Teaching and learning strategies to support primary aged children with FASD
Primary School ResourcesThis factsheet is designed to assist teaching and support staff to adapt teaching and learning strategies to meet the needs of children with FASD. Children with FASD can experience learning and behavioural challenges due to the neurodevelopmental impairments caused by prenatal alcohol exposure. Classroom behaviours need to be seen in this context. For many educators, this shift in awareness is crucial to their practice, and underscores the importance of early diagnosis of FASD. For these children, the focus should be on understanding that their performance is based on ‘brain’ injury not ‘bad behaviour’.
It’s important to remember that each child with FASD is different, and these strategies may not be effective every time. Maintaining flexibility is crucial in supporting children in their ongoing learning. Additionally, FASD is so prevalent, many educators may not realise they are interacting daily with students who have undiagnosed or misdiagnosed FASD. The strategies in this factsheet will be useful to support many children experiencing difficulties in the classroom, even if a child does not have a formal FASD diagnosis. As the pathway to a FASD diagnosis can be lengthy, it’s important that support strategies are implemented as soon as possible.
1 Give short concrete instructions
Young people with FASD often have difficulties with communication and language. When giving instructions it’s important to use simple concrete language, state exactly what you want the student to do, and avoid using words with double meaning. For example:
- Instead of saying ‘settle down’ or ‘behave yourself’ say ‘please stop talking’.
- Use direct clear instructions such as ‘please stay in your seat’ instead of ‘don’t wander’ or ‘you know the rules’.
It is also important to give short instructions or only one instruction at a time. Memory impairment associated with FASD can impair a student’s ability to hold multiple pieces of information in their mind at one time. For example, instead of staying ‘pack your books away and tidy up your desk’ say:
- ‘stop writing’;
- ‘put your pencil down’;
- ‘close your workbook’; and
- ‘place your workbook and pencil into your bag’.
It’s important to allow time for the student to process, understand and complete each step before moving onto the next step.
2 Use visual aids
Young people with FASD may have difficulty with abstract thinking, planning, and memory. The use of visual aids to accompany verbal instructions or abstract concepts will assist a student with FASD in their learning. For example, using a sand timer to show how long a task will take can help young people with FASD understand and visualise time. Some primary-focused examples include a visual timetable of the class schedule, or use of number lines, dice, or coins for mathematics lessons. In secondary school, examples may include the use of mind maps or graphic organisers, a visual schedule with images of classrooms and teachers, and checklists or planning templates to organise information. It can also be helpful to give students visual aids that they can use at home or refer back to after leaving school.
Click here for a brief video example of a visual schedule.
3 Focus attention
The ability to focus and concentrate on relevant information can be impaired in an individual with FASD. Before beginning an activity (i.e., giving instructions, teaching a lesson, reading a story etc.) it is important to engage students with FASD to ensure they are listening and watching. It can be useful to use a class-wide call-and-response or count-down (e.g., “3, 2, 1… Time to be quiet and listen”) or say their name in a caring way before you begin speaking. This adjustment accommodates the fact that young people with FASD have compromised attention, concentration and focusing skills.
4 Maintain structure and routine
Young people with FASD may struggle with adjusting to change or shifting to new activities. It’s important to maintain a consistent and predictable routine which allows a young person with FASD to know what is coming next and therefore what to expect. This structured and caring teacher practice can improve a young person’s ability to learn by decreasing anxiety and cueing recall of familiar tasks. If a routine is to be interrupted, it’s important to prepare young people with FASD for the change (e.g., in the case of a school excursion or changing the order of lessons).
Throughout secondary school, collaborate with other teachers to develop consistent structures and routines across classes. For example, use a predictable lesson structure, schedule regular tasks on specific days, and encourage students to arrive at school at the same time each day and move to class when the bell rings. For further information on supporting changes to routine, click here to visit our Transitions during adolescence factsheet.
5 Allow additional processing time
FASD can affect a child’s ability to process information. This means that a child with FASD may require longer to take in and respond to visual and auditory information. It is important to allow a child with FASD additional time to respond to a question, or to complete a task or activity. For example, if a child with FASD is asked a question, it’s important to allow response time before moving on or providing the answer.
6 Allow frequent breaks
FASD can impair self-regulation, which is the ability to engage in deliberate and thoughtful actions while remaining attentive and emotionally appropriate for the situation. In the school environment, this can affect the ability to change activities or maintain attention. Recess and lunch breaks are very important for students with FASD. But allowing additional frequent breaks (particularly including opportunities for physical exercise and movement) can be a useful strategy to improve self-regulation and attention. For example, a weight bearing exercise such as asking a student to return books to the library can be a useful physical activity to expend excess energy. In secondary school, build brief, structured breaks into longer activities, such as a short stretch or mindfulness exercise (e.g., Student Wellbeing Hub). Support adolescents to recognise when they need a break, and develop a self-regulation plan, such as having a break pass or providing a designated calm space. Young people with FASD often have difficulty with interoception, which is the ability to recognise internal signals like hunger, body temperature, or when they need to use the bathroom. As such, it can be helpful to ensure that students with FASD have easy access to food or to the bathroom without asking for permission.
7 Repetition
Due to the impact of FASD on memory, young people may have difficulty recalling learned information. It is common for young people with FASD to demonstrate inconsistent recall – i.e., they might remember information one day but be unable to recall it the next day. Consistent repetition, (supported by visual aids) of new information, skills, instructions, or routines can help to reinforce learned information.
8 Personalised and multi-modal learning
There is no typical pattern of impairment in FASD, and each individual will have their own strengths and challenges. It’s important to personalise teaching and learning strategies for each student according to their unique strengths, challenges, capacities, and interests. Multi-modal or multi-sensory learning involves as many senses as possible, as well as a variety of modes and media. When teaching a young person with FASD, it’s important to engage and stimulate the student by accommodating their learning style. For example, young people with FASD often excel at physical activity – playing a team sport at school can teach them how to follow rules, co-operate with others, and build important social skills in a situation that they enjoy. Similarly, harnessing a young persons’ interests can help them engage in learning. For example, learning to read or write from a book on a topic they are interested in, or choosing from multiple modes of assessments, such as creating a video instead of writing an essay. It can also be useful to
Click here to view a NOFASD booklet with examples of integrating strengths and interests into the curriculum on page 11.
9 Model, rehearse or roleplay
FASD can impair social and emotional skills in young people, which can lead to difficulties with relationships (e.g., making friends, being subjected to teasing or bullying), and result in inappropriate behaviours (e.g., aggression, disruptiveness). Modelling, role-playing, or rehearsing real life situations can be a useful technique for teaching social and emotional skills. Some examples include:
- Scripting or role-playing a forthcoming situation (e.g., a school excursion) so the student can rehearse the appropriate language and behaviour for the occasion.
- Modelling or demonstrating the appropriate eye contact, tone of voice, body language, or manners (e.g., not interrupting) to use when interacting with peers.
For an example of explicitly teaching social and emotional skills, visit our Social and emotional development in adolescence factsheet.
References
Basaraba, D. (2016). FASD: From isolation to inclusion in Australian schools. [Doctoral thesis, Deakin University]. https://dro.deakin.edu.au/eserv/DU:30089393/basaraba-fasdfrom-2016A.pdf
Blackburn C. (2021) Supporting a Child with FASD in the Classroom. In: Mukherjee R.A.S., Aiton N. (eds) Prevention, Recognition and Management of Fetal Alcohol Spectrum Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-73966-9_29
Carpenter, B. (2011). Pedagogically bereft! Improving learning outcomes for children with foetal alcohol spectrum disorders. British Journal of Special Education, 38(1), 37–43. https://doi.org/10.1111/j.1467-8578.2011.00495.x
Coles, C.D., Taddeo, E., & Millians, M. (2011). Innovative educational interventions with school-aged children affected by Fetal Alcohol Spectrum Disorders (FASD). In S.A. Adubato & D.E. Cohen (Eds.), Prenatal Alcohol Use and Fetal Alcohol Spectrum Disorders: Diagnosis, Assessment and New Directions in Research and Multimodal Treatment. Bentham Science Publishers, Sharjah, UAE.
Gill, K., & Thompson-Hodgetts, S. (2018). Self-regulation in fetal alcohol spectrum disorder: A concept analysis. Journal of Occupational Therapy, Schools, & Early Intervention, 11(3), 329–345. https://doi.org/10.1080/19411243.2018.1455550
Kully-Martens, K., Denys, K., Treit, S., Tamana, S., & Rasmussen, C. (2012). A Review of Social Skills Deficits in Individuals with Fetal Alcohol Spectrum Disorders and Prenatal Alcohol Exposure: Profiles, Mechanisms, and Interventions. Alcoholism: Clinical and Experimental Research, 36(4), 568–576.https://doi.org/10.1111/j.1530-0277.2011.01661.x
Millar, J. A., Thompson, J., Schwab, D., Hanlon‐Dearman, A., Goodman, D., Koren, G., & Masotti, P. (2017). Educating students with FASD: linking policy, research and practice. Journal of Research in Special Educational Needs, 17(1), 3–17. https://doi.org/10.1111/1471-3802.12090
Millians, M. N. (2015). Educational Needs and Care of Children with FASD. Current Developmental Disorders Reports, 2(3), 210–218.https://doi.org/10.1007/s40474-015-0055-5
Mitten, H.R. (2013). Evidence-based practice guidelines for Fetal Alcohol Spectrum Disorder and literacy and learning. International Journal of Special Education, 28(3), 44-57. https://files.eric.ed.gov/fulltext/EJ1024410.pdf
Weston, J. & Thomas, S. (2018). Fetal alcohol spectrum disorder (FASD) and complex trauma: a resource for educators. Fitzroy Crossing, WA: Marninwarntikura Women’s Resource Centre.
Project partners
