“Secondary Disabilities” / Behaviours

1. “Secondary Disabilities” / Behaviours • The feelings / behaviours that develop over time when the primary disabilities are not supported (Streissguth, 1996)but….might be other manifestations of the primary brain alterations (Clarren, 2009)

2. FASD Faith Ability Strength Determination Myles Himmelreich

3. FAS: Facial Features http://depts.washington.edu/fasdpn/htmls/fas-face.htm

4. “Tip of the Iceberg”

5. FASD: Diagnostic categories Fetal Alcohol Syndrome (“Tip of the Iceberg”) Alcohol-Related Neurodevelopmental Disorder (ARND) Partial Fetal Alcohol Syndrome (pFAS) *Static Encephalopathy

6. Photo from C. Shurtleff Children’s Hospital and Medical Center Seattle, Washington

7. Photo from C. Shurtleff Children’s Hospital and Medical Center Seattle, Washington

8. Brain Activity slide A fMRI study comparing the amount of activity required by the brain to complete a task (example: using working memory). a- alcohol affected b - neurotypical www.nrc-cnrc.gc.ca/eng/ projects/ibd/functional2.html a b

9. Executive Functioning A set of abilities required to attain goals efficiently in nonroutine situations. Kodituwakku

10. Putting It All Together Bill Standeven, MOE, 2009

11. SOA LEIC (Top)

12. SOA Dragon Man Wheel

13. Diagnosis Designation Medical diagnosis of an FASD does not equal Ministry of Education designation as “special needs” ??? What is the severity of the impact of the medical condition on the student’s learning and behaviour???

14. Other Research on Mental Health and Prenatal Alcohol Exposure Astley, 2010; O’Conner, 2009*

15. LEIC Planning Tool Guide • LEIC Planning Tool Guide • Page 1: Sample LEIC Form • Pages 2 - 3: Guiding Questions • Page 4: “Age-Appropriate” (Dysmaturity) Examples • Pages 5 - 6: Examples of Disabilities and Expectations (Dysmaturity/Uneven Maturation) • Pages 7 - 9: Examples of Strategies • Page 10: Instructions for Group Activity • For sample of completed LEIC form, see powerpoint package

16. LEIC Planning Tool - group work • Create a pseudonym for the student - put in day, month and year of birth • Put your email addresses on the form* • Use your guided questions in the LEIC Planning Tool Guide (pages 2 - 3) - complete the top 1/3 of the LEIC Planning Tool (15 min) - complete middle 1/3 of the LEIC Planning Tool (15 min) - choose only two possible primary disabilities - start with #1: “possible primary disabilities” and then #2… then #3 - complete bottom 1/3 of the LEIC Planning Tool (20 min) * We collect and email back to you!*

17. Multi-disciplinary Assessment • Provincial Health Assessment Network • Vancouver Coastal Health Authority • Complex Developmental Behavioural Conditions (CDBC) • FASD, ASD and CCY • Other multi-disciplinary assessment processes (see MOE guidelines)

18. Strategies: Environments • Sensory needs? Hyper or hypo?* • “Fidget” items (if tactile seeking) • Control sensory input (ie lighting, noise etc) • Use calming music or “white” noise • Allow headphones • *Consult with OT!

19. Strategies: Environments • Visual supports • Safe, quiet place • Tennis balls on chair/legs • Designated display areas • Colour code items • SUPER vision

20. Strategies: Environments • Visual schedules • Clutter free • Preferential seating • Organize and label shelves, bins, etc

21. Strategies: Language/Communication • Be consistent - try to repeat using same words but make sure student knows vocab! (may have to change words or paraphrase) • Get to the point - drop all extra words (e.g. “Book, pencil, to the carpet”) • Think about words in a telegram (value per word) • Say specifically what you want done (eg. instead of “No running” say “Walking, please”) • Do not ask “why”

22. Strategies: Language/Communication • Show what you want • Talk about the here and now • Use “now” • Give directions in order (avoid “before/after”) • “Show me” NOT “Tell me” • Avoid negative negotiation

23. Strategies: Language/Communication • Use visual cues: gestures, pictures, actions, etc • Silence is golden • Speak slowly and pause frequently • Ask simple, direct questions - less is best • Ask “yes”/“no” questions or give two choices

24. Strategies: Language/Communication • Give directions one step at a time • Start with the individual’s name • Use names - avoid pronouns • Concrete - no idioms • Positive phrasing • Allow more time

25. Key Worker/Parent Support Resources • Key Worker and Parent Support: • insert name, agency and contact information • MCFD website: www.mcf.gov.bc.ca/fasd • POPFASD website: www.fasdoutreach.ca

26. Resources • Human: • District Partner • Key Worker • Community • Other Resources: • Handout Package • Website: www.fasdoutreach.ca

27. Individual Education Plans IEP eLearning modules http://www.fasdoutreach.ca/elearning/developing-iep IEP’s for Students with Special Needs http://www.bced.gov.bc.ca/specialed/iepssn.htm Parent’s Guide to IEP’s http://www.bcssa.org/resources.html#specialed • Ministry of Education - Special Services… http://www.bced.gov.bc.ca/specialed/ppandg.htm

28. Attachment Early stressors Culture Nutrition Living situation Transitions Religious/Spiritual Medications Dislocation Peer supports/ mentors Family relations Wellness/Mental Health Complex trauma Financial situation Current community/world events “Time of month” Weather Other …

29. Adaptation Learning Attention Reasoning Memory Motor Executive Function Regulation of State Speech/Language Sleep + • Brain anomalies • Neurological signs ALARMMERSS+ From: Conry, Fast and Others

30. Thank you POPFASD Office 250-564-6574 www.fasdoutreach.ca Have Team Will Travel

31. More New Slides • See “Generic Full Day” for: • Updates on MOE • Updates on POPFASD • Updates on Resources • Case Study: Tony