Bridging the Gap for Fetal Alcohol Effect Children
By Debbie Evensen
and the public in Alaska are deeply concerned about the educational
implication of prenatally alcohol/drug exposed children. At a recent
community support group for teachers and other professionals working
with children with Fetal Alcohol/Drug Effects, the frustration level
was obvious. Teachers shared feelings of being overwhelmed, not
only with the sheer numbers of these students entering their classrooms,
but also with the ineffectiveness of traditional techniques in teaching
Syndrome is the leading cause of birth defects in the United States
today. The students with Fetal Alcohol Syndrome/Fetal Alcohol Effects
(FAS/FAE) demonstrate a wide variety of deficits, depending on the
period of fetal brain development when the alcohol or drugs were
ingested. A review of the literature shows that only the most severely
affected children are discussed, while the other 80%, many undiagnosed,
are at-risk for developing significant school problems. The need
for long-term planning is obvious.
to alcohol in utero do not represent a particular socioeconomic
class of children though, and may be as varied as children who are
not so exposed. However, there are many commonalties among FAS/FAE
children and the following generalizations can be made.
specific sites of alcohol caused brain damage have been correlated:
hippocampal damage has been implicated in learning and memory deficits,
and dam- age to the cerebellum may affect motor control. FAS/FAE
children have severe information processing deficits, which means
that the connecting link between taking in the information and the
subsequent action is defective.
FAS/ FAE children may have learning disabilities in the following
- 1. input
(recording of information from the senses)
- 2. integration
(process of interpreting the input)
- 3. memory
(storage of information for later use)
- 4. output
(answer, response, completed task, etc.) This requires appropriate
use of language and motor skills. FAS/FAE children have a language
dysfunction. They may be highly verbal, but cannot translate the.
words into action.
For the child with FAS/ FAE, spotty or intermittent learning and
retrieval is normal. The following examples show the types of behavior
that can be expected.
A child is
asked to bring her toys from the living room into her toy box in
the bedroom. She may do one of two things, 1) goes into the bedroom
and cannot remember what to do, or 2) goes into the living room
and arranges the cushions on the couch.
A junior high
student gets angry at her older sister and stamps out the door of
her house to go to her best friend's house, not taking into the
account that it is winter, 11:30 pm.,or that she is dressed only
in her underwear.
instance, an elementary child is asked to wait outside the school
room for his mother to finish visiting with his teacher. He willingly
walks out into the hallway. Halfway there he stops and looks around,
gets a drink of water and goes into the gymnasium where he waits
for his mother.
A child calculates
the addition facts with 100% accuracy one day; the next morning
he misses over 50% of the same problems.
girl is given a thorough list of chores to accomplish. When her
parents remind her of the chores they make sure to list the jobs
in detail, thinking that this clarification wil l make her attend
to the tasks in a more thorough way. She is unable to differentiate
between the masses of verbal input, and is totally lost after the
third item. Not wanting to be accused of noncompliance, she goes
off to her room thinking of whatever stuck in her mind, hoping somehow
to get by. Her parents berate her for not listening and paying attention,
and reprimand her for "not caring" about helping the family.
A high school
student is asked by school staff members to come up with a solution
to a specific social situation. The. more people talk with him,
and the more sensory input he receives on the subject, the more
frustrated he becomes with his inability to come up with an answer.
Finally, he "shuts down," will not discuss the issue further
and sits in his chair refusing to do anything at all.
teaching techniques assume that with minimal assistance the child
is capable of taking in verbal instructions, processing the information,
remembering what is expected and completing the assigned tasks.
This can be an impossible task for the FAS/FAE child without extensive
assistance and learning methods that bridge the information processing
that incorporate multi-sensory, whole brain strategies into daily
academic instruction are modalities of learning that have been successful,
and are helping to bridge this gap for FAS/FAE students. The following
is a summary of some of these techniques:
- Set the stage
for learning with the teaching of relaxation. FAS/FAE students
are easily over stimulated and frustrated. They can be taught
how to relax and avoid "shutdown."
- Use visual
cues,simple terms and concrete language when giving oral directions.
Remember the "K.I.S.S."method. (Keep It Short and Simple)
- Use music
and rhyme as teaching strategies. Not only do FAS/FAE students
enjoy music, but it facilitates both memory and retrieval of information.
Any fact or rule can be put to music, a rap or a simple limerick
or rhyme to facilitate input, integration and retrieval from long-term
memory. For example, complete the following: In 1492 Columbus
(In 1942 Columbus sailed the ocean blue.)
kinaesthetic activities as an integral part of the teaching process.
Movement facilitates learning. Example: jumping rope to jingles
to learn math facts. Practice oral spelling words with cheer leading
or drumming activities.
new concepts with information the student already understands,
helping to build networks of knowledge from which the student
can begin to organize her/his world. Use examples from the students
daily life when teaching math or language.
- Use "scripting"
throughout the school curriculum. Short, easy to read teacher
written plays can be used to teach any subject, and can help the
child generalize information to the outside world. Practice social
skills with scripts designed to specific situations. Teach history
events with written scripts involving the historical figures being
- Use the visual
mode of learning as much as possible. Use class
- made videotapes
to teach. As an example, videotape sequencing activities (what
to do when you first get to school in the morning)and allow the
children to watch them over and over. The repetition will increase
learning and they will love watching them selves doing it right!
Use/ draw pictures to aid the understanding of a concept.
- Allow the
child to draw a picture to explain what (she is feeling- Draw
pictures along with the rules for the classroom.
behavior in students with Fetal Alcohol Effect as a manifestation
of physiologic damage rather than wilful misconduct emphasizes the
need to provide additional ways of learning and moves our thinking
away from moral interpretations. With appropriate modifications
to our instructional techniques, children with FAS/ FAE can learn
to function successfully in school and prepare for adult life.
Cloud, 1991; Spira and Evensen, 199 1; Caldwell, 1990; Murphy, 1991;
Martinsen. 199 1; Streissguth, 199 1; Riley, 1990; West,