Students with Fetal Alcohol Syndrome are similar
to children with learning disabilities, in that they have difficulty
with auditory and/or visual perception, the reception or input
of information into the brain; processing, organization and sequence,
the integration of information into the brain; auditory and/or
visual memory, the retrieval from storage and motorical, oral;
and/or written language, the output or expression of that information.
Make sure you have the students attention before giving instructions. When giving instruction implement the use of gestural movement and voice variations to express grammatical relations. Use pictures of steps involved in a task, or have the instructions written down for the student to refer to if needed.
Directions should be clear, concise, simple, and given one step at a time. Avoid figurative, ambiguous, and idiomatic speech. This type of speech confuses the student.
Use the same verbage/words when giving instructions or going over an activity, i.e., calendar skill: if an activity is started by saying "today is Monday, yesterday was Sunday" the activity should be continued the rest of the week by repeating the same word format "today is ________, yesterday was___________ ," versus the next day saying "What is today, does anyone remember what day yesterday was?"
Educators and parents have noted that to "sing song" rules, directions, or steps to an activity, helps the child remember. Also reported is that kinesthetic or motoric activity along with the "sing-song" helps the child to retain better. (Utilize all the senses whenever possible, as multisensory learning strengthens the information and provides for more than one way to recall).
Information presented in clusters, groups, and sequences help with learning, along with providing learning to some type of rhythm, i.e., clap hands, drum on desk, and rap or music.
Act out directions whenever possible. If a student is to pick up papers and put them in a certain place, walk through each step before you have the student do the task.
Check student comprehension before beginning a task. A student may indicate that he/she understands, when in fact, they do not. The student might be afraid to ask for clarification, or embarrassed because of peer reaction. One can quietly check student progress to determine if the student has comprehension, then provide needed assistance. Praise the student each time he/she does ask for repetition or clarification of information. Check to see if the student can tell you in his own words what is to be done. A student with Fetal Alcohol Syndrome can often tell you verbatim what you just said, but still may not understand what to do.
Modify assignments as needed. Remember to teach at developmental level not age level, using materials that are adapted so that the student is not embarrassed by peers for using a "lower level" book or materials. Make sure the student's IEP is followed to determine specific strengths and weakness of the student.
Monitor frequently, be cognizant of the fact that these children get easily frustrated and over stimulated. Pressure, from not knowing and understanding, and fatigue, from trying to understand and know, can cause behavioral frustration which can lead to outbursts.
Body/kinesthetic movement helps students with Fetal Alcohol Syndrome process material through body movement and sensations. Use physical activities, dramatic/creative movement, role play to provide for more pathways for the student to remember.
Remember that to know material one day does not mean that the student will know the material the next day. The student will need clues or memory joggers to help with retrieval of information. *** Note: A student can show mastery in more than one way, i.e., he/she can draw cartoon forms, or a student can record on the tape recorder what he/she has learned about a certain topic, vs. having to write about it. A student can provide or describe visuals for a chapter on the tape recorder for the other students to listen to. Implement the use of mnemonic devices to help aid the memory.
Students with Fetal Alcohol Syndrome are very visual, and the use of pictures, images, photos of the children actually involved in activities help the students remember the structure and/or schedule, which is important each day in providing the organization that these students need.
Monitor the student for any signs of stress that may develop into a behavior outburst and redirect the student if needed. Signs of stress may be seen as follows: reddening of face, clenching of fists or jaws, rubbing eyes, breaking pencils, increased restlessness, refusal to do work and so on.
Remember that praise for these students is very important and helps to build their self- esteem. Most of the time these students have been in a negative cycle of failure and rejection from peers and others, which can result in negative self esteem. "Catch" the student doing something good, shape desired behaviors, i.e., praise any attempt on the students part to comply or achieve positive student behavior.
Have positive statements, certificates, coupons (to trade in later for a reward) handy to give to the student when displaying appropriate behaviors or on task behavior. Reward positive behavior immediately.
Let the student tell you what works best for him/her, and ask the parent/caretakers what works for them. They can be a valuable resource and they need to be involved in the education programming for the child, as should all the professionals, in order to provide a more consistent environment for the success of the student.
Seat the student near the teachers desk or an area where most instruction is presented yet not exclusive of the regular class setting.
Place the student in an area where the rest of the students are not directly in the line of vision of the student.
Have students who are perceived as positive role models or who will not easily be drawn into negative behaviors seated closest to the student.
Limit distracting stimuli as much as possible; hanging mobils, posters, visuals, sometime cause a child with Fetal Alcohol Syndrome to become overly stimulated and restless.
Distracting stimuli can also be:
Lunchroom (smells are too distacting)
High traffic areas
Doors or Windows
Provide an area that can be used when the student becomes over stimulated. Set the area up with earphones (to block out distracting noises or to listen to soft music which can be soothing to some students). Pictures of relaxation techniques can also be displayed for the student to refer too. Note: This area can be used for all students.
Transition between activities can be a time of great stress unless planned for in advance. "Cue" as to when an activity is to be ended, as closure is very important for a student with Fetal Alcohol Syndrome. One may use (tactile), touch student on shoulder or elbow; along with (verbal), " the puzzle needs to be completed in four minutes"; paired with (visual), hold up four fingers; (kinesthetic), have student hold up four fingers; and (concrete), a four minute timer.
One can also have a taped message available on a tape recorder to provide a calm verbal countdown. (i.e.," you are doing a good job finishing your activity, you have four minuted left" and so on until the countdown is completed). Flash cards can also be prepared to signal the remaining minutes left. Calming music has also been known to be effective.
While the students are involved with the closure of the activity, quietly verbalize "I like the way you are finishing your activity. We will start on our next activty when time is up for this one." The next activity should be within sight and readily available for the student.
When time is up, involve the student with the actual closure by letting the student experience the closure. Several techniques may be incorporated which utilize several senses: mark the activity off on the activity chart; take the activity picture card out of pocket chart and put it in the completed activities pocket; turn picture over on the hook chart; unclip clothespin with designated picture activity and put in clothespin bag. The same routine should be consistently followed each day.
The student may not have adequate verbal language
skill to describe or tell what he knows, but may be able to draw,
role play or gesture information.
Provide clues such as "do you mean ______ or_______?"
Give beginning sounds of words
If presenting a work sheet provide multiple choice cues or pictures.
Teach compensatory strategies for word finding by describing size, function, shape, etc. * Note, strategies or certain aides for help may be typed up and put in a note book for the student to refer to. Pictures of steps can be incorporated if needed. Titles may include:
How to check my work
How to recall information
How to ask for help
How to help memory
What to do if I am mad
Use whatever the student needs to help with learning strategies: pictures, pictures drawn by the student, drawn by the teacher for the student, or polaroids of student doing certain tasks. Remember to ask the student what helps as they often know how they learn best.
Cue each step: What comes first, second and so on.
Sequences can be acted out.
Teach students to cross out each step as it is completed.
Use "personal cue cards" with words or pictures of needed materials for a lesson, activity etc.
Show and tell the student how many steps in a task, hold up four fingers if four steps, have students hold up four fingers, then write down how many steps.
Start part of the sequence then have the students complete the task.
Provide individual number lines, alphabet, days of weeks, or calender, either in a notebook or on the desk.
Provide sequence of days activities, weekly activities, and monthly activities so the student will have a reminder.
Information presented to the student should be in short segements.
It is important to utilize multisensory input as this strengthens the information presented and helps with recall of information.
Use visual cues with oral information, along with gestures and voice inflections.
Try to make the information revelant to the child by using experiences that the child can relate to or is familiar with to make connections.
Tie the information to previous learning as much as possible.
After information is presented verbally, along with the visual, provide for visual imagery. The student may need to learn this process. Initially, have the student close eyes and create a colorful visual image that uses information from the students actual experiences. If rehearsed enough, this method can help with recall of information.
Important information can be taped for the student to listen to repeatedly.
Students with Fetal Alcohol Syndrome require a lot of repetition of material that is to be learned, with frequent rehearsal of the material learned in a variety of settings, using a multi-sensory approach. "Mastery" of material one day, should not imply that learning will be retained. The inability of the student to retreive information at certain times will cause material that has been "mastered" one day to be "lost or misplaced" on another day.
Remember: REPEAT, REPEAT, REPEAT! REHEARSE, REHEARSE, REHEARSE!
When a student with Fetal Alcohol Syndrome is in a new or different environment, arrangements should be made to orient the child to his surroundings. The following should be implemented:
All personnel should be aware of problems with orientation and help the student to find his/her way back versus reprimanding the student for not being where he/she is supposed to be. The student should not be sent on an errand or allowed to go to an area of the school plant alone until the student is familiar with and can find his/her own way to a particular area without getting lost or side-tracked.
To help orient the student to his/her environment, consider the following:
Walk the student through the physical plant several times, noting the areas that the student will be in, such as the restrooms, lunchroom, classrooms and other areas that the student schedule denotes.
Next, walk the student through the physical plant with a map of the plant, showing the student how to move his/her finger along the path you walk (kinesthetic, tactile). Practice this several times until the student indicates that he/she knows how to get to each place. It sometimes helps to have the student draw the physical plant if the student is able to or likes to draw. Monitor as the student practices getting to each place without help.
Once the student becomes comfortable, set the student up in a positive situation. Try setting up some kind of system whereby the student is a "greeter of newcomers" and shows new students around. At first, this should be monitored until the student becomes adept with the surroundings. This can also be utilized as a reward contingent upon behavior expectations that are met in a positive manner.
A color coded map, (to carry in pocket or notebook), to refer to if lost, that directs/orients the student through the use of color coding or symbol matching and placed on doors or areas that the student is to be in, can be helpful.
Let the student help to determine what kind of technique would help in finding the way to certain areas. Note: when the student is involved in planning or determining the best way to remember or learn material, the material is often easier for the student to retreive.
Prepared by Darla Hess, M.Ed., Instructional Specialist
Emory University Fetal Alcohol Syndrome Research Project, in collaboration with the Centers for Disease Control and Prevention and Emory School of Public Health: Epidemiology.
DBHDD provides treatment and support services to people with mental illnesses and addictive diseases, and support to people with mental retardation and related developmental disabilities.