary actions at school including expulsions and suspensions. These students often exhibit attention problems, similar to those with ADHD, as well as mood swings, problems with lying and stealing, and acting immaturely. All of these challenges often lead to low social competence and poor social and interpersonal skills (Miller, 2006).
Academic/Cognitive:
Professionals used to believe that all individuals with FAS were mentally retarded, however we now know that this is not the case. Students with FAS have cognitive profiles that resemble those of students with learning disabilities. Some cognitive areas students with FAS struggle with include “understanding abstract concepts, reasoning, memory and organization problems” (Miller, 2006, p. 15). This results in difficulty with reading, math, and writing (Miller, 2006).
Adaptive Behaviour:
Students with FAS may have adaptive behaviour deficits that range in severity. Less severe adaptive behaviour deficits may include things like difficulty understanding time and sequence, and poor organization. More severe adaptive behaviour deficits include things like difficulty making everyday decisions, understanding basic safety routines in a variety of settings, and independent task completion. Students with FAS may also have difficulty with remembering information and following multistep directions (Miller, 2006).
How can I Differentiate Instruction for Students with FAS?
The majority of students with FAS are educated in regular classrooms (Dybdahl & Ryan, 2009), so it is important that educators know how to differentiate instruction and accommodate educational programs for such students. Due to the wide range of needs between students with FAS, special education programs should be developed on a student-by-student basis. Functional behaviour assessments should be completed to determine specific areas of student need (Miller, 2006).
Despite the range of educational needs, students with FAS will benefit from direct instruction, and consistency of intervention strategies across situations. This includes consistency in personnel and environmental supports as well (Miller, 2006). Like students with other exceptionalities, students with FAS will benefit from extra time and repeated practice of new skills (Dybdahl & Ryan, 2009; Miller, 2006).
It is important to remember that all students have strengths, no matter what their exceptionality is. Students with FAS tend to be excellent at visualizing things, and physical education. They tend to excel in mathematics to a greater degree than other subject areas (Dybdahl & Ryan, 2009). Teachers should pay close attention to their students’ strengths, not just their weaknesses, when developing IEPs and special education programs.
What Resources are Available for Parents and Teachers of Students with FAS?
Admitting to prenatal alcohol consumption can be difficult for mothers of children with FAS (Hutchinson & Martin, 2012 ), and is often something adoptive parents are unaware of prior to adopting a child (Dybdahl & Rhan, 2009).
Admitting to prenatal alcohol consumption can be difficult for mothers of children with FAS (Hutchinson & Martin, 2012 ), and is often something adoptive parents are unaware of prior to adopting a child (Dybdahl & Rhan, 2009).
Parent Resources:
- FASlink Fetal Alcohol Disorders Society www.faslink.org
- FASworld http://www.fasworld.com
- Caring for Kids http://www.caringforkids.cps.ca/handouts/fetal_alcohol_spectrum_disorder
- National Organization on Fetal Alcohol Syndrome http://www.nofas.org
Teacher Resources:
- Teaching Students with Fetal Alcohol Syndrome/Effects: A Resource Guide http://www.bced.gov.bc.ca/specialed/fas/
- Teaching Students with Fetal Alcohol Spectrum Disorder https://education.alberta.ca/media/377037/fasd.pdf
- Planning for Students with Fetal Alcohol Spectrum Disorder http://www.publications.gov.sk.ca/details.cfm?p=33258
- Tapping Hidden Strengths: Planning for Students who are Alcohol-Affected http://www.edu.gov.mb.ca/k12/specedu/fas/pdf/FASD_Document.pdf
References:
Dybdahl, C. S., Ryan, S. (2009). Inclusion for students with fetal alcohol syndrome: Classroom teachers talk about practice. Preventing School Failure, 53(3), p. 185-195.
Hutchinson, N. L., Martin, A. K. (2012). Inclusive classrooms in Ontario schools. Pearson Canada: USA.Miller, D. (2006). Students with fetal alcohol syndrome: Updating our knowledge, improving their programs. Teaching Exceptional Children, 38(4) p. 12-18.