Fetal Alcohol Spectrum Disorder (FASD) is a completely preventable disability and the leading cause of mental retardation caused by alcohol exposure during the prenatal period, particularly in critical stages of development. Children affected by FASD may exhibit a range of characteristics including learning and behavioral problems, with varying degrees of intellectual disability. Supportive strategies for parents and educators are essential to help these children succeed in their learning environments.

1. Fetal Alcohol Spectrum Disorder 100% Avertable Disability #1 Cause of Mental Retardation

2. What causes FASD? Exposure to alcohol during prenatal period More frequent alcohol use increases the risk to the fetus. Only a few drinks during critical phases of development may lead to FASD. Critical stages of development occur within the first month of pregnancy. (Frequently, the mother does not know she is pregnant before alcohol exposure has harmed the fetus). Fathers who drink heavily prior to the conception of the baby may adversely affect the baby.

3. Alcohol Exposure During the Pregnancy Trimesters First: During the first trimester, alcohol interferes with the migration and organization of brain cells and the formation of the CNS. Second: Heavy drinking during the second trimester, particularly from the 10th to 20th week after conception, seems to cause more clinical features of FAS than at other times during pregnancy. Third: During the third trimester, the hippocampus is greatly affected, which leads to problems with encoding visual and auditory information (reading and math) and the inability to form or retain new memories.

4. Dark lines = Great fetal sensitivity Light lines = Continued alcohol sensitivity

5. FAS Physical Characteristics Head Small head circumference Small eye openings Smooth, wide philtrum Thin upper-lip Other Organ deformities Skeletal abnormalities Central nervous system damage Behavioral problems * Facial characteristics may not be present at all if the mother did not drink alcohol during the brief period that the mid-face was forming - around the 20th week of pregnancy.

6. Intellectual Characteristics IQ ranges from very low to above average Difficulty storing and retrieving information Struggles with abstract concepts Trouble staying at task Difficulty generalizing knowledge and experiences

7. Behavioral Issues Unaware of social mores Poor judgment Hyperactivity Impulsive Emotionally Immature Unable to remember and or apply rules * Problems often intensify as the child moves though the teen years and manifest in criminal behaviors

8. Degree of Disability Mild Disability Developmental delays IQ normal to above normal Learning disabilities Behavioral disabilities including ADHD, impulsiveness, and anxiety Little or no physical deformities Severe Disability Developmental delays Mean IQ under 70 Learning disabilities Behavioral disabilities including ADHD, impulsiveness, and anxiety Profound physical deformities

9. Fetal Alcohol Effects or FAE FAE is not as easily identifiable as FAS because there may be fewer physical abnormalities, but knowledge of maternal use of alcohol makes it certain that brain damage has occurred.

10. FAE Continued. . . Kids with FAE show little or no physical abnormalities I.Q. may range between 20 - 130 Learning disabilities Motor skills dysfunction Hyperactivity Hypoactivity ADD Criminal activity Court and Mental Health involvement

11. FACTS ABOUT FAS AND FAE 1. At least 5,000 babies are born each year with FAS. 2. 50,000 children show symptoms of FAE. 3. FAS is the leading known cause of mental retardation. 4. FAS/FAE found in all races and socio-economic groups. 5. FAS/FAE is irreversible physical and mental damage. 6. Many children labeled as learning disabled are believed to be FAE children. 7. The behavioral and mental problems of FAE children are no less than those of FAS children.

12. FACTS ABOUT FAS AND FAE, Cont. 8. Many children with FAS/FAE are unable to understand cause and effect, or distant consequences. 9. Many FAS/FAE children have poor coordination, short attention spans, are either hyperactive or hypoactive, and have behavioral problems. 10. Costs to the American taxpayers is $321 every year in care, detainment, prosecution, institutionalization and incarceration for misjudged or undiagnosed FAS/FAE people. 11. The cost to the FAS/FAE person is inestimable, because it lasts a lifetime.

13. Fetal Alcohol Spectrum Disorder Impact on Learning

14. Most Common Factors Impacting Learning (Child can’t vs. Child won’t) Primary / Inherent Attention deficits Delayed speech Poor motor skills Learning Disabilities Difficulty following directions Secondary / Behavioral Easily frustrated Aggressive behavior Easily tired Anxiety Transition difficulties

15. As a Parent, Words to Live By… Always be positive; laugh whenever you can. Argue with them less. Engage them in activities that they enjoy. Punish less. Always hug them and tell them you love them, even when you are upset or angry. Never give up!!!! Crying is OK. Monitor and regulate what they watch on television.

16. Cont. . . Do not make them relive the poor decisions they have made. Do not ask too much of them or they will put a lot of pressure on themselves. Get enough sleep, good food, and exercise. They need you to be at your best to help them be their best. Join an FASD Support Group.

17. With support through structure, supervision, routine, and consistency, your child may experience success.

18. Remember, “STRATEGIES NOT SOLLUTIONS!” FAS Children do learn, but all learn differently, “find what works best and stick to it!” Create a friendly and structured home environment that is familiar. . . Creating routines/schedules serves as anchors overtime for children with FAS/FAE Limit changes in their routine/schedules “less is better!” To avoid overwhelming

19. Teachers, Signs/Clues External Signs: Daydreaming 50% of class time Bitten fingers, fingernails and/or lips Silence for long periods Forgetfulness on a hourly/daily basis Anger Facial deformities

20. Teacher Cont. . . Internal Signs: Confusion Frequently asks: What time is it? What class is this? Emotional Breakdowns Tears things without making noises Retreat from everything, staring High anxiety, non-verbal Inappropriate sexual activities Inappropriate touching

21. Teaching Tips Create a calm and quite learning environment Limit distractions Instead of telling them to take notes: Tell them what to write (Accommodation) Tell them to listen for something they hear more than once Listen for lists Provide them with a copy of your notes

22. Parenting and Teaching Try differently, not harder!

23. References Emory University (n.d.). Maternal Substance Abuse and Child Development. Retrieved December 28, 2009 from http://www.psychiatry.emory.edu/ PROGRAMS/GADrug/fasqa.htm#does Graefe, Sara. (2004). (Ed.). Living with FASD: A Guide For Parents. British Columbia: Special Needs Adoptive Parents. Groundwork Press. Retrieved December 23, 2009 from website: http://www.faslink.org/strategies_not_solutions.pdf Kellerman, Teresa (2005). Symptoms of Fetal Alcohol Spectrum Disorders. Retrieved December 28, 2009 from http://www.come- over.to/FAS/faschar.htm Kellerman, Teresa (2008). Prenatal Alcohol Exposure and the Brain. Retrieved December 28, 2009 from http://www.come-over.to/FAS/FASbrain.htm

24. References Continued Kock, Gregory C. &Kupesky, Regina H. (2002). Parenting the Hurt Child: Helping Adoptive Families Heal and Grow. Pinon Press. Retrieved December 23, 2009 from website: http://www.faslink.org/strategies_not_solutions.pdf Learning about FASD (2009). Retrieved December 31, 2009 from http://www.fasdoutreach.ca/elearning/learning-about-fasd Look Who’s in Jail! (n.d.). Retrieved December 29, 2009 from http://www.come-over.to/FAS/jailbaby.htm Mayo Clinic (2009). Fetal Alcohol Ayndrome. Retrieved December 28, 2009, from http://www.mayoclinic.com/health/fetal-alcohol- syndrome/DS00184/ DSECTION=symptoms. National Institute on Alcohol Abuse and Alcoholism (n.d.). Module 10K Fetal Alcohol Exposure. Retrieved January 2, 2010 from http://pubs.niaaa.nih.gov/publications/Social/Module10KFetaExposure /Module10K.html