Resulting from prenatal alcohol exposure, fetal alcohol spectrum disorder (FASD) is characterized by a range of cognitive, social, and adaptive impairments. Although the effects of FASD vary in range and severity, students with FASD often offer unique challenges and dilemmas to teachers and parents alike. These difficulties may include unusual learning and behavior patterns, requiring specialized assessment and individualized educational planning with a collaborative focus. Educators could benefit from advanced training in early intervention strategies for accommodating instruction to support students with FASD. Despite the fact that students with FASD usually do not outgrow the disorder, early diagnosis along with intensive and appropriate intervention can make an enormous difference in the child’s life.
Keywords: Fetal alcohol spectrum disorder, education, special education, learning disabilities
Fetal Alcohol Spectrum Disorder (FASD)
Fetal Alcohol Spectrum Disorder (FASD) is a life-long disorder caused by prenatal alcohol exposure. The umbrella term of FASD includes Fetal Alcohol Syndrome (FAS), partial Fetal Alcohol Syndrome (pFAS), Alcohol-Related Neurodevelopmental Disorder (ARND), and Neurobehavioral Disorder associated with Prenatal Alcohol Exposure (ND-PAE) (American Psychiatric Association, 2013; Chasnoff, Wells, Telford, Schmidt, & Messer, 2010; Chudley et al., 2005). FASD can include a wide range of cognitive (e.g., intelligence, executive control, short- and long-term memory, and attention), social (e.g., suggestibility, communication skills, and gullibility), and adaptive impairments (e.g., decision making and problem solving abilities) (Brown, Gudjonsson, & Connor, 2011; Kodituwakku, 2009; McGee & Riley, 2007; O’Connor & Paley, 2009; Rasmussen, 2005).
No universal set of FASD criteria fits all cases because the appearance and severity of these symptoms varies as a function of the time and dose of prenatal alcohol exposure. In addition to these symptoms, students with FASD often experience an array of comorbid behavioral (e.g., ADHD and conduct disorder), mood (i.e., major depression and bipolar disorder), anxiety, and substance use disorders (Brown, Connor, & Adler, 2012; Han et al., 2015; Petrenko, Tahir, Mahoney, & Chin, 2014; Stevens, Nash, Koren, & Rovet, 2013). This complex interplay of comorbid psychiatric symptoms makes screening and assessment difficult, which can increase the likelihood of missed diagnosis or misdiagnosis and contribute to negative long-term academic outcomes. To help combat these issues, the Diagnostic and Statistical Manual-5th Edition (APA, 2013) recently introduced Neurodevelopmental Disorder Associated with Prenatal Alcohol Exposure (ND-PAE) as a disorder for future study.
Because FASD impacts between 2 and 5% of the United States population, educators are likely to encounter this disorder in most classrooms (May et al., 2014). Students with FASD can exhibit a wide range of deficits in ability and adaptive and executive functioning, all of which contribute to a host of academic challenges (Swart, Hall, McKee, & Ford, 2014). Many of these students will require the supports and services of special education programming. Modified forms of special educational services that address the unique features of this disorder may warrant consideration. In light of the pervasive difficulties inherent in this population, it is critical for educators to identify educational interventions incorporating a continuum of supportive collaboration and evidence-based practices (Duquette, Stodel, Fullarton, & Hagglund, 2006; Olson, Oti, Gelo, & Beck, 2009; Streissguth, 1997). Empowering educators and school administrators to recognize and refer students to appropriate resources significantly increases the likelihood of positive outcomes for all students with FASD. Early intervention provides students with the best chance for long-term success (Clarren, Olson, Clarren, & Astley, 2000; Edmonds & Crichton, 2008).
Implications for Education Professionals
To maximize the possibility of educational success, instructional plans should be individualized in a developmentally appropriate manner that considers the symptoms and difficulties of FASD. Students with FASD may benefit from the utilization of functional approaches that emphasize the development of life-skills, self-advocacy, social skills, and behavioral regulation. School counseling services may be particularly helpful because the symptoms of FASD often predispose clients to higher rates of victimization and trauma than the general population. Given the range of expertise that such educational programming necessitates, professionals need to collaborate and partner with a network of medical, mental health, and social services professionals.
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