Teaching Students with Developmental Disabilities: Tips from Teens and Young Adults with Fetal Alcohol Spectrum Disorder
Duquette, Cheryll, Stodel, Emma, Fullarton, Stephanie, Hagglund, Karras, Teaching Exceptional Children
Most teachers have-or at some point will have-a student or students with Fetal Alcohol Spectrum Disorder (FASD) in their classroom. Yet because affected students may or may not possess the facial abnormalities that are characteristics of the disorder, their condition is sometimes "hidden." In other instances it is misdiagnosed. How can you identify students with FASD? And once identified, how can you best address their educational needs?
Fetal Alcohol Spectrum Disorder is a term that encompasses the various neurodevelopmental disorders experienced by individuals with prenatal alcohol exposure. FASD incorporates the terms Fetal Alcohol Syndrome (FAS), Fetal Alcohol Effects (FAE), and Alcohol-Related Neurodevelopmental Disorder (ARND). A diagnosis of FAS is made when an individual has a diminutive stature, small head circumference, the characteristic facial features (i.e., small eye slits, short nose, long and flat philtrum, thin upper lip, and flat mid-face), as well as central nervous system abnormalities (Stratton, Howe, & Battaglia, 1996). FAE and ARND are diagnostic terms used when an individual demonstrates neurodevelopmental disorders but not the facial abnormalities, the absence of which makes the condition a "hidden" disability. Of note is that the brain damage may be equally severe for all three diagnoses, regardless of the presence of physical and facial characteristics.
Although FASD may be the primary disability, secondary disabilities, such as depression, homelessness, trouble with the law, unwanted pregnancies, difficulties keeping a job, addiction problems, and suicide ideation, often develop during adolescence (Streissguth, 1997). FAS rates range from 0.2 to 1.5 cases per 1,000 live births in different areas of the United States, and other prenatal alcohol-related conditions, such as ARND, are believed to occur three times as often as FAS (Centers for Disease Control and Prevention, 2003). A recent report estimated that the lifetime cost in 2002 for one individual with FASD is $2 million (Centers for Disease Control and Prevention).
Characteristics of Students With FASD
Students with FASD have difficulties with impulsivity and executive functions (e.g., attention, planning, organizing, self-regulation, and self-monitoring) and are often first diagnosed with attention deficit/hyperactivity disorder (ADHD); (Streissguth, 1997). These students' processing and memory difficulties may result in a diagnosis of learning disabilities. Table 1 summarizes common learning and behavior characteristics exhibited by students with FASD (Goldschmidt, Richardson, Stoffer, Geva, & Day, 1996; Kerns, Don, Mateer, & Streissguth, 1997; Mattson & Riley, 1998; Streissguth, Aase, Clarren, Randels, LaDue, & Smith, 1991; Streissguth, Barr, Kogan, & Bookstein, 1996).
Although individuals with FASD share many of the characteristics shown by those with ADHD and learning disabilities (LD), the differentiating traits are an inability to generalize from one situation to another; being overwhelmed in stimulating environments; difficulties predicting outcomes and learning from consequences; problems with mathematics, time, and money; and an inability to retain information.
FASD is the leading cause of intellectual disabilities (Abel & Sokol, 1987); however most individuals with FASD have IQs in the normal range (Kerns et al., 1997; Streissguth, 1997). Many of them also have good verbal abilities that tend to mask their deficiencies and give others the impression that they do not have a disability. Moreover, most of these students are educated in general education classrooms as either full-time or part-time placements. Hence, given the range of learning and behavioral problems associated with FASD and the potential for teachers to misunderstand the nature of FASD, it is not surprising that many students are met with a lack of empathy and are denied accommodations; these responses, in turn, often lead to frustration and thoughts of dropping out of school. …