Prevention of Fetal Alcohol Damage in Northern Native Communities:

1. Prevention of Fetal Alcohol Damage in Northern Native Communities: FASD in Lab Mice A Practical School-Based Approach

2. Presentation Outline • Speaker contact info & introductions • FASD and Alaska • Overview of an Innovative and Promising Approach to FASD Prevention Education in Rural Alaska: The “FASD in Lab Mice” Project • Types of Communities in which the FASD in Lab Mice Prevention Project was Implemented • Prevention of FASD: Facilitating the use of mice in the K-12 setting • Materials and Methods of the FASD in Lab Mice Prevention Project • Outline of the Approach - A Brief Description • Video clips showing techniques for picking up mice, intubation procedure, euthanasia, laparotomy and fetal removal • Reception and Response by Students, including Students with FASD • Reception and Response by Native Communities • Academic Outcomes • Other Outcomes • Lessons Learned • Conclusion • Questions and interactive discussion with the audience

3. Acknowledgements This project received support and guidance from: • SERRC • Alaska Science & Technology Foundation • Yukon Flats School District • Southwest Region School District • USA Today • University Alaska Fairbanks IACUC • Anchorage Council on FASD • Diane Malbin, Cheri Scott, & Michael Baldwin • Special thanks to the students, parents, and communities who participated.

4. Steven Jacquier stevenjacquier@gmail.com Northern Educational Consulting; Anchorage, AK David Gilliam David.Gilliam@unco.edu University of Northern Colorado, Greeley Judith Kleinfeld ffjsk@uaf.edu University of Alaska Fairbanks

5. Dr. Judith Kleinfeld • Director, Boys Project • Co-Director, Northern Studies Program • Fantastic Antone Succeeds and Fantastic Antone Grows Up • Rural education research in Alaska

6. Two excellent books on FASD In these two volumes Dr. Kleinfeld gathers together the experienced perspective and hard-won “wisdom of practice” contributed by parents, teachers, and other caregivers of children and youth with FASD as well as the perspective of children and youth with FASD themselves.

7. The Steven & Dave Show! • Steven (top) is a “scientific do-gooder” & teacher in Alaska’s public schools, with a background in international development work. • Dave (bottom) is an internationally known and respected laboratory researcher and university professor. • Guess which one of the two of us put this slideshow together?

8. Doing Battle with FASD in Alaska • Thanks to a teacher in Middle School giving me a copy of Call of the Wild to read…. • Dr. Kleinfeld’s “Teachers for Alaska” progam and her work on FASD • Seeing the problem of FASD firsthand and asking “How best to prevent FASD?” • Locating and enlisting Dr. Gilliam in the effort • Students moving it to a higher level of success via peer education

9. Please make sure you receive a draft copy of our article; this has the detailed numbers, statistics, & references for everything we are presenting today (plus other info which time precludes us presenting here). Watch this site for the article’s forthcoming publication in The Northern Review: www.yukoncollege.yk.ca

10. Romantic images and mythos of isolated far northern Alaska Native communities…

11. …Pragmatic realities of a typical rural Alaska Native village

13. Students commonly report that prior to their involvement with the FASD in Lab Mice project they had no idea whatsoever regarding these points:*The type of alcohol in all forms of booze is the same: ethanol, the causal agent of FASD.*The amount of ethanol in a beer is the same as in a glass of wine or shot glass of hard liquor (only the dilution factor with water and presence of congeners such as color and flavorings differs between the various beverages).*The strong solvent properties of ethanol in water allow this form of alcohol to pass throughout the body just as water does and everywhere that water does, and so to act upon and damage the central nervous system and virtually all other developing organs.*The surprisingly large caloric energy in the ethanol in one drink.*The teratogenic action is based on both dose consumed and developmental window of vulnerability (in other words, a person does not need to be an alcoholic in order to give birth to a baby damaged by FASD if the one exposure comes at just the wrong moment).*The outcomes of drinking during pregnancy can be clearly seen and measured by contrasting an ethanol-exposed treatment group against a normal control group, and these outcomes range from pervasively subtle yet profound to shockingly obvious damage.

14. ScienceDaily, 05MAR2009 • Students Benefit From Depth, Rather Than Breadth, In High School Science Courses • Study relates the amount of content covered on a particular topic to students’ performance in colege-level science classes. • 8,310 college students evaluated. • Reports that high school students who study fewer science topics, but study them in greater depth, have an advantage in college science classes over their peers who study more topics and spend less time on each. http://www.sciencedaily.com/releases/2009/03/090305131814.htm

15. Students as Junior Scientists • To really understand FASD, students need to genuinely deeply explore the issues over time in ways they find meaningful through their individual learning modalities. • Becoming researchers, in this approach students learn about the scientific method and design an experiment testing the effect of alcohol on the developing offspring.

16. One “manipulated variable”… • Students are guided to design an experiment where all conditions are held constant between two groups of pregnant mice except for the single manipulated variable of dosing with alcohol.

17. Prevention of FASD: Facilitating the use of mice in the K-12 setting • Careful preparation needed before a mouse ever arrives on site. • Involvement of stakeholders from traditional Tribal Council, community elders, and parents to school district administrators. • Incorporation of cultural and school needs into the program. • Experimental protocol approved by Institutional Animal Care & Use Committee of a cooperating institution (typically a regional university).

18. Aardvarks to Zebra fish… • Exposure to alcohol disrupts embryological development in organisms from sea urchins to humans. • Chicks and lab rats were two animal models considered for this project early on, but rejected. • The path led to David Gilliam at UNC and delightfully charismatic little black lab mice. • “B6” lab mice turned out to be ideal in almost every way for the purposes of this prevention approach. • Photo shows Control and Treatment pups from an animal model of FASD in beagles [Project Cork - Dartmouth]

19. The specific ideal subject • Not just any strain of mouse will serve for consistently demonstrating specific effects of alcohol exposure on growth and development. • From an elderly lady’s greenhouse in England to Bar Harbor, Maine, to Colorado, to rural Alaska …a well-traveled line of mice!

20. C57BL/6J strain (aka B6) mice from The Jackson Laboratory

21. Respect and Appreciation • Students held their lab mice in high regard, enjoyed working with them daily, respected them as lab subjects, and deeply appreciated the learning gained thanks to the lab mice.

22. What this approach is not…and should never be: • A scare tactic regarding alcohol and pregnancy • Sensationalized, exaggerated, or distorted claims • …rather, this approach cultivates a careful, methodical, thorough examination of data revealing clear cause and effect relationships and processes involved.

23. Materials and Methods of the FASD in Lab Mice Prevention Project • Mice, mouse cages, bedding, mouse chow, tools, electronic balances, ethanol (and secure storage), texts …set-up can be accomplished for a couple/few thousand dollars, depending on class size. • The time and labor involved is significant and not to be underestimated; real commitment is needed to undertake this prevention strategy and see it through properly and successfully.

24. “Textbooks” • Madaras’ “What’s Happening to My Body?” books for girls and boys, respectively, are high-interest material. • The texts were always available for parent review and locally approved beforehand for use at a site. • Many students found these texts so useful and interesting they bought and kept their copies permanently. • A wide diversity of supplemental materials were also used.

30. Video clips showing techniques for: • Controlling the mouse • Getting the (intubation) needle ready • The gavage technique • Caesarian section

31. Careful measurement and close observation were emphasized throughout. Students found their comparisons of Control and Treatment group outcomes to be compelling evidence.

32. Older student practicing intubation technique with deceased mouse as younger students observe. Only after a student demonstrated 100% proficiency with intubation on dead mice would s/he be allowed to advance to performing intubations with live mice.

34. Mice are humanely sacrificed via cervical dislocation; the process is instant and painless.

40. Students are highly effective in holding the interest of peers, younger students, and community members alike when they present the same material which causes glazed eyes and yawns if the local teacher is talking.

41. Kinesthetic Activities for Teaching Every Concept • Molecular Structure---Model Building • Solvent Properties of ETOH---Price Tag Sticker Removal with ETOH v. Water • Solvent Properties of ETOH---Sharpie Marker Bleed with ETOH v Salty Water • Equivalents---Bottles, Cans, Shot Glasses & Food Coloring in Water • Energy in ETOH---Flaming Pan Demo • Comparative Anatomy---Dissections • Cell Types & Organ Physiology---Microscopy and Scientific Drawing • Data Analysis---Graphic Displays and Models • …and, of course, those perennial favorites: skits, raps, songs, & games

43. Student demonstrating the energy bound in the ethanol of just one beer, glass of wine, or shot of liquor.

44. Relevant Homework • Homework which is meaningful and practical to the lives of the students reinforces and advances learning. • 3x5 cards: anonymous questions. • Your homework: go to www.parade.com read the article “Eat It or Avoid it?” by Joy Bauer, and e-mail a note to Parade.

45. Subsequent to their project participation boys reported strong feelings regarding the role of fathers in supporting mothers through a healthy FASD-free pregnancy

46. Reception and Response by Students, including Students with FASD • Tremendously positive. • Understanding themselves not as being “bad,” “evil,” “stupid,” “dumb,” “weird” or any other such pejorative but rather as people experiencing a brain injury was tremendously liberating for these students. Classmates understood other students in a more sophisticated way allowing them to interpret problems as rooted in FASD rather than as willful misconduct. This was the case for parents as well.

47. Reception and Response by Native CommunitiesOver course of ten years the FASD in Lab Mice prevention education project was piloted throughout the school year in six Native villages located in two culturally different regions of Alaska. The project was warmly welcomed everywhere it was offered. Students and communities were so excited about the project they wanted not only to give presentations to other students and elders in their own communities, but also to communicate what they had found to other Native communities as well. Students prepared posters and presentations, passed out test tubes showing defects in mouse pups, did slideshows and high-interest demonstrations. The project was demonstrated in this manner in an additional thirteen Native villages located in four different regions of Alaska, as well as at a number of statewide conferences, and to the state legislature.David Gilliam has achieved significant success in using this approach with Advanced Placement high school students in Colorado.

48. Academic OutcomesStudents not only learn about the effects of alcohol on outcomes of pregnancy via this prevention education approach, but also increase their mastery of significant content knowledge and skills in reading, writing, mathematics, social studies, economics, and science more broadly.Students prepare written products such as reports and posters incorporating the numerical summaries of their data along with descriptions of the process, outcomes, and their conclusions. Virtually all students showed greater gains on standardized tests (boys as well as girls) than comparable peers in neighboring classrooms of the same schools and peers in villages located within the same school district but where the approach was not being used. Students also developed practical job skills and effective work habits: team planning, cooperative group effort in daily tasks, data collection and processing, report presentation, and public speaking. The project was enthusiastically embraced and the occasion of much thoughtful reflection among girls yet especially appealed to boys.

49. Other OutcomesPractical job skillsGains in self-esteemExpansion of cultural awareness and reinforcement of traditional heritageAwards and recognitions near and far alike (science fairs, newspapers, radio, TV, books, Alaska state legislature)Scholarships, internships, and college acceptancesMore positive valuation of educationRecognition of responsibility of males as partners and parentsInterventions in situations high FASD-outcome risk with peersPositive changes in not only knowledge and attitudes but also beliefs and behaviors.

50. Decisionville The FASD in Lab Mice project was incorporated as an interactive module within a CD-ROM computer game produced for the State of Alaska, available from RurAL-Cap