Educating Children Under the Influence
of  Prenatal  Alcohol  Exposure
Jocie DeVries

Families raising children with FAS/E frequently look to teachers for
hope that the next school year and the new classroom will provide a more
successful learning environment for their child than the last. This
issue of FAS Times is therefore dedicated to teachers and the enormous
task that has been put in front of them. As Linda LaFever says,
Teachers, the problem is not your ability but the disability of FAS/E.
None of us would allow a student in the classroom that was drunk, but
you will have students in your classroom that will have a desperate
daily struggle to get out from under the prenatal influence of alcohol.
In many ways the permanent behavioral traits of individuals with FAS/E
mimic the temporary personality changes in a person who uses alcohol
abusively. The classroom teacher of students with FAS/E, school
counselor, bus driver, principal, lunchroom monitor, school custodian
and playground supervisor will have a daily struggle to develop
strategies so this intoxicated person can fit in and learn. The job
will be just as difficult as trying to reason with a drunk.

FAS FAX FOR TEACHERS
The FAS Family Resource Institute has trained teachers across Washington
State since we collected and organized the data from our first FAS
Family Survey in 1991. We have continued to receive input from families
and individuals with FAS/E through subsequent surveys, the FAS Needs
Assessment Retreat in 1994 and through the crisis and referral phone
line which was begun in 1990. This collective family experience is
illustrated and shared through the 10 hour Intervention Touchpoint
Seminar, FAS FAX: What Parents Wish Teachers Knew About FAS/E. We are
going to share a little bit of this information with you in this issue
of FAS Times in hopes that this school year will, in reality, be more
successful for everyone.

AN EDUCATIONAL MILESTONE FOR STUDENTS WITH FAS/E
First of all, teachers and school personnel often tell us that they can
spot learning problems as early as first grade. By the second or third
grade, educators can document developmental learning delays in students.
On the other hand, parents of children with FAS/E complain that teachers
and school counselors often accuse them of poor parenting. But by age
nine, even an optimistic parent who has the full support of educational
staff realizes that the skills and talents first perceived in the child
have faded; dreams have shattered into a nightmare which looms on the
horizon - what is wrong with my child? According to reports from
families, age nine is the educational milestone for students who were
disabled by prenatal alcohol exposure but have normal IQ levels. It is
at this point that we receive calls from frantic parents who feel that
they have no one in their community to whom they can turn. It would be
so helpful if parents and teachers had a way to capture this moment and
begin working together.  The FAS training that we offer to educators
helps to bridge this communication gap.

Another important issue that has surfaced out of the collective family
experience is the fact that there seem to be three primary life stages
with FAS/E: The Teachable Years, The Antisocial Years and The
Dysfunctional Years.

THE TEACHABLE YEARS
The Teachable Years are the years between birth and age 9 or 10. Of
course, the type of damage the child suffered from prenatal alcohol
exposure will determine what the child can learn and retain. For
example, if the child has an IQ level of 53 and is deaf, he/she will not
be able to progress academically like a child who can hear and has an IQ
of 108. However, there is something very significant and similar about
their logic (or lack of it) no matter what the IQ level. These children
look and act more like each other than they do their own family members.
The collective family experience has confirmed these observations time
and time again.
But whatever their innate abilities, teachers and parents of children
with FAS/E have a window of opportunity to work together to maximize the
child’s potential during this stage. Researchers from the University of
Washington and the FAS collective family experience both report that
children with FAS/E have a tendency to display antisocial behavior.
Consequently, the teachable years must not be wasted, if we want to keep
our streets safe and  if we want to prevent future generations with this
disability.

We need to keep in mind that these years are not only the time to
maximize the educational potential of the children, but they also form
the foundation of  emotional stability for the rest of their lives.
Therefore, all of the protective factors that facilitate bonding and
attachment must be in place before the adolescent years. Preventing
child abuse must be a top priority for these vulnerable children, so
they aren’t as likely to become aggressive and predatory.

THE ANTISOCIAL YEARS
Depending on the FAS interventions that are available to the family and
the presence of co-existing mental health diagnoses in the child with
FAS/E, the antisocial years emerge sometime between age 10 and age 18.
When that happens parents tell us they feel lucky if their child is
mentally retarded because there are realistic expectations and services
that have been developed for such disabilities. In contrast, research
shows that no matter how much effort, sweat and tears parents put
foreword for their child during the Teachable Years, even if the IQ is
normal, conscience development will be arrested at age 9 or 10.    Every
year afterwards, the developmental gaps between the child with FAS/E and
developmentally normal children will become more and more apparent.
Their peers will eventually notice; the child will be taunted and will
fight back until depression or anger dominates his/her life. If the
faculties of reasoning, judgment, will and conscience are arrested at
age 9 or 10, the faculty of IQ can not compensate for the loss of the
other faculties of the mind.

Unlike people with Down Syndrome for example, who have a distinguishing
look which generates compassion from the general public, teens with
FAS/E can have pervasive cognitive deficits but only a small percent
have facial features which cause them to appear disabled.
Family members of adolescents with FAS/E unanimously report that they
behave like moral chameleons. Since normal teenagers typically shun kids
with FAS/E because they think they’re weird, the attitudes and values
they display in the classroom are often reflected from someone who is
rebellious, mentally unbalanced or even predatory. As a society we have
two choices - we can continue to try and stuff kids with FAS/E into
regular classrooms, which really does not help anyone, or we can provide
educational settings for these moral chameleons and keep them and the
community safe. One predominant suggestion for school administrators has
emerged from both the collective family experience and researchers at
the University of Washington - regular, inclusive classrooms are
inappropriate learning environments for students with FAS/E. While there
are a few exceptions, students with FAS/E usually do not do well in
inclusive classrooms and they often have behavior that is terribly
disruptive to nondisabled and gifted students. From the FAS collective
family experience, it is unrealistic for school administrators to expect
one  teacher  to control  students with behavioral manifestations of
their disability and have any time or emotional energy left for
teaching.

THE DYSFUNCTIONAL YEARS
Parents report that there is an overwhelming grief associated with the
Dysfunctional Years of FAS/E. By the time the child reaches adulthood,
theoretically at age 18 to 21, the hopes and dreams of parents have been
shattered and they are emotionally exhausted. If we parents are very
lucky, we are still married. The adult children, however, have just
begun to feel their oats and want to be out on their own. What a scary
time for parents to see the prodigal child launch out on their own,
having a severe lack of judgment, memory and reasoning. When our
children did launch out on their own, we learned that: antibiotics do
cure some sexually transmitted diseases but not others; HIV is spread by
multiple sex partners which is common in some social circles; selling
your blood can bring in a steady income; good hygiene is absent in most
affordable housing situations; hepatitis is very contagious and it can
kill you.  Life with someone who will be forever under the influence of
alcohol is . . . interesting. Even adults with FAS/E will use your
toothbrush!

The grief of FAS/E is a reoccurring event, but there is a flip side.
Individuals with FAS/E are fun people to be around and fun people to
love. In their eyes, those of us who are normal are the ones with a
problem - we’re fun impaired! This is true not only for our family, but
is also reported as a collective family experience.

The interventions on page 10 were developed from our advocacy experience
with families who have older teens with FAS/E, who are presenting
serious antisocial behavior. One of the most difficult problems for
parents, teachers and school counselors is how to unscramble the origin
of the antisocial behavior. This is important because the origin will
determine which intervention direction will produce the best educational
results and the happiest adult.

TWO CENTS FOR KIDS
In order to educate students with FAS/E and prepare them for adulthood,
parents need partnerships with good teachers. Good teachers and
interventions that will prevent another generation of babies with  FAS/E
will cost money. However, there may be a practical solution to this
problem. Washington State legislators cut the state beer tax by nearly
half a penny during the 1997 legislative session. The cut will reduce
the state general fund by about $4.5 million a year, according to USA
Today on May 23, 1997.

Now, I know I’m not a rocket scientist, but it seems to me that there is
one logical source to pay for FAS intervention services - alcohol tax.
It has been 24 years since the disability of FAS was discovered at the
University of Washington. Since that time  the collective family
experience has shown which FAS interventions are successful. Just think,
if legislators appropriated two cents for kids, we would have 18 million
dollars each year for children living under the influence of prenatal
alcohol exposure.

Reprinted from FAS Times, Fall 97.

Eight Keys to Remember in the Classroom
by Vicky McKinney

I remember thinking, What a beautiful child, when three-year-old Abby
was placed in our home as a foster child. The caseworker explained that
she had some behavior problems and a few learning disabilities, but that
was to be expected because of the six foster placements prior to us. We
did not consider her to be much of a challenge. After all, we had done a
pretty good job with our three birth sons. The caseworker went on to
explain all she needed was love, security and stability. No problem, I
thought to myself, we can provide that.

After truly believing that for four exhausting years, I finally had to
admit there was something different about this child. Her memory only
lasted as long as the object was in front of her. She was an emotional
time bomb waiting to go in any direction with no rational reason
attached to her behavior. She did not seem to learn through experience
and logical thinking escaped her. Yet, she was so loving and she could
not be separated from me for any length of time.

By 1990, the frustration level in our home had reached an all time high.
It was about this time I tuned into  a TBS channel and saw a program on
Fetal Alcohol Syndrome. I could not believe what I was hearing. They
were describing my daughter! This was to be the key to our future.

I made an appointment at Children’s Hospital, where Abby was diagnosed
as having FAS. Try, if you can, to imagine experiencing grief and joy in
the same moment. There was a reason  for her behavior and learning
disability! But there is no fix and the potential for a normal life
was not to be expected for her.

Determined to make a difference for Abby, I started calling agencies to
find out about what programs Abby could qualify for. After all, I had
just been told that FAS/E was the number one cause of mental retardation
in the U.S. But I was to learn there was NO HELP available. NOTHING!
Even our state’s own, very large health department transferred my call
eight times and on the last one, a voice asked, F-A-  What? I was
stunned by the lack of awareness among not only the general public, but

by the professionals as well.

In my search for answers, I finally met some wonderful parents with
information which would make our world livable again. Working together,
the Fetal Alcohol Syndrome Family Resource Institute was formed.
Through this nonprofit organization, we endeavor to educate the public
and professionals regarding the reality of FAS/E. Understanding and
working with these children on a daily basis, without any knowledge of
FAS/E, can be a very frustrating and exhausting task. To understand a
child prenatally exposed to alcohol, you must understand that each
child’s specific type of damage is different, depending on many factors.

Over fifty percent of the children and adults with Fetal Alcohol
Syndrome have an IQ above 70. They do not qualify for special education
programs and, if FAS/E has not been recognized, they are often
misdiagnosed or labeled as ADD, ADHD, or just plain lazy and stubborn.
So what can educators do?

Find out all you can about FAS/E. Hold a workshop in your school.
Children with this disability can learn. They just learn in a different
manner. The major keys we have found to unlocking educational doors for
Abby and others with her disability, include the following:

   * We have found that our children benefit from early specific motor
     and mental stimulation. Programs for early intervention, with
     realistic  expectations adjusted to their specific strengths and
     weaknesses, work well.
   * Structure! Structure! Structure!
   * Classrooms should have as little stimuli as possible. Our children
     have trouble filtering out unnecessary stimuli, which we find very
     easy to do everyday.
   * Use concrete learning methods. Abstract thinking is very difficult.
     Most children with FAS/E will learn from something they can see,
     feel or touch.
   * Only one command or task should be given at a time. Talk over any
     change in the schedule ahead of time, as transitions are very
     difficult. Our children find security in knowing what to expect
     next. They do not adjust easily to change.
   * Don’t be disappointed if what you teach them today is not with them
     tomorrow. It is not a reflection of your ability, but it is a
     reflection of their disability.
   * Be practical. Help them learn vocational and life skills. Teach
     math with a calculator and time with a digital watch. Use a timer
     to help set the boundaries for activities.
   * The reward system works wonders, but the rewards need to be
     immediate. A sticker or positive recognition means more to our
     children than the promise of $500 at the end of a good semester.

 Each day we emphasize the successes Abby achieves. We find failure to
be only a starting point towards success.

Reprinted from FAS Times, Fall 97.


Reaching Out: Teacher to Students
by Diane Davis

Three years ago the Chapter I aide at the elementary school where I
worked, volunteered to take six little second grade boys that we
suspected were drug-affected children and teach them all day long, for
the last two weeks of school. She was finished with all the program for
her other students, so was able to devote all of her attention to these
six boys, all of whom had been in lots of trouble, both academically and
behaviorally, for most of the school year.
Thelma Valentine was the name of this gifted woman. Without any formal
training about FAS/FAE, she knew instinctively what to do. First of all,
she arranged the boys’ desks in a horseshoe fashion. Her desk was
between the two ends of the horseshoe so that the boys would be able to
see her well and vice versa.

Thelma was very clear in letting the boys know her rules, her
expectations, and what the daily routine would be. She informed them
that if one student had to go to the bathroom, they would all go with
him, and that they were to stay together and under her supervision at
recess and at lunchtime.

Academically, she did not push them to do work that was clearly beyond
their comprehension, but she expected them to do what they were capable
of, and to do it well. They were then rewarded with dimestore toys or
treats to eat. When they did especially well, they got to watch a video
and have popcorn.

What Thelma discovered was that the boys were very responsive as long as
she supervised them closely. If she just turned her back for a minute,
however, most of them would not be able to stay on task. They needed her
to keep them grounded.

Thelma also realized that one of the reasons the boys had so often
gotten into trouble on the playground was because they had no
understanding of game rules. As a result, they would run around
aimlessly and bother other students who were playing. With Thelma
present to explain game rules to them and to help them learn how to play
together, their harassing of other children stopped and they began to
enjoy playing games with each other.

By the end of the two weeks, five of the six boys had made considerable
progress in their academics, behavior, and social skills. They were
smiling and feeling good about themselves, rather than hanging their
heads because once again, they had gotten into trouble. The sixth boy
was often tardy or absent. His family took little interest in his
schoolwork or his emotional well-being, so consequently, he didn’t do as
well as the other students.

When school began the following year, four of the six boys returned.
They looked for Thelma but she had transferred to another school. They
told me how much she had taught them, and how well they were going to do
in the coming year because of what they had learned from her. They
sincerely meant what they said - I could see it in their    eyes - but
within two weeks, they were all sliding downhill. They needed the
constant supervision that Thelma had given them, as well as the smaller
sized classroom, the structure, order, and routine, and Thelma’s belief
in and love for them.

There are many children like the six boys Thelma taught. We know what
they need from the school system. We owe them the opportunity to learn
in a safe environment that is set up to meet their special needs. The
impact can be very positive and rewarding. We must continue to advocate
for the classrooms these children learn best in, and the teachers who
have the patience, skills, and insight that Thelma had.

(This article is reprinted by permission from a chapter in the book,
Reaching Out to Children with FAS/FAE by Diane Davis. Her book may be
purchased from Prentice Hall for $20 by calling 1-800-288-4745. This is
an excellent resource for teachers, counselors and parents. )


Reaching Out: Teacher to Teacher
by Diane Davis

Tips for Teachers

   * Allow yourself to become educated; find out all you can. Check FAS
     web sites on the internet. It isn’t you - it’s the damage!
   * Read the file on the new student and take the time to add to the
     file so the next teacher can refer to it.
   * Enlist the help of parents; be sure to educate the parent
     volunteers about the disability of FAS/E.
   * Find other teachers who have students with FAS/E and support each
     other. Many times administrators don’t get it.
   * If administrators won’t listen, take a group of parents to meet
     with them.
   * Study learning styles. It really helps to know which approach to
     use with all your students. You may also discover your teaching
     style in the process since it is based on your learning style.

Outside the Classroom

   * What is the plan for recess? Does the child have adequate
     supervision?
   * Who will supervise during lunch time?
   * Who will accompany the child when the classroom is not
     self-contained and students go elsewhere for reading, math, music,
     etc.? Will it be an adult or another student from the room?
   * Will the child be allowed to go on field trips? If so, who will
     supervise the child one-on-one? If not, where will he go within the
     school?
   * Inside the Classroom
   * Each student needs a 70% success rate. So give a pop quiz that is
     below their level at the beginning of each day so they can at least
     have a positive jump start.
   * Where can the child sit so that he will be able to focus better and
     be the least disruptive? Some teachers use carrels around the
     student’s desk to help block out too much stimulation. Other
     teachers have a desk located in the back or side of the room for
     the student to go to. It is important that whatever the set-up is,
     it should not be perceived by the student as punitive.
   * What is the child’s learning style? Is he visual, auditory,
     kinesthetic?
   * What can the teacher realistically expect from the student
     academically? (If the child has trouble keeping up with the others
     in his class, assignments may have to be shortened or changed so
     that he has a better chance of being successful.)
   * How can the teacher build on the student’s strengths?
   * Who is available to work one-on-one with the child (an aide,
     intern, parent or other volunteers)?
   * What types of discipline work or don’t work?
   * What strategies should be used if the child has an outburst in
     class? For example, does the teacher leave his class to deal with
     the child one-on-one in private? Or, should the student be sent to
     the counselor, principal, or designated other?

(This article is reprinted by permission from a chapter in the book,
Reaching Out to Children with FAS/FAE by Diane Davis. Her book may be
purchased from Prentice Hall for $20 by calling 1-800-288-4745. This is
an excellent resource for teachers, counselors and parents. )