Presentation for the Youth at Risk Conference, Savannah GA March 2013

1. Fostering Social
Emotional Skills &
Academic Success for
Students with FASD
Cheryl A. Wissick, Ph.D. University of South Carolina
Trainer, SC FASD Collaborative
Presentation Youth at Risk, Savannah GA, 3-4-13
Presentation adapted from information from
Dan Dubovsky, FASD Specialist, FASD Center CFE, SAMHSA
Roger Zoorob, M.D., Meharry Medical College
& Support from
South Carolina Collaborative FASD

2. Resources
• FASD Center: FASDsoutheast.org
• Center for Excellence in FASD:
•FASDcenter.samsha.org

3. Scfasd.weebly.com

4. Resources for Presentation
Wikispaces
Behaviorsolutions
Webtoolboxes

5. Objectives
•What do you know? Pre evaluation
•What do you want to know?
•Establish a goal for today
•FASD: overview and misconceptions
•Social Emotional Solutions
•Academic Solutions

6. FASD: Fast Facts
•FASD – 100% preventable, 0% curable
•If you are pregnant, don’t drink.
•If you drink, don’t get pregnant.
•Exposure to alcohol can affect the brain
development at any time during
pregnancy.
•FASD leading preventable cause of ID & DD
in Western World

7. New Research YEA
Scientists identify molecular events:
1- Alcohol inhibits critical L1 cell adhesion
form the brain & spinal cord
2- Certain compounds can block alcohol’s
inhibition
1st Trimester 2nd Trimester 3rd Trimester
Alcohol interferes Alcohol causes Alcohol leads to
with organization clinical features of problems encoding
of brain cells FAS visual & auditory
information

8. Prevalence of Any Alcohol Use among Women
Aged 18-44 Years – United States, 1991-2005
•High-risk drinking among women has not
declined in the past decade
Behavioral Risk Factor Surveillance System, 1991-2005, United States
60
50
Prevalence (%)
40
30
20
10
0
Not pregnant Pregnant

9. High School girls 2011 data
70
60
50
40
Current
30 Binge
Binge/alcohol
20
10
0
Total White, non- Black, non- Hispanic Other, non- 9 10 11 12
Hispanic Hispanic Hispanic†

10. Binge Drinking
Binge Drinking Prevalence %
30
25
20
15
10
5
0
Age Ethnicity Education Income

11. How much is too much alcohol
•What is a standard drink:
• 12 oz. of beer
• 5 oz. of wine
• 4 oz. sherry
• 1 ½ oz. of liquor
• 12 oz wine spritzer
•NO alcohol in any form is safe during
pregnancy.

12. FASD
•Fetal Alcohol Spectrum Disorders is
not a diagnostic category, but rather
an umbrella term describing the
effects that can occur in a person
whose mother drank alcohol during
pregnancy.
•FASD is what a person
has not what a person is.

13. Person First language
•FASD is what a person has not what a
person is.
•Teenager with fetal alcohol spectrum
disorders
•Student with a learning disability
•Man with red hat
•Can you think of one?

14. Misconception #1
You know a child has been affected by
alcohol by the way he/she looks.
• Facial effects decrease as children age
• Full facial effects are only required for a
diagnosis if one cannot substantiate that the
mother drank during pregnancy.
• FASD is much broader than just FAS
• FAS has dysmorphic facial features, growth
deficit and CNS abnormality

15. Misconception #2
Students with FASD all have severe
intellectual disabilities
• Students with a FASD can have a range of
abilities from severe intellectual disabilities
to learning disabilities (IQ range 20-110)
• Students with a FASD can be labeled as
having ADHD, ODD, Personality
disorder, Learning Disability, Depression but
FASD is the umbrella
• Leading cause of ID but only 25% have ID

16. Misconception #3
FASD is not as prevalent as Autism
• Estimates are that more children are affected
by alcohol than the number of students
identified as having autism spectrum
disorders
• FASD is not as publicized due to stigma
• Good data are not collected on the incidence
of FASD – only birth records of mothers
“known” to drink are recorded.

17. Misconception #4
Alcohol does not cause as much damage as
cocaine or heroin.
• Alcohol has long range effects on behavior and
brain functioning.
• FASD is a lifelong disorder.

18. Misconception #5
If there is no cure, then why bother with
identification.
• Early identification helps provide structure and a
stable environment.
• Early identification can assist with strategies for
instruction

19. Misconception #6
Only women who are alcoholics & have a low
SES give birth to babies with a FASD.
• We cannot predict how much alcohol exposure
will lead to a FASD.
• What constitutes one drink is much smaller than
what we usually consider.
• FASD is more prevalent in middle to upper class
situations than lower class.

20. Misconception #7
If I use evidence based practices the student
will respond, otherwise the student is not
trying.
•Students do not respond to typical
language-based approaches.
•We have to shift thinking to what is wrong
with the curriculum and not what what is
wrong with the student.

21. So when to consider a FASD & try
other techniques?
•Students or clients who do not
respond to Research & Evidence based
strategies
•Students or clients do not respond to
typical rewards and consequences
•Students or clients who appear to be
unmotivated and unresponsive

22. Why? Brain disorder
creates gaps
Chart of age level functioning
Source:

23. Consider FASD as the
umbrella

24. Strengths Based Approach
•What do they do well?
•What do they like to do?
•What are their best qualities?
•What are your funniest experiences with
them?
•Identify strengths in
family, teachers, community, school
•Always focus on the individual first

25. “Typical” strengths
• Friendly • Determined
• Likeable • Have points of
insight
• Verbal
• Good with younger
• Helpful children or elderly
• Caring
• Hard Worker

26. Barriers
Do not learn by experiencing
consequences of their behavior.
•Act oppositional & have outbursts .
•Keep breaking the rules.
•Problems with lying or filling in the truth.
•Only respond to immediate rewards and
consequences.
•Difficulty with social situations & friends

27. Techniques: Consequences
•Do not use natural consequences and make
all consequence short term – (1 day max)
•USE positive reinforcement – immediately
•Do not take away what they like to do as a
consequence for their behavior.

28. Techniques: Lying
•Discover the “purpose” of the lying, a
behavior analysis
•Verify the person’s story from credible
sources, not always peers.
•Not always a connect between what they
feel to how they act so they might “look”
like lying.

29. Techniques: Social
•Provide Social skills training & model with
peers. Keep them actively involved
•Work on Strengths and help foster
relationships with positive peers.
•Provide positive mentors
•Social skill training so that others do not
see them as weird, strange, being
inappropriate

30. Techniques: Rules
•Make sure rules are simple, be positive
Have students explain what the rule means
and not just repeat the rule
•Act out the rules or see if they can provide
a Not-Example
•Provide reasons for rules

31. Techniques: Outbursts
•Look for signs of stress
•Provide quiet environments for chill out
•Ask if they need help
•Be there to provide assistance
•Provide second chances
•Check our expectations
•Be consistent & calm

32. Barriers to Learning
Attention
•Coming to attention
•Filtering out other distractions
•Staying on task for long periods
•Shifting attention

33. Barriers to learning
Verbal Reception
•Verbal expressive ability is much more
advanced than verbal receptive skills or
ability to produce written products.
•Can’t process several directions at once
•Can SAY what they need to do but they
cannot show they can do it

34. Barriers to Learning
Working memory
•Problems with Storage and retrieval
•Inability to hold information in memory
while performing a mental operation
Cannot keep track of multiple plans to
remember what they were supposed to
do when

35. Barriers to Learning
Impaired Number Sense
•Difficulty with concepts*:
telling time, money, measurement
•Difficulty with time as a function of retelling
events, Impaired sense of timeline
•Difficulty planning and mental manipulation

36. Barrier to learning
Abstract Concepts
•Slow Processing rate
•Difficulty with prediction
•Difficulty making links or forming
associations
•Problems making generalizations
•Literal thinking

37. Overall Strategies
•Simplify & structure the environment
•Use a lot of repetition & rephrasing
•Provide one direction or rule at a time.
•De-stress situations as it creates cortisol in
their brain.
•Be consistent!!

38. Take home information
•We can’t change behavior of the damaged
brain but we can change our approach or
environment.
•Consider their point of view as they learn
and see things differently

39. Remember
LISTEN… when they tell you that they cannot
do something but they are trying as they do
get frustrated: like trying to put together
something from IKEA every day!

40. Other resources from
ScFASD.weebly.com

41. Do2Learn

43. http://edmontonfetalalcoholnetwork.org

45. Resources to teach
students

47. Help spread the word
with the FASD Knot
Can you follow the picture directions to make
an FASD knot?
Cheryl Wissick cwissick@sc.edu
Or Drwissickusc@gmail.com
http://behaviorsolutions.wikispaces.com

48. •All images of Lego from the Morgue File
•http://www.morguefile.com/