Last week I was lucky enough to be able to attend a conference on Fetal Alcohol Spectrum Disorder, organised by the Royal College of Paediatrics and Child Health Scotland, hosted at the beautiful Royal College of Physicians on Queen Street. Although I’d heard a bit about Fetal Alcohol Syndrome in the past, I am ashamed to say it was an area I knew very very little about. Below, I’m going to summarise briefly some of the key things I learned, make some suggestions for supporting affected children and young people, and tell you where you can find out more.
What I learned
I’m going to try and keep this snappy, with just a few key points, but you can find out more by following the links at the end of this post.
- Fetal Alcohol Spectrum Disorder is common, expensive and entirely preventable. Data from Canada estimates that as many of 1 in 100 births are affected by alcohol – and the Canadians drink less than us. It is thought that many children on the spectrum are misdiagnosed as having a different condition.
- Some mothers can drink heavily and have unaffected children, whereas others drink only once in their pregnancy and their children are severely affected. There are likely to be genetic factors at play, but these are currently unknown. In Scotland, the advice is to drink no alcohol at all during pregnancy for this reason – this is different to advice in England and other countries.
- Fetal Alcohol Spectrum Disorder is a continuum of permanent birth defects, caused by a mother drinking alcohol during her pregnancy. At the more extreme end, it includes Fetal Alcohol Syndrome with its associated physical characteristics, but many people on the spectrum have no physical characteristics at all.
- At the extreme end of the spectrum, Fetal Alcohol Syndrome expresses physically as the child being below average height and weight, often having a small head, and a distinct set of facial features, as seen below:
- People who have Fetal Alcohol Spectrum Disorder are “wired differently“. In the womb, we do not have the ability to metabolise alcohol in the same way as we do as an adult, so it therefore acts as a poison, and causes brain damage.
- Children with Fetal Alcohol Spectrum Disorder have a developmental age of about half of their chronological age. Often, processing takes one of the biggest hits but can be masked by good verbal skills (though this is not always the case, sometimes speech can be affected). Take a look at this video of a young man with Fetal Alcohol Spectrum Disorder who explains what living with the condition is like:
How we can support children and young people with Fetal Alcohol Spectrum Disorder Most teachers, particularly the lovely ones that read this blog, will be well-used to adapting their teaching to support a wide range of needs. So, I suspect a lot of what I say next below will be nothing new – I’m not intending to “teach my granny to suck eggs”, rather I hope you can use the suggestions below as a jumping-off point for your own ideas.
- Modifying the classroom environment – children and young people with Fetal Alcohol Spectrum disorder often have different sensory needs. They will need a place to “escape” to if it all gets a bit much, and can be overwhelmed by a lot of sensory input. Consider the placement of wall displays/other potentially distracting items. Sensory stimulus is also important – try messy play, using wobble cushions or chewlery etc.
- Communicate clearly – short-term memory is often affected, so a pupil may forget an instruction, which they seemed to take on board, very quickly. Support their understanding by repeating instructions, giving them time to process information, and having text and visual “back-ups” to verbal commands in the environment, e.g. learning outcomes on the board, visual timetables etc.
- Manage changes carefully – this can be exceptionally challenging for pupils as a preference for routine is common. Prepare them for unusual events by introducing the idea early. Consider using social stories.
- Teach social skills – children and young people with Fetal Alcohol Spectrum Disorder learn slowly, and have a delay in their developmental age. Therefore, we need to start teaching them the social skills they will need as a teenager when they are 7, 8, 9 etc.
- Support their organisation skills – understand that organisation can be a challenge for these pupils. Why not support them by using a digital workflow rather than lots of pieces of paper. Pupils can easily submit work online by a variety of means and have it marked and returned to them. Contact me for more details about this, and keep an eye on the CPD directory next year.
Find out more
You can view all the presentation slides from the conference.
You can also browse all the tweets from the conference.
NHS Education for Scotland have produced an e-learning resource on Fetal Alcohol Spectrum Disorder. It’s a pretty comprehensive resource, so you could pick and choose the parts most appropriate to you or your staff – or even use it as a stimulus for discussion with pupils.
Read Education Scotland’s CfE briefing on personalised learning.
The Wikipedia page on Fetal Alcohol Syndrome is worth a read, too.