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.