FASlink Fetal Alcohol Disorders Society

Bridging the Gap

Active Learning: Bridging the Gap for Fetal Alcohol Effect Children

By Debbie Evensen Fall 1991

Professionals 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 these children.

Fetal Alcohol 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.

Children exposed 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.

Behaviors and 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.

Therefore, FAS/ FAE children may have learning disabilities in the following four domains:

  • 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.

Case Studies: 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.

In another 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.

An adolescent 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.

Effective Techniques:

Traditional 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 gap.

Techniques 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:

  1. 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."
  2. Use visual cues,simple terms and concrete language when giving oral directions. Remember the "K.I.S.S."method. (Keep It Short and Simple)
  3. 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.)
  4. Incorporate 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.
  5. Integrate 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.
  6. 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 studied.
  7. Use the visual mode of learning as much as possible. Use class
  8. 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.
  9. Allow the child to draw a picture to explain what (she is feeling- Draw pictures along with the rules for the classroom.

Summary

Understanding 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.

(Morse, 1991; Cloud, 1991; Spira and Evensen, 199 1; Caldwell, 1990; Murphy, 1991; Martinsen. 199 1; Streissguth, 199 1; Riley, 1990; West,