Wednesday, November 21, 2007

Not In My Town Presentation

Today, I presented to educators and other human services personnel in Thief River Falls, MN. I told some of them the Powerpoint presentation would be on this site. I will have to have you go to my professional efolio site and find it in under the Work Samples tab.

Thanks to all who attended today. I hope we can continue this dialogue about getting more information to the students and families.

Saturday, October 20, 2007

What Interventions Work?

I was asked by a University student if there were any interventions for an FASD student. Here was my response (with a few changes).

I have some time tonight, so I am going to try to answer your question.

The only true intervention for Fetal Alcohol Spectrum Disorder is to not drink. When the alcohol enters the bloodstream of the mother, the damage begins. The damage continues until the mother stops drinking or the child is born. It can continue if the mother breast feeds and drinks alcohol during the period of time she breastfeeds.

Early intervention gives the child the best chance of success. The window of time for early intervention has passed by 5 years old. Even the early intervention has minimal success. The brain damage has already occurred. From birth of the child until the child reaches 3 to 4 years old, a full Syndrome, and any FASD child would need focused and intensive diagnosis of hearing, vision, sensory sensitivity, large motor movement, and a full spectrum of physical evaluations. Academically, the child would need intense phonemic and verbal and physical prescriptive activities designed to stimulate the neurons to their maximum capability. Research suggests this type of early intervention provides for more success. I would submit that a parent or guardian who is providing this type of therapy or activities is providing the structure an FASD child needs to give him or her the best chance for success.

Besides having an early diagnosis and intense interventions as a baby, structure in an FASD child's life is the one single best intervention. Unfortunately, many FASD children are born of FASD parents and structure is not something an FASD parent is capable of providing. An FASD brain needs another brain to remind, refocus, direct, and protect the FASD child. An FASD brain is impulsive and does not have the connections other brains have. The FASD child needs structure both in the home and in the school setting. Transistions throw them off. One strategy is to have timers in the classrooms that ring 5 minutes and 2 minutes before transistions. When the timer goes off, the teacher reminds the class that the transistion is coming. This gives the FASD brain time to prepare for transistions. Schedules that change every day are not condusive to structure an FASD brain needs. Bus rides are especially difficult for an FASD brain.

Less sensory inputs rather than more. An FASD brain can not take in all the sensory inputs a normal brain can. Elementary classrooms and books are full of sensory demonstrations. A classroom with limited color and wall hangings provides a calmer environment for the FASD brain.

Another stategy that works is to focus on asking the FASD child a question when the child is observed to be off task, out of place, or doing something that is not allowed in the classroom. Typically , when asked, for instance, "Is that out of place?" the FASD child will be reminded and will return to the activity. You would need to train the child what "in place" means. The question does two things. First, you, as the adult, are using non-shaming, non-blaming language. This presentation does not blame the child for doing something they should not be doing. An example of shaming, blaming language is "Johnny, I told you to sit down!" By always remembering "Brain Damage", you understand what the child is doing is not a fault of the child. Secondly, this questioning give the brain a "jolt" or "restart" and the child has control of his or her thought, however fleeting.

The FASD brain has a hard time following a sequence of commands. "Johnny, go over to the bookshelf, pick up your Social Studies book, go back to your seat and open to page 35." is a series of 4 commands. An FASD brain will hear the first command and not have a clue as to what follows. The child will go to the bookshelf and stand there. A typical teacher response would be, "Johnny, what did I just tell you?" Think Brain Damage! Johnny's brain truly will not be able to follow the sequence of commands. The intervention is to always give one command at a time for the FASD brain. A software called FastForward can be used to train the brain to follow a sequence of commands. The research shows success with this strategy, although there has not been any specific research with FASD brains.

Computer software. An FASD brain needs to have many concepts presented many times. An adult can only review so much before getting frustrated, angry, and shaming/blaming. Have you every heard a teacher say, "How many times do I have to tell you?" A computer never gets angry with a student. A computer gives immediate feedback to a student. A computer with the right software in the classroom allows an FASD brain to move forward in the curriculum at their achievement pace, while saving face with the other kids in the classroom. An FASD brain will shut down when a adult says the above. When the FASD brain shuts down, you get the secondary disabilities of depression, anger, emotional, behavioral disabilities, etc.

Medication. In many cases, FASD is misdiagnosed as ADD or ADHD. Medication does work as an intervention in many FASD brains. The meds, when applied correctly and that may take several different attempts of type and dosage, will give the FASD brain a window of time every day to gather knowledge. How the brain is able to use the knowledge is tied directly to what areas of the brain is damaged. Remember, an FASD brain is not necessarily unintelligent, the brain just does not have the necessary links to make the intelligence work the way a normal brain works.

In my experience, many FASD brains need touch to facilitate learning. Numbers and letters are learned using object letters to feel, touch, squeeze, and stroke. Subject such as, science, reading, math, and others are better learned using kinetic strategies, to the extent the FASD brain can learn and remember. The mouse on the computer gives the FASD brain a tool to move and direct.

Some FASD brains need constant motion, so having devices on the chairs that makes the brain constantly have to balance can help. Objects the child can handle, squeeze, and/or flex can meet the need for the brain to constantly give muscles the command to move.

I could go on. I hope this helps. Please feel free to ask more questions.

Wednesday, October 17, 2007

Alcohol Babies

Crack Babies! Meth Babies! Cocaine Babies! We have seen and heard about all. In fact, I have had adoptive mothers tell me they went to Europe to adopt because they did not want crack or meth babies. It is so easy to identify and demonize mothers who deliver crack or meth babies. It is so socially acceptable to look to those mothers and say they are producing babies that the rest of society will need to take care of. We have no problem as a society to identify the crack and meth babies. But here is the problem. We only know of the crack and meth babies if the mother is using crack or meth at the end of the pregnancy. Evidence of any impact the drug has will only be evident if the drug is being used at the end of the pregnancy. Both drugs will leave the body within days. Certainly damage will occur with a crack or meth baby, but not the type of brain damage that will have lifetime reprecussions.

People are not getting the message when we use terms like FAS, FAE, FASD, ARND, pFASD, etc. We need to simplify the message. We need to link to what everyone knows. We need to reach the ones who don't care. Well, here is my solution.

I submit we need to start a new designation, one that is short and to the point......ALCOHOL BABIES. The difference between crack and meth babies and Alcohol Babies is when and how and what damage occurs. An Alcohol Baby can be damaged before the mother even knows she is pregnant. Drinking alcohol any time during the pregnancy will cause damage. Alcohol Babies are permanently damaged. An expectant mother could binge one day and go through all the rest of her pregnancy without drinking and create an Alcohol Baby. Evidence of the damage from drinking does not disappear like it does with meth and crack babies. Alcohol Babies are putting much more strain on our social system than crack and meth babies, we just don't know it. We need to have a shock campaign to get the message out loud and clear! Alcohol Babies cost our system over hundreds of thousands of dollars and more each over the course of their lifetime. Alcohol Babies fill our special education systems, judicial systems, and social systems. Many Alcohol Babies grow up to be violent offenders, abusers, and sexual predators. Many Alcohol Babies grow up and have Alcohol Babies. We need to stop this epidemic of Alcohol Babies!

Sunday, September 16, 2007

How has FASD impacted our Society

Has anyone asked the question for violent perpetrators such as Son of Sam David Berkowitz, Ted Bundy, John Wayne Gacy, Jeffrey Dahlmer and others who have captured the media attention as serial killers? I would bet we would be amazed at how many were fetally exposed to alcohol.

Wikipedia states (among other traits):

The element of fantasy in a serial killer's development is extremely important. They often begin fantasizing about murder during or even before adolescence. Their fantasy lives are very rich and they daydream compulsively about domination, submission, and murder, usually with very specific elements to the fantasy that will eventually be apparent in their real crimes.
Some serial killers display one or more of what are known as the "MacDonald triad" of warning signs in childhood. These are:

Fire starting, or arson invariably for the thrill of destroying things, for gaining attention, or for making the perpetrator feel more powerful.
Cruelty to animals (related to "zoosadism"). Many children may be cruel to animals, such as pulling the legs off spiders, but future serial killers often kill larger animals, like dogs and cats, and frequently for their solitary enjoyment rather than to impress peers.
Bed wetting beyond the age when children normally grow out of such behavior.


I think we would be utterly amazed at the impact of FASD. Only when society can see how it effects them on a day to day emotional basis, a financial basis, or in a personal way like paralyzing fear, will we truly have an impact on stopping this tragedy.

The greater community has not seen this as the reservations communities has. Bill Lawrence, editor of the Ojibwe News contacted me last year to gather information on FASD, as he saw the growing level of violence on the reservations and was looking for the root cause. His editorials on FASD were revealing, as he did his homework to find out more about the behaviors exhibited by FASD victims. He concluded, as I have, the violence on the reservations are a direct result of the brain damage of FASD. The elders on the reservations sit in fear of their lives while the bullets fly. The gangs own the streets and villages at night. Young kids are drawn or threatened into gangs. FASD kids become the gang enforcers and victims of gang violence, as they will act without caution due to the inability to connect an action to a consequence. Guns have become part of the action. Adrenalin feeds the action. Alcohol, the drug of choice, feed the action. So little attention is paid to the level of violence on the reservations due in part to the reservation's policies of limited or no access to information. The people on the reservations know how much impact FASD has in their lives, but most are unwilling to admit the problem due to the fact they contributed to the problem by drinking during their pregnancy or allowed their partner, daughter, or partner to drink during the pregnancy. The only ones who would talk to me about it were the grandmothers who are taking care of FASD grandchildren because the mothers had discarded the children, were in jail, or had lost custody because of their actions (most of the time because the mothers are FASD). Only once, after I wrote an article about FASD, did an American Indian mother talk to me about her child and the lifelong devastating effect her drinking during the pregnancy had on her child. Through all this, tribal leaders still refuse to see or state the truth. In fact, I have had tribal leaders go after me politically because I dared to state the obvious. I consider their attacks a badge of honor. I can't stand back and see this happening to innocent victims because some political figure wants to hide his head in the sand. We need to have the same aggressiveness when it comes to political actions at the state and federal level.

Reservations are a microcosm of what can happen in our society. Russia and mid-European countries are other windows into FASD impacts in society. Canada is further ahead of the USA in recognizing the impact of FASD. Wake up America. This is real!!!!!!

Thursday, September 13, 2007

Our Profession

Service provider professional such as teachers, law enforcement, social workers, etc are reactive by profession. We react to behaviors, whether by a child or adult, with a practiced behavior technique designed to work for the normal brain. The normal brain can respond in a manner that meets the anticipated result of the technique. We are a long way from diagnosing the root cause of the behavior rather than reacting to a secondary observable behavior and assigning some prescriptive antidote for the behavior. With the FASD brain, the diagnostic methods need to be focused on the root cause of the behavior. We, as educators, are not trained to do that. Even when the root cause is explained, a typical educator will react with disbelief to the point of the detriment of the FASD child. "Yes, she has FASD, but she is acting willfully." or "Any child can learn that, even if he is FASD." Or, as I heard today from a principal, "What is FAS?"

Today I met with a mother who learned last week during our conversation her child was most likely FASD. We had talked about her child's behaviors and as a result of asking the question, she became aware the behaviors her child displayed were a result of her drinking before she knew she was pregnant. In the IEP meeting, the typical special education jargon was being used to describe the child's behaviors and what the school was going to do to assist this child. This was my first IEP meeting in this new school, so I was being careful with my input. After about 30 minutes, I asked the mother if I could speak about what we had discussed the previous week. She, in a relieved voice, said yes. I then broached the subject of FASD and what that meant for this child. This mother, who was the biological mother, became very animated and seemed so relieved that she finally had a reason for her child's behaviors. She had read all the material I had sent home with her the prior week. She asked for more and wanted to know where she could take her child for a proper diagnosis. She asked for more specific assessment to see her child had specific deficits. She wanted to know as much as she could about her child's needs. Contrary to what we may think, the mothers of FASD children, from my experience, are thankful to find out and are wanting to do what is right for their child, even if they were the ones who drank during the pregnancy. This mother will have a better chance of doing what is going to work for her child, now she knows. This mother will have a better chance of getting assistance from FASD organizations when it comes to meeting with service providers. This child will have a better chance now her mother knows and is willing to work with the school to meet the needs of her child.

I can't tell you the times other educators have told me not to ask the question of a mother. I can tell you I have never had a mother tell me she didn't drink during the pregnancy after I have asked the question. I can tell you every mother who has told me yes has asked for as much information I could get her regarding FASD. As educators we can not be wimps. We can not assume the mother will collapse with grief at finding out she was the cause of the brain damage. Maybe she will, but a child's life is at stake. When you know the devastating effects of FASD, we are remiss as educators, social workers, etc if we do not ask the question and deal with the answer.

Sunday, September 9, 2007

My Wellspring of Idealism

After a difficult two years in Idaho, I have returned to Minnesota to continue my career. Eighteen years in Indian Education has been both rewarding and challenging. I found a particularly difficult situation in Idaho that spiraled into chaos after I published an article in the Idaho State Journal entitled " A Fatal Link". This article was my thoughts, observations, and research on the link between FASD and violent incidents including school shootings.

One thing I have found on the reservations is the denial of the impact or existence of FASD. My observation suggests 60 to 70 percent of the students attending the tribal schools I have worked in are victims of FASD. The majority of those students are living with one biological parent, a grandparent, or an auntie. I have seen up to fourteen children under the age of 15 living with one grandmother, a woman so tired she could hardly function at work, let alone take care of fourteen disfunctional children. This household was the court authorized house of horrors for the younger children who were victims of the older perpetrators. All we could do at the school was to report.

Years of this had caused my wellspring of idealism to run dry. When I returned to Minnesota this June, I had to heal. I have started a new job in a healthy community and found the epidemic of FASD is prevalent there as well as on the reservations. Today, I opened my blog and read comments. I would like to thank Kari and Jo for opening up my wellspring again. I will continue writing. I will continue telling everyone so more eyes are opened. I also know that eyes need to be continually reminded to stay opened, because so quickly we forget if we are not continually reminded. I salute the parents who are so committed to their FASD children. To those parents, I say structure and support are so vital. I have seen the evidence of a lack of support and structure. Your children have a chance, the ones with no support or structure don't have a chance.

Wednesday, August 29, 2007

It's Everywhere

I have taken a new job at a charter school. This is the first time I have worked in a non-tribal school since I began my career. I have enjoyed the first couple of weeks and look forward to the day the students come to the school.

In the two weeks I have been here, I have seen evidence of the FASD epidemic. Just today, I interviewed a candidate for a position. This candidate spoke candidly about her adopted children and their disabilities. All the red flags were there. Another person identified FASD as the root cause of her adopted child after years of struggling with his disabilities. She will have to continue with the struggles, but now she has information that will help her understand her son.

I know I will have an impact bringing a higher level of understanding of the victims of FASD.

Wednesday, May 23, 2007

Coming like a Flood

Is there an epidemic? What is the definition of epidemic? Wikipedia defines an epidemic as new cases in a given human population, during a given period, at a rate that substantially exceeds what is "expected". Well, this week was an epidemic. First my colleague identified 2 possible FASD relatives as I wrote about in the blog "I Can See Clearly Now". The same day, another colleague came to my office to ask about FASD, as there was a parent coming to an IEP meeting who had identified his child as FASD. As that staff person gathered the information I provided, she started talking about her adopted son whose mother drank during the pregnancy. I could see the realization hit her as she wiped away tears. Her son was FASD. He was suffering from depression and had tried to commit suicide. He also had other behavioral indicators. All I could say was to read, learn, and understand the behaviors were not a result of poor parenting. She left clutching the information in her hand and with a website address to study about her future with an FASD child.

Today is Wednesday, Already, I am aware of two colleagues who are seeing through enlightened eyes. But the week is not over. This morning, two consultants for the tribe visited the school. As I have come to do, I mention my research into school shooters. Imagine my surprise when one of the consultants immediately responded with, "I adopted an FASD child. He started a fire in a school. When he got into the navy, he started a fire and was put into the brig." I almost fell over. Here is another incident that links FASD children to aberrant behaviors in school. Not to be outdone, the other consultant told me his brother teaches in a school where an FASD child brought a gun to school. Another link to FASD and school shooters. Both are willing to provide more information on their experiences.

Six additional examples of FASD in three days. Is this an epidemic? Well, not 15 minutes after I left the meeting with the consultants, another colleague pulled me aside and told me about her experience last night. Her friend, a doctor, and her friend's husband, a cop, invited her for dinner. During the dinner, the cop told of a recent experience with a child, an eight year old girl, who was taken by the police after attempting to kill her 6 month old sister. The description of the eight year old's behaviors and responses to questions caused my colleague’s immediate response of, "Is she FASD?" My colleague has learned to ask the question. Now the question has been asked, the cop can find the answer.

Well, by today, Thursday, the flood continued. My collegue, who told me about her adopted son, came to me today with his pictures. While the pictures were not conclusive, her discription of her son's behaviors, the indication by the Romanian adoption agency that his mother drank alcohol, and his diagnosis of ADHD led me to the conclusion that her son is a victim of FASD. She then started telling me about her daughter, another adopted child from Romania. She said she and her husband went to Europe to adopt because they did not want a cocaine baby. That is so sad, as cocaine babies did not suffer brain damage, while FASD babies do and our society made such a big issue of cocaine babies in the late 80's and early 90's. After she explained her daughters behaviors and challenges with reading and her limited thinking abilities, I saw the tears well up in her eyes again as she began to understand how her family was impacted by FASD. Two children......last week she did not know, now she has something to study so she will have a better understanding of what her family is looking at in the future.

This is an epidemic that is invisible to most people. When you have your eyes opened, you can see it. Please, please learn more about FASD. Only when we can see the epidemic will we understand what this is costing each individual victim and society as a whole.

Monday, May 21, 2007

I Can See Clearly Now

A collegue came back to work after being with his family during an unexpected family crisis. During this difficult time, he began to look at his family with eyes experienced in identifying FASD behaviors and experienced in asking the question, in this case, asking himself if his sisters had drank any alcohol during their pregnanies. His revelation to me this morning was similar to mine when I reached a point of understanding. The process of understanding the impact of FASD is just that, a process. At first, there is disbelief. A non-believer says this is not something that impacts people like they are saying. No way.....this guy telling me this is off his rocker..... Or, as a counselor told me 5 months ago, "We got trained in that a couple of years ago, that is not a problem now". Then, you work with FASD victims for a while. For much of that time, you do not believe the kid is brain damaged. No, he is just defying me, or he is not paying attention, or he can control his behavior, he just does not want to. Then you see more and more kids with the same condition. Each time, that crazy superintendent asks if the child is FASD. Every time, you think he is crazy. Next, you find yourself asking the question on the first display of a behavior, then.......then....you start seeing with opened eyes. That kid in the newspaper who murdered that girl. Is he FASD? Yes, maybe that is what was wrong with those kids in that public school where I taught for years. Their parents were drinkers. Now you have moved through the disbelieving part of the process and are seeing through informed eyes. Then, you start looking at people who are near and dear to you. When you reach that point, you have a clear understanding of the true impact of FASD in our society. My collegue now can see clearly the impact in his family, just like I saw the impact in my family. Only when I can get people to see like I see, will we truly be able to change the disbelieving attitudes in our society.

Why do I say the attitudes need changing? Click on my youtube tirade against Coors Brewing and read the first comment. That type of attitude is more common than not and needs changing.

Sunday, May 20, 2007

Not My Town

Mid-Minnesota nice, playground for the cities, Brainerd is the gateway to the lakes of central Minnesota. Behind the hustle and bustle of this growing city, the specter of FASD hides behind the community's ignorance, much like any other community in the nation. Oh, FASD happens on the reservation thirty miles away, that that is not our problem. Well, Brainerd, it is your problem.

A few examples of the hidden epidemic
A local businessman presented at the Brainerd Lakes Rotary meeting on an upcoming fundraising drive. Following the presentation, I visited with him about using some of the funds generated for FASD Awareness. To my surprise, he energetically engaged me in the conversation, seemingly relieved to talk to someone who understood FASD. His story did not surprise me. His was one I had heard several times from several different parents in the Brainerd Lakes area.

He and his wife adopted a son. Their dream of having a loving relationship dissolved into years of seeking help for the multitude of problems they were experiencing. Finally, after having to take their son to a professional over 3 1/2 hours away in North Dakota, they found the answer, an answer that gave them a name, but not a prescription to heal the symptoms. Their son was permanently brain damaged by the pre-natal exposure to alcohol by the birth mother. Within my small circle, this is the first of many examples of the hidden epidemic in Brainerd.

While I consulted with the National Indian School Board Association and tribal schools across Minnesota, I began building a house. One of the men I hired to work with me became a good friend. He and his wife had adopted two daughters as babies and raised them in a fine Christian home. They were deeply involved in their church and in the lives of their daughters. From the outside, an unknowing person would have no suspicion of the difficulties they were experiencing. These difficulties were driving them to doubt their abilities as parents.

One day, he came to me distressed with what had happened with his daughter. The story was so familiar with me. His daughter did not seem to comprehend what was right or wrong and she was in her early adolescent years. The incident he related to me happened at the church and was traumatic, embarrassing, and humiliating to her parents , and her reaction was one of shrugging her shoulders as if it did not mean anything to her. I asked him to show me a picture of her. When I started explaining what FASD was, he immediately identified the fact the biological mother drank alcohol when she was pregnant with both girls. I showed him the physical characteristics on the girl's faces. Both he and his wife started researching FASD on the websites I had shown them. They needed to know this was not a result of their parenting. They were feeling very guilty and depressed with the behaviors of both girls. Just knowing the root cause of her behaviors gave them something to grasp and try to understand.

Among the same circle of friends, another business owner came to me asking for advice. He had adopted two children birthed by his sister who had been drinking during her pregnancies. His adopted son was tantrumming and his behaviors were escalating. He was asking what to do, as he knew I worked with children with similar brain damage. He and his wife were struggling with their guilt about their parenting skills also. All I could really say is to keep high structure in his son's life, as that is strategy that will provide the most success.

For many years, I have watched a young girl grow into a teenager. Her parents were deeply involved with the community, spending an enormous amount of time with friends as they developed a hugely successful yearly event. Much of that time was spent selling beer to raise money and the parties after the fundraising events were beer soaked.

This young girl is a handful. Her parents participate in activities with their daughter and provide a structured household. She is talented, talkative, and has a short attention span. Sadly, her face shows physical characteristics of FASD. Another example.

When my daughter was in th 9th grade, I had the opportunity to speak to her Life Skills class. My daughter had told the teacher I knew about FASD and would be willing to talk to her class. The hour went well and I had time for questions. The girls were very interested and inquisitive. Then, out of the blue, one of the 9th grade girls said, "That's what's wrong with my brother!" She went on to explain that her mother and father divorced when her mother was pregnant with her brother. She could remember her mother going on a several month long drinking binge. The result was a brother with brain damage. She now knew, and the revelation was something she was struggling with. Another example of the hidden epidemic in Brainerd.

A seventeen year-old murderer with FASD and another murderer who committed suicide, two more examples of violent actions by FASD men in Brainerd. These are the ones I know. My belief is Brainerd has no idea how this epidemic is effecting them.

Each of these parents could write a chapter in my book. Each have different, yet similar experiences of ignorant professionals, inaccurate diagnosis, and children who defy the common perception of kids will be kids, and behaviors are the result of poor parenting. In my home town, I could not get the local newspaper to start asking the question.......if I can't make it happen in Brainerd, what chance do I have to make it happen across the country? Please help me pass this message!

Saturday, May 19, 2007

Where the Abnormal Has Become Normal

Where the Abnormal Has Become Normal

Within the first three years of my teaching experience, I could not escape the fact that many of the students in my classroom were exhibiting behaviors indicating something was drastically wrong with their thinking patterns. From the Bureau of Indian Affairs bureaucrats and national Indian education literature, I was hearing theories of cultural differences and dominant society “white man’s world” impact on our students, but those theories, romantic as they sounded, did not begin to touch on the depth of the problem. Students sight reading as fast as anyone in the class, but unable to comprehend what they were reading, students who would not remember concepts and skills from one day to the next, let alone one hour to the next, students who had physical deformities and medical conditions at a much higher rate than normal, students who would tantrum, students who were impulsively impulsive, students who were exhibiting abnormal sexual deviancy, students who would, at the drop of a hat, become aggressive toward adults and other students, students who would not think anything of spitting in the face of a teacher or taking a big stick and threatening the principal. Their interpersonal behaviors and academic behaviors were years behind, and in many ways, well outside the norm. Yet, but for a couple of the kids, behind their survival mask, they were kind and tender, remorseful and wanting forgiveness, eager to please, and keenly aware that they were not “normal”. And, these students had other ways of showing their feelings, such as native dance and art. In a strange sort of way, they were more accepted in the tribal schools because they became the ‘normal student’ and the usually normal student was the exception. I worked in a place where the abnormal had become normal.

This phenomenon was the same in the second and, in a lesser degree, in the third tribal school I worked in. Good, well-meaning teachers, working in the schools for a long period of time, would begin to have a skewed sense of reality. Students years behind academically would be getting A’s and B’s. Average achieving students would be considered gifted when compared to the entire student population. An essay of questionable quality would be touted as excellent. High stakes testing procedures were compromised by teachers in order to “give the student every chance to succeed”. Curriculum was watered down, minimized, adapted, or completed changed to accommodate the majority of students in the classrooms. These practices, well-meaning as they were, would then create a skewed sense of reality for the ‘normal students’ when he or she, either returned to public school, went out into the work force, or attempted college. The academic abnormal had become normal in attempt to create a feeling of success for the students.

I don’t know how to impress on anyone reading this the depth of the problem in the tribal schools and, to a lesser degree, in the public schools. Our FASD children are victims of a terrible affliction. Remember, it is not that the FASD student is not intelligent, its just his or her brain can’t organize and generalize the information like a normal brain. Just think what it would be like to daily have people shaming you for not remembering what was said or taught yesterday, for accusing you of not acting your age, of threatening you with punishment when you don’t understand why or what the punishment is for, giving you several directions at once when you can only focus on one direction at a time, or looking at you with contempt because you can’t do what others your age can and should be doing. I believe the No Child Left Behind mandates have created a stressful dilemma for our schools. FASD students are at a high risk for failure and the pressure on the classroom teachers puts the teachers at risk to act in a manner that is counterproductive with FASD children.

Thursday, May 17, 2007

What Works? Computers

"I just told you that yesterday", "Where did you put your pencil?" "We went over that last week." "How could you forget that? I told you that yesterday." On and on goes the comments. Farther and farther behind Johnny goes, with gaps in learning that seemingly were filled throughout the past lessons. He doesn't seem to remember, or is it he just isn't paying attention.

"Adults with FAS/E {and children too} have what is known as “flow- through phenomena” – information may be learned, stored, and retained for a while, only to disappear without warning, and reappear just as suddenly, all with no predictable pattern – hours, days or weeks later. What can be said with certainty, is that this unpredictable pattern happens just often enough to convince those who do not understand, this this is deliberate “behavior”, under the control of the person with FAS/E. The reality is very different, and no one is ever more frustrated than the person with FAS/E, who must constantly deal with the reactions of others to this behavior." NEUROBEHAVIOUR IN ADOLESCENTS AND ADULTSFAS/E Support Network
http://www.fetalalcohol.com/


So what works with students? Computers. Computer assisted instruction. Computers do not get angry with FASD students when the student has to do a problem over and over. The proper computer asisted instruction software will present skills to students and manage the student's responses, moving the student forward as they show mastery. The appropriate program will continue to review to assess mastery, remediating as necessary. Good software provides immediate feedback to responses, which is optimum for the FASD brain. Lesson lengths can be managed on an individual basis. Gaps in learning can be found easily with good software and software assessment tools. A students who can not move today's lesson into short term and long term memory on the first, second, third, tenth, or 100th attempt create a management nightmare for the classroom teacher. I have been told Albert Einstien said something to the effect of " Computers are fast, accurate, and stupid, humans are slow, inaccurate, and intelligent. So let's put them together to become fast, accurate, and intelligent." We need to use technology as much as possible to provide the best opportunity for FASD students to learn. One parent, in a youtube video, The Invisible Children and Families of FASD,Part 2, states her daughter had to have a skill presented 625 times before her daughter was successful with that skill.

I had the opportunity to listen to Dr. Ann Striesguth in Minneapolis, MN at an FAS workshop. She is the preeminent researcher of FASD, now retired. One of the animal research studies she presented supports the above statement of the mother. In the research, the researchers injected alcohol into eggs and incubated the eggs. As the eggs hatched, the chicks looked exactly like any other chick. The only thing different was the injected alcohol. These chicks were placed in a box that had a small enclosure in the corner with a plexiglass window and an open door. In an opposite corner of the box, a feeder bowl was placed. Stooge chicks were placed by the feeder bowl to intice the other chicks to the feed. The FAE (Fetal Alcohol Effected, FASD without any physical deformities) chicks were placed in the small corner enclosure, along with some normal chicks. All the chicks pecked on th plexiglass window, peck, peck, peck.....soon the normal chicks started exploring and found the open door and went to the feed. The FASD chicks continued to peck, peck, and peck on the window. The researchers, after some time, guided the FASD chicks to the door and the feed. The next day, same results. After five days, some of the FASD chicks learned. Some never learned.

How can this be extrapolated to the classroom? We need to have tools to give FASD students multiple presentations of the skills and concepts, with the understanding that FASD students may need many presentations without any shaming and blaming attitudes. Computers can to that. Adults working with FASD students need to understand FASD students may not be able to generalize information, such as learning by observation of other students. Students who look normal may have brain damage that prohibits their brain from gathering information and sorting it like a normal brain. We can't stop trying, because after the 5, 10th, or 100th time, the FASD brain may grasp the skill or concept.

Tuesday, May 15, 2007

What Works? Non-Shaming, Non-Blaming Language

Johnny, I told you that yesterday! Why don't you remember? How many times do I have to tell you? How come you didn't bring your pencil? How many times do I have to tell you? Act your age! How old are you? You are acting like a child! You....you .....you.....

Shaming and Blaming Language

The most effective strategy I have implemented school wide was the development of a common language. I have to credit a strong knowledgeable woman, Vonnie Vader, for introducing me to the theory of behavior management that utilizes a non-shaming, non-blaming common language approach. The more I witnessed this in action, the more I realized it fit what I had been searching for, appropriate strategies for FASD.

The above examples are shaming and blaming. The adult directs the shame or blame onto the student. This type of language immediately puts the student on the defensive. I submit a normal brain can sort out the intent of the language and, though the shame and blame hits home, the normal brain will not react impulsively. FASD exhibits itself in impulsive behaviors. An FASD brain will re-act impulsively with a behavior that will be defensive. This defensive behavior may be seen as aggressive, such as lashing out at the teacher, hitting, or swearing. In this case, the teacher is the anticedent to the behavior. Unfortunately, I have witnessed time and time again the teacher blaming the student for the impulsive behavior and not understanding the brain damage and not being willing to take any responsibility for causing the behavior by his or her shaming and blaming language.

So what is non-shaming, non-blaming language? Vonnie Vader had developed four questions that were asked for any behavior needing change. We implemented the questions in our middle school with almost immediate success. Within 6 weeks, the high school was asking to be trained because of the difference in the middle school. The questions were:

Is that off task?

Is that out of place?

Is that physical contact?

Is that noise?

We defined the terms off task, out of place, physical contact, and noise. The teachers were provided an in-service on the theory behind the concept. Vonnie spent 6 weeks in our school modeling the concept. Within 6 weeks, not only were the teachers using the language, the students were also.

The behavior management theory simply is this. Something triggers a behavior. We don't know what that is many times. There are so many mitigating factors in a student's life that could be the trigger. The only thing.....the only thing we have control over is how we act toward the child. Maybe the single parent did not come home last night and the student had to get himself up, as well as the other sibling, find some cold cereal without milk for breakfast, got into a fight with the younger brother, and was teased on the bus about his clothes he was wearing for the third time this week. We don't know what triggers a student.

So, Johnny is sitting in his seat, figeting, and not paying attention to his assigment. A normal student would have a hard time concentrating with everything that is not going right in this child's life, let alone a student with brain damage from FASD. The teacher looks at Johnny and says,"How many times have I told you to pay attention!" Johnny's brain impulsively reacts, maybe with swearing, something he hears daily, or with a violent reaction. His brain has limited,if no ability to control his initial impulse. Now Johnny is in trouble and the teacher can find fault with him. This has been a pattern for this young man.

Now, let's use the non-shaming, non-blaming approach. Everything being the same, the teacher asks, "Johnny, is that off task?" First, the language does not include the word you. The question asks about the behavior. By asking the question, the teacher is providing Johnny with the opportunity to think about whether he is off task or not. This gives the FASD brain time to think, rather than react defensively. (Now, if Johnny has triggered and is beginning to escalate in behaviors, questions turn to statements and Johnny needs to be removed to a safe location to de-escalate. Schools with a large number of FASD students need to have a safe environment for FASD students to escalate and de-escalate.) So many times, I have seen the student immediately bring himself back to attention with a, "Oh, yea." and try to attend to the assignment. Understanding the impulsivity and inability to sort out the inputs to the FASD brain is important for each teacher to know, so the teacher does not get angry and blame when he or she has to ask the question time and time again. The strategy is to remind the FASD brain, rather than blame the child.

The FASD brain does not think the way you and I think a brain should think. So much of FASD does not exhibit itself in physical characteristics, so educators should always be aware the behaviors they are seeing in normal appearing students may be the result of FASD. The non-shaming, non-blaming language works for all student, regardless of FASD or not.

Monday, May 14, 2007

A Breath of Fresh Air

I met someone this evening who probably does not know how much she impacted me in such a short time. The Principal's Partnership is an organization that supports principals across much of the nation. This evening, I was invited by the Principal's Partnership to participate in a dinner for principals in southeast Idaho. The team leader, Glady Nienstaedt, had asked her friend, Jeanette Phillips, from Polson MT, to come down to our country to speak. Her informal presentation was a delight to listen to and the time went quickly. I had the priviledge to visit with her after the meeting. I was flattered she was interested in the work I do, and our conversation, though brief, had a huge impact on me. The connections one makes are hard to fathom. Words can have such an impact. She left me with a Margaret Mead quote, " Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it's the only thing that ever has."

I can do this! Thanks Jeanette!

A Force Within

I struggle with the force within me that drives me to informing everyone I meet about FASD. I see my mother in me. She was driven to tell everyone about God. I am afraid I drive people away when I get passionate about that which I speak and believe. On the other hand, if I did not have the passion and drive my mother did, I would walk away from my work and from the plight of every child born with this lifelong affliction.

Sunday, May 13, 2007

Further Potential Evidence of a Link

The pressure is pretty intense this month. I am a target for three of the 12 elected tribal council and school board official. The three, who happen to be on the tribal council, have used devious political methods to go after me. Why? Because I am non-native and I have uttered the un-utterable. I have said students at the school where I work and the others I have worked for have a high rate of FASD. In the words of one elected tribal council member, I am stereotyping Indians. I wish he could prove me wrong. I really wish he could prove me wrong, because if I am wrong, the students will be much more resilient, more academic, more successful than I am seeing as of now. Oh, I wish I were wrong.

I am took a day off and got away for a three day weekend. Central Idaho beckoned me. Up to Challis and along the Salmon to Stanley. The further I drove, the more beautiful the drive became. I could feel the tension leave my body. I ended up at a quiet campground on Redfish Lake. Out came the camping gear and I began to build a campfire.

I never know when I will be confronted with evidence of FASD or the lack of knowledge of FASD. There, in the only campground that was open in mid-May, I once again found myself amazed.

A retired gentleman, the only person I saw walking through the campground, approached me, asking about my 9’ pontoon boat. He had a friend that was interesting in purchasing one and wanted to know where to find a similar boat. We began to chat and the conversation came around to our occupations. When I mentioned my position with the tribe, he said, “Oh, really, that must be a challenge. I was a teacher for 35 years. A friend of mine worked in Alaska in one of the villages. He said it was like Vietnam. There was so much drinking.” That opened the conversation regarding alcohol and Alaskan Natives, which led to me mentioning FASD. He had no idea what I was talking about. I had to explain what FASD was and I could see he was completely unaware and he quickly changed the subject to something he was more familiar with, the Iraq war. Of course, he grew up and completed his education prior to anyone knowing about FASD. I need to remember the rest of the world does not know or is not interested in knowing the extent of the problem.

An article May 10th in the Minneapolis Star Tribune further confirmed my belief there is a link between school shooters and FASD. The young adolescent who killed the principal of his school in Wisconsin last year suffers from conditions that are linked to FASD. According to the article, his defense attorneys stated he has Attention Deficit Disorder and Hyperactivity Disorder. Another red flag was the fact he lived with and was abused by his father and stepmother since he was three. That would indicate to me his mother did not get custody of him when he was three. What would cause a judge to give custody to a father? The mother either died or was extremely negligent. What is the most likely reason for negligence? Alcohol abuse. Another school shooter case that makes me determined to find out if there is a link between FASD and school shooters.

Tuesday, May 8, 2007

An Appropo Visit

We had a family visit our school today to tell the story of their son who died of alcohol poisoning. He had just graduated from high school and had moved into an apartment with two other friends. They partied, he died. Our student population was very quiet during this presentation. A young man in the community committed suicide last week, so many of our students were raw from emotion. In the past year and a half, two students have been killed in car accidents related to alcohol and two mothers who work at the school have lost one of their twenty-some year old children to alcohol related accidents. We have 160 students in the school. Since I have been gone from my last school, two young men whom I had worked with have died of alcohol related automobile accidents. That school had about 60 students in the high school.

The dad of the young man who died of alcohol poisoning is walking from Arizona to Montana to spread his ashes in Montana, the land that he loved. What a committment to his son! He is telling the story wherever he can. As I write, he is telling his tragic story to this community. His story spans the divide between the Native American and the Caucasian. His pain is palatable and real. His is a story of the killing power of alcohol.

Saturday, May 5, 2007

The Beginning of a Journey

I began my teaching career in the late 1980's and have spent my entire professional career in Indian Education. My idealism was high and the level of understanding of my students was low. Withing a couple of years, I was seeing something I could not explain. I had learned how to change behaviors by observing the modeling of my parents, my teachers, and my coursework in college. I thought deviant behaviors needed the same approach. I soon realized the behavior strategies I was using did not have the desired impact on the many of my students. I saw repeat behaviors, tantrums, impulsive actions, sexually deviant behaviors, and low academic abilities with the majority of the students in my classrooms. Not only my classroom struggled with this phenomenom, the entire school seemed to be struggling with the same issues. Students were provided the opportunity to learn, but many did not seem to retain what was learned. Impulsive language and physical behaviors were the norm, rather than the exception. My first year of teaching was in a classroom with no windows, twenty-four 6th graders, with little support for the 8 students who were diagnosed the following year with EBD (Emotional Behavior Disability). I was kicked, spit upon, assaulted, glasses broken, shirt torn, and thought my middle name was "F------g White Asshole." Most of my student came from single parent homes or lived with grandmothers or aunties. All were low income and most lived in tribal housing scattered over a large rural area. Few had structure in their lives. The school was the only place many student got a hot meal. But through it all, I saw the other side of each of these kids, the sometimes tender, sometimes desparate, sometimes remorseful side, and began to wonder what caused all the actions I witnessed.

One day, a nurse came to the school and provided an in-service to the teachers on Fetal Alcohol Syndrome and Fetal Alcohol Effects (now known as Fetal Alcohol Spectrum Disorder (FASD)). Each slide of the presentation brought more focus to the cause of the behaviors I was experiencing. Pictures of FASD children mirrored the faces of several of the students I was teaching. Behaviors identified by the nurse matched the behaviors all our teachers were struggling with. That hour began my journey of studying the research of Fetal Alcohol Spectrum Disorder and toward the goal of stopping this devastating totally preventable disability.

This revelation hit home regarding my students and I began to realize that someone very close to me was a victim of FASD and was displaying many of the same behaviors. His parents had taken him to psychologists and counselors who could not determine a reason for his behaviors, tantrums, and academic disability. The parents were hard drinking people of German descent. Any event in their home revolved around beer and wine. The more I researched the then limited understanding of FASD, the more I realized I was seeing something that almost nobody else was seeing, the epidemic of FASD, and it was hitting close to home. A new child was born into this family. As my wife and I looked at the picture of the infant, my heart dropped. This innocent baby, new to the world, had entered the world with two strikes against her. She had all the physical characteristics of a full Fetal Alcohol Syndrome child. Eventually, more than 7 children were born into this family with some observable level of FASD. The matriarch of this family told me her doctor has told her to drink to calm her nerves. No one knew, at that time, the ramifications of that action and this family lives with FASD on a daily basis. Fortunately for this family, there is a strong structure, the one component that gives FASD children the best chance for success.

I began to develop strategies to work with FASD students. I did not talk to many people about it, as very few people even wanted to talk about it. When I would try to explain, many people moved to the moral issue of drinking, rather than try to understand the ramifications of a mother drinking during a pregnancy. Then, a startling revelation came to light that gave strength to my arguments.

Our pastor and his wife could not have children. They had adopted three, a girl and two boys, before moving into our church. They were patient, kind, and attentive parents. Their children grew into insolent, disobedient, and deliquent adolescents with academic difficulties. This was a very humbling experience for these fine people. I was seeing the same behaviors with these three as I was witnessing in my classroom. In a conversation with the pastor, the subject of FASD came up. All three children came from mothers who drank during their pregnancy. All three were identified as Fetal Alcohol Syndrome children. All three had similar disabilities and behaviors. None of the public school teachers working with their children understood FASD. A pattern was beginning to form in my mind. We, as educators, physicians, social workers, psychologist, etc., are reactive to behaviors by the nature of our business and create a diagnosis with a prescription to cure the symptom, and as such, miss the root cause. The symptoms of FASD are a result of brain damage that happens before the child is born and is lifelong. I began to see I needed to re-visit my assumptions of teaching students. I needed to look at my classroom using the continuing growth of research of FASD. I needed to change the classroom environment, change my approach to teaching, and change how I worked with students in order to change their behaviors. I started to think about the ramification of not speaking out, of not bringing this message to the world, of not trying to stop the root cause. I began to see I needed to find out as much as I could about this mostly unknown, and mostly unbelieved epidemic. I committed myself to making a difference.

Thursday, May 3, 2007

Coors, What are you thinking?

It starts like any ordinary beer commercial. He walks to the fridge and picks up a beer and gets excited when the mountain turns blue. Then the female partner bursts out of the bathroom, excitedly showing him the pregnancy test that has turned blue.

What gives, Coors Brewing Company? Do any of you know that drinking any alcohol any time during of the pregnancy, after the zygote becomes a fetus, will damage the brain of the fetus? How can you, as a reputable corporation, make a commercial that celebrates a cold beer while making fun of a pregnancy? Anyone who has any understanding of the damage drinking during a pregnancy can cause would know the man in the commercial should have immediately taken all the beer out of the house so the mother did not have anyone influencing her to drink any alcohol. Another inference I make is the mother probably drank your beer prior to knowing she was pregnant, and, in that case, has already damaged the brain of the unborn child. Instead, your commercial makes fun of the mother. Your message minimizes a pregnancy in a situation I would suggest is ripe for the man influencing the mother to drink. Anytime his addiction to your product is more important than the life he brings into the world, the loser is the child. Shame on you Coors. Take that advertisement off the air!

A Fatal Link?

School Shooters and Violent Juveniles, Are We Asking the Right Question?

Published in the Idaho State Journal, April 15, 2007

If I were to tell you my dad passed away from lung cancer, what is the first question that comes to your mind? Did he smoke? Now, if I were to tell you a 17 year-old boy walked into an apartment in a small town in a mid-western state and gunned down another 15 year-old boy, what is the first question that comes to mind? I believe the question we should be asking is: Did the mother of this child drink ANY alcohol while she was pregnant with this child?

In 2005, a student killed two people including his grandfather, took his grandfather’s police car to his school in Red Lake, Minnesota and shot and killed 7 students before killing himself. He had the facial and behavioral characteristics of Fetal Alcohol Syndrome (FAS) and his mother was a heavy drinker. As this tragedy played out, I started to research a another Minnesota school shooting that happened in 1966, when a student with a handgun walked up to another student at my hometown high school, shot and critically wounded this student, then fired six shots into Mr. Wiley, the administrator who told him to give him the gun. Mr. Wiley died eight days later. This shooter, I found out, had abusive alcoholic parents and the behavioral and physical characteristics of FAS. This was before anyone knew or heard of FAS. More research showed Minnesota’s third school shooter at Rocori Cold Springs High School in 2003 displayed characteristics of FAE. And yes, a 17 year old did shoot another 15 year old in a downtown apartment in the city I was living in, and, due to knowing and working with that youth and having to take him home several times, I knew the shooter manifested the characteristic and had a diagnosis of FAS. Are we asking the right question when violent abnormal behavior happens? Do we know the root cause of this violence? I believe we would be amazed if we knew the extent of violence and societal damage brought on by the disabilities associated with FASD. (Fetal Alcohol Spectrum Disorder – a description covering the spectrum from minimal loss of potential to severe brain and physical damage up to and including the death of the fetus or infant)

My interest in learning as much as I could about FASD began when I started working in schools that had a high number of FAS and FAE students. In the past 18 years as a teacher, principal and now, as superintendent, I have experienced the difficulties of teaching children who had the litany of learning disabilities and behavioral problems associated with FASD. I also found out that the FAS, the syndrome is only the tip of the iceberg. Fetal alcohol effects (FAE), without any distinguishing physical features, is equally as disabling, is not easily recognized, and is much more common than the syndrome. Due to having normal physical features, we think the FAE child or adult thinks as a normal child or adult, when in effect, the FAE brain damage does not allow that brain to think normally. In the early 1990’s, my educational experience was then linked to my observation of a family close to me and I began to see how deeply effected I was personally and how little our communities knew of this epidemic. When I speak about FASD as a trainer and consultant, I am amazed at how little is known about this epidemic.

This completely preventable and largely unidentified epidemic is sweeping our community, state, nation and world, leaving in its wake children with lifelong brain damage and adults unable to cope with daily living skills. Our social services system, court systems, police departments, judicial systems, jails, prisons and school systems are struggling with the increasing load caused by this epidemic. The lack of education and unwillingness to confront the epidemic is sure to add more to the already staggering statistics.

Until the 1960’s, the only voices speaking out against alcohol consumption during pregnancies were denounced as moralists. It’s been known since biblical and classical times that women who ingested alcohol during their pregnancies often gave birth to impaired children. In 1500 AD, Sir Francis Bacon, an influential politician noted,"If the mother…drink wine or strong drink immoderately…it endangereth the child to become lunatic, or of imperfect memory.” It wasn’t until the late 1960’s that research in France began to correlate brain damage to alcohol consumption during fetal development. Now, almost 40 years later, research has clearly established the link of drinking alcohol during a pregnancy to brain damage and other physical disabilities and deformities.

Did you know?

-Alcohol is a teratogen defined as any chemical, substance, or exposure that may cause birth defects to the developing fetus. (thalidomide, a sedative used in the 1960’s is a teratogen which caused thousands of deformed children before being banned)

-Alcohol, as a teratogen, damages the fetal development of the brain and causes physical deformities, while cocaine and meth does not.

-It is a felony to provide cocaine to a minor (developing fetus) while it is a misdemeanor to provide alcohol to a minor (developing fetus)
Deficiencies of a cocaine and meth baby can be overcome, while damage from alcohol is permanent damage.

-The features of fetal alcohol syndrome (FAS) occur in 30-40% of babies born to chronic alcoholics. Another 50-70% of such babies may suffer from fetal alcohol effects (FAE), which is more specific to brain damage.

-The Journal of American Medical Association reports a startling 20% of women nationwide continue to drink after finding out they are pregnant. The incidence of drinking during pregnancy has increased substantially in the past several years.

-Over 50% of college educated women of childbearing years drink alcohol. This statistic is alarming when taking into consideration the time between conception and realization of a pregnancy.

-Only 39% of women even know what Fetal Alcohol Syndrome or Fetal Alcohol Effects are.

-The ethanol in alcohol interacts with the potassium in the fetus brain cell walls causing the brain cells to malform or die.

-A binge of 5 drinks during a pregnancy could result in full-blown Fetal Alcohol Syndrome. During the first trimester, alcohol interferes with the migration and organization of brain cells. Alcohol during the second trimester causes more clinical features of FAS. During the third trimester, the hippocampus is greatly affected, which leads to problems with encoding visual and auditory information

-80% of FASD children will drink during their childbearing years.

-80% of adopted children suffer from FASD.

FASlink, Fetal Alcohol Disorders Society, a website devoted to promoting FAS education and discussion, boldly states “FASD is grossly under-reported.” They state “few doctors have been trained to diagnose it. Most prefer to use ‘non-judgmental’ diagnoses such as LD, MR . . . Bi-Polar, etc. These ‘symptoms’ do not come with the social garbage of an alcohol associated disability.” In fact, until recently, very few medical institutions even train doctors in the diagnosis of FASD, or have curriculum that warns against drinking during pregnancies. This practice does not create an urgency to anyone to ask the right question. Three years ago, when my daughter was ready to deliver her first child, she was asked if she took drugs, but not asked if she drank any alcohol during the pregnancy. When I asked the nurse about this, the nurse did not know about FASD and was offended I questioned her.

The brain damage from FASD does not disappear when the child becomes an adult. A typical full blown Fetal Alcohol Syndrome adult does not become emancipated from adult supervision until the age of 35, if at all, spending time in either the social services system, jail, prison, or living with parents or relatives. An average FAS child will be provided Special Education services in public schools (currently 15% of public school students are being served by Special Education, a disquieting correlation to the percentage of women who drink during their pregnancy), starting in the Early Childhood program and continuing until graduation, if they do not drop out. Many run into trouble as early juveniles due to limited or non-existent impulse control, problems with judgment and memory, and inability to link consequences to their actions. Use of alcohol, drugs, gangs, sexual promiscuity, and violence are secondary outcomes of the brain damage from FASD. The list of learning disabilities include difficulties in:
· learning language and language use, especially receptive language
· generalizing information
· mastering new or recently learned skills
· memory (ie. remembering something from a year ago but not from yesterday)
· predicting outcomes or cause and effect
· distinguishing fact from fantasy
· distinguishing friends from strangers (ie. may think someone they met five minutes ago is a friend)
· controlling their impulses
· lack of learning from experience because they do not understand cause and effect, behavior and experience
· following more than one direction at a time

What can we do? Both the mother and father bear responsibility for the health of the fetus. Fathers need to know the dangers of FASD and refrain from putting their partner into situations where drinking may happen. Women in their childbearing years need to know the brain damage that will result from alcohol consumption to the developing fetus and not drink at all when any possibility of a pregnancy could occur. Doctors need to continually ask expectant mothers to completely refrain from alcohol. Doctors need to have the training and courage to identify both Fetal Alcohol Syndrome and Fetal Alcohol Effected children as early as possible. Teachers need to understand the brain damage caused by FASD and need to inform students about the dangers of drinking during pregnancy before students reach childbearing age. Parents need to be diligent in setting an example, as well as being specific of the dangers of drinking during a pregnancy. Laws must be changed to protect the fetus. Litigation against alcohol producing companies may need to happen to bring this issue to the forefront. As a society, we need to have the expectation that drinking during a pregnancy is absolutely, without exception, unacceptable. And, in order to uncover the magnitude of this epidemic, when juvenile and adult deviant and/or violent behavior happens, we always need to ask the question: Did the mother drink ANY alcohol during the pregnancy?