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What is fetal alcohol spectrum disorder?
What is fetal alcohol spectrum disorder?
FASD is an umbrella term used to encompass the range of possible effects of prenatal exposure to alcohol (British Medical Association, 2007).
The following diagnostic or educational terms are included in the spectrum:
Foetal alcohol syndrome (FAS) – the most easily recognisable condition due to characteristic facial features which are formed during the first trimester of pregnancy and dissipate with age
Partial foetal alcohol syndrome (pFAS) – some but not all of the criteria for FAS are met
Foetal alcohol effects (FAE) – the symptoms are not usually visible (eg behaviour disorders, attention deficits, etc)
Alcohol related neurodevelopmental disorder (ARND) – can include attention deficits, behaviour disorders, obsessive/compulsive disorder
Alcohol related birth defects (ARBD) – includes characteristics such as organ damage, heart defects, sight/hearing problems, skeletal damage and joint defects
The characteristics of FASD are individual to each student depending on timing and dosage of maternal alcohol consumption, and maternal well-being and health during pregnancy. Generally, however, the following characteristics may be observed in these students:
Possible strengths
Students may be:
bright in some areas;
highly verbal
artistic, musical, athletic, have good practical skills
friendly, helpful, affectionate and good with younger students
determined and persistent.
Likely difficulties
Students may:
be easily influenced by others
have difficulty predicting and understanding the consequences of actions
despite a good vocabulary, struggle to understand what is said to them
have difficulty in separating fact from fantasy
display behaviours which will need support, such as lying, stealing, temper tantrums
have delayed physical, emotional and cognitive development (delayed developmental milestones)
have poor impulse control, hyperactivity and poor memory
experience sensory processing difficulties
have social communication difficulties, particularly in the areas of interpreting the actions of others and in understanding how to respond in social situations; this is due to their impulsivity and lack of inhibition, and may lead to inappropriate sexual behaviour when older
have dietary and feeding difficulties/small stature/health problems such as frequent and persistent colds, visual and hearing impairments.
Implications for teaching and learning
As a result of their disability, students may experience:
memory problems; difficulty storing and retrieving information
inconsistent performance (on and off days)
impulsivity, distractibility, disorganisation
ability to repeat instructions, but inability to put them into action
difficulty with abstractions, such as maths, money management, time concepts
cognitive processing deficits, so need time to take in information and to respond
slow auditory pace (may only understand every third word of normally paced conversation)
developmental lags (may act younger than chronological age)
inability to predict outcomes or understand consequences.
Supporting students with FASD
Have a safe, structured environment, where the student’s difficulty in following verbal instruction is supported by visually presented material. If helpful, use screens or something similar to reduce the distraction around the area where they work. Keep instructions short and simple.
Support their independence and organisational skills by creating clearly defined areas of the classroom for specific activities; use labelling and general tidiness to help them to find what they need.
Have a set routine for carrying out their work, so they know what is expected of them.
Allow them time to take in what is said and to form a response. Provide plenty of repetition to aid recall.
Check that they understand class and school rules and give them the chance to go over them regularly.
Provide plenty of encouragement and praise when they achieve. Use their strengths and interest to personalise learning and assist motivation.
Help them to understand their feelings and practice the vocabulary to express how they feel. (It is thought that up to 80% of children affected by FASD are with foster or adoptive families, and that some may have lived with a number of families before they are placed with adoptive families. These experiences may lead to impaired emotional understanding.
Maintain regular contact with home in order to give consistent messages and to provide support.
The transition between primary and secondary education can be difficult for students with FASD, as they may already have had a number of changes in their lives. Try to ensure that there is a smooth transition and that support remains in place.
For teenagers, issues around emotions, friendships and sexual behaviour, independence and achievement can be difficult, particularly if family relationships are unusual.
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