1. 1 FAS 101 PowerPoint Presentation I Segment 3: FAS 101

2. 2 What This Presentation Addresses Description of FAS and ARND How alcohol affects the fetus Central nervous system and behavioral problems of children with FAS/ARND Diagnosing FAS Why school staff should learn about FAS and ARND

3. 3 What Is FAS (Fetal Alcohol Syndrome)? A set of physical, behavioral, and cognitive disorders seen in individuals exposed to alcohol prenatally

4. 4 Diagnosing FAS Child must have signs in each of three areas: Growth retardation Abnormalities in the central nervous system (CNS) Facial abnormalities

5. 5 What Is FAE (Fetal Alcohol Effects)? One or two (but not all three) diagnostic signs of FAS. Typically have growth retardation and CNS abnormalities. To separate physical and neurologic signs, the terms ARBD and ARND were introduced.

6. 6 What Is ARBD (Alcohol-Related Birth Defects)? Physical abnormalities that can result from prenatal alcohol exposure Typically includes cardiac, skeletal, renal, auditory, and/or ocular system abnormalities

7. 7 What Is ARND (Alcohol-Related Neurodevelopmental Disorder)? CNS abnormalities that result from prenatal alcohol exposure. Children with ARND look normal, so they often are not diagnosed. Possible to have both ARBD and ARND. In this course, the terms FAS and ARND will be used together (i.e., FAS/ARND).

8. 8 How Common Are FAS and ARND? Exact rates are not known. In U.S., FAS estimates range from 2 to 15 cases per 10,000 births. ARND and ARBD occur 3 to 4 times more often than FAS. FAS and ARND occur worldwide.

9. 9 Why Does Alcohol Affect the Fetus? Alcohol is a teratogen—a substance or condition that the fetus is exposed to that impedes growth and disrupts normal development.

10. 10 How Does Alcohol Affect the Fetus? Alcohol in the mother’s blood moves across the placenta to the fetus. The more alcohol the mother drinks and the longer the fetus is exposed to alcohol, the greater the risk to fetal brain, body growth, and physical development. Alcohol use during pregnancy does not always result in FAS.

11. 11 What Influences the Effects of Alcohol on the Fetus? Blood alcohol concentration of the mother. Timing of exposure. Genetic sensitivity of mother and fetus to alcohol. Metabolism of the mother. If the mother continues heavy alcohol use, the risk of having a child with FAS increases with each pregnancy.

12. 12 Timing of Alcohol Consumption First trimester: Alcohol can cause abnormalities in the physical structure of all organs of the fetus. In all 3 trimesters, alcohol affects the following:  Growth and size of fetus  Growth and development of the central nervous system (brain and spinal cord) Third trimester: Brain is particularly vulnerable to alcohol.

13. 13 How Much Alcohol Use Causes FAS/ARND? We don’t know. Surgeon General recommends no alcohol use during pregnancy. Whenever a pregnant woman stops drinking, she can improve her baby’s health and her own.

14. 14 Role of the Father Father’s use does not biologically contribute to FAS or ARND. A heavy-drinking partner can create barriers for a mother to abstain from alcohol during pregnancy. A supportive partner can positively influence the mother to abstain during pregnancy.

15. 15 Cognitive Impairments of FAS All people with FAS/ARND have cognition that is diminished from their optimal cognition. The majority have low-average to borderline- average I.Q. (70 to 85). 25% of people with FAS/ARND are mentally retarded (I.Q. ≤70). The challenge of affected children who “test fine” but don’t function or advance appropriately in classroom.

16. 16 Central Nervous System Problems Sleep and sucking disturbances in infancy Mental retardation (ranging from mild to severe) Short attention span Speech and language disorders Learning problems Problems processing visual and auditory information Poor reasoning or judgment Memory problems Problems generalizing information from one situation to another

17. 17 Behavior and FAS/ARND Hyperactivity, inappropriate social behavior/difficulty reading social cues, difficulty with transitions, low tolerance for frustration. Child may appear to be lazy or misbehaving but often cannot do something because of the way his/her brain works. Focus on helping the child adopt appropriate behaviors in specific situations.

18. 18 IEPs and FAS/ARND IEP is a student-centered planning tool created by a school team. Addresses academics, behavior, social interactions, and communication. Periodic IEP meetings involving parents can aid communication with family and indicate when revisions to plan are necessary.

19. 19 Evaluation for Special Education Services Affected students may be evaluated for special education services. Evaluation focuses on IQ, achievement, adaptive living skills. Some districts perform more comprehensive assessment. Findings lead to development of IEP (Individualized Education Plan) for student.

20. 20 Do Children Outgrow the Problems of FAS/ARND? There is no cure, but children learn to adapt as they mature. Some abnormalities (e.g., facial features, speech and motor problems) may decrease over time. Behavioral, emotional, and social problems can become more evident in adolescents and adults. Early diagnosis and provision of services can lead to adaptations to lessen the severity of effects of FAS/ARND.

21. 21 Why Diagnose FAS? Parents and school can help more effectively. Can eliminate other causes and focus on most beneficial strategies for the child. With diagnosis, child may become eligible for services. Early intervention is more likely to reduce the child’s problems and increase his or her functioning.

22. 22 Who Can Assess Children for FAS/ARND? Diagnosis is made on basis of clinical signs. No laboratory test, so diagnosis may be difficult. Dysmorphologists, pediatric neurologists, clinical geneticists are typically most skilled at diagnosing FAS/ARND. Prenatal exposure to alcohol can cause multiple problems that present in a variety of ways in children. Assessment commonly happens when the child reaches school age.

23. 23 Secondary Disabilities Occur as a result of primary FAS/ARND disabilities the child was born with. One study found increased mental health problems, trouble in school, trouble with the law, inappropriate sexual behaviors. Importance of early diagnosis and focused intervention to improve outcomes.

24. 24 How Can FAS/ARND Be Prevented? Abstain from consuming alcohol while pregnant Link alcohol-abusing women with programs to help them stop drinking while pregnant

25. 25 Why Should School Staff Learn About FAS/ARND? Many traditional teaching strategies don’t work with children with FAS/ARND. Learning strategies for working with students with FAS/ARND can prevent or reduce their disruptive behaviors. Many simple classroom adaptations for FAS/ARND help all students. When staff understand stressors of FAS on the family, they can form better partnerships with families.

26. 26 Impact of FAS/ARND on the Family Biological Family Some students with FAS/ARND live with biological mother and/or father. Mother and father may feel guilt and anger about her drinking during pregnancy. Challenge of getting help for child’s problems.

27. 27 Impact of FAS/ARND on the Family Biological Family Some students with FAS/ARND live with biological mother and/or father. Mother and father may feel guilt and anger about her drinking during pregnancy. Challenge of getting help for child’s problems.

28. 28 Impact on the Family (Continued) Foster and Adoptive Parents Many affected children live with foster or adoptive parents. May be frustrated by lack of completeness of child’s medical records. May have difficulty accepting that their dreams for the child may not come to pass. Challenge of getting help for child’s complex problems.

29. 29 School Staff Working with Parents/Caregivers Acknowledge difficulty of raising a child with FAS/ARND. Ask parents what strategies work at home and be receptive to what they share. Assist parents in obtaining support services for child and family. Continue trying to connect with parents who do not respond. Build positive alliances that reinforce strengths of child and family.

30. 30 We Have Discussed Description of FAS and ARND How alcohol affects the fetus Central nervous system and behavioral problems of children with FAS/ARND Diagnosing FAS Why school staff should learn about FAS and ARND

31. PowerPoint Presentation II Segment 5: FAS/ARND Strategies

32. FAS/ARND Strategies for School Staff Handout: Keep in Mind Many children with FAS/ARND are in a regular classroom. Their teachers need to be aware of strategies for helping them. Teachers already use many strategies that work for students with FAS/ARND. Strategies for FAS/ARND often help the entire classroom run more smoothly.

33. FAS/ARND Strategies for School Staff Handout: Keep in Mind (Cont’d.) Students with FAS/ARND may always need bridges for comprehension (e.g., taping alphabet to desk). Some of the strategies require trying something unfamiliar—give it a try! If one strategy doesn’t work, try another.