Teaching and learning strategies to support primary aged children with FASD
Children affected by FASD can learn and behave differently to neurotypical children due to the impact of prenatal alcohol exposure. The learning challenges experienced by children with FASD are due to their neurodevelopmental impairments. 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’.
The strategies below are designed to assist teaching and support staff to adapt teaching and learning strategies to meet the needs of children with FASD. However, 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, while the strategies are designed to support children with FASD, due to the overlap between FASD and other neurodevelopmental disorders they may be useful for other children who are experiencing difficulties in the classroom.
1 Give short concrete instructions
Children with FASD often have challenges or difficulties with communication including both speech (articulation) and language (understanding and expression). When giving instructions it’s important to use simple concrete language, state exactly what you want the child 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
Children 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. Some examples include: a visual timetable of the class schedule, or use of number lines, dice, or coins for mathematics lessons.
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 with children with FASD to ensure they are listening and watching. It can be useful to say their name in a caring way before you begin speaking. This adjustment accommodates the fact that children with FASD have compromised attention, concentration and focusing skills.
4 Maintain structure and routine
Children 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 child with FASD to know what is coming next and therefore what to expect. This structured and caring teacher practice can improve a child’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 children with FASD for the change (e.g., in the case of a school excursion or changing the order of lessons).
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 a child’s ability to change activities or maintain attention. Allowing 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 child to return books to the library can be a useful physical activity to expend excess energy. Recess and lunch breaks are also very important for a child with FASD.
7 Repetition
Due to the impact of FASD on memory, a child may have difficulty recalling learned information. It is common for children 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 assist a child by reinforcing learned information.
8 Personalised and multi-modal learning
There is no typical pattern of impairment in FASD, and each child will have their own strengths and challenges. It’s important to personalise teaching and learning strategies for each student according to their individual 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 child with FASD, it’s important to engage and stimulate the student by accommodating their learning style. For example, children with FASD often excel at physical activity – playing a team sport at school can teach a child how to follow rules, co-operate with others, and build important social skills in a situation that they enjoy.
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 a child’s social and emotional skills, 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.
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.
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