The Impact of Fetal Alcohol Syndrome on Students - Essay Example

Abstract Although it is possible for a child to be born with an impairment due to a variety of reasons, the problems that can be presented as a result of a child being afflicted with Fetal Alcohol Syndrome, or FAS, are entirely preventable. Any caring mother should not consume alcohol during her pregnancy, because the likely punishment that may be endured by her child is far too harsh for a fleeting pleasure. Children afflicted with FAS suffer from learning difficulties as a result of damage to their central nervous system, in addition to suffering from physical defects as a result of damage due to alcohol consumed by their mothers prior to birth. However, it is possible to try to do more to better educate such children in an inclusive setting. This brief essay presents a discussion about FAS, its impact on students afflicted with this preventable condition and what can be done to improve the teaching of a language, such as English, to these children. Contents Introduction 1 The Effects of Foetal Alcohol Syndrome on School Age Children and their Behaviour 2 Effective Language Teaching and Inclusion for Children with FAS 11 Conclusion 14 Bibliography/ References 16 List of Figures Figure 1: A Child with Fetal Alcohol Syndrome 7 List of Tables Table 1: Principles, Methods and Materials used in an Intervention Program for Improving Language in Children with FSA 10 Table 2: Transactional Strategies for Practice and Coaching Instruction 13 Introduction Alcohol and tobacco are the most commonly used drugs in many nations. The use of alcohol is often a socially accepted practice that is culturally well accepted. However, the use of alcohol has been associated with a range of social, physical and psychological factors that have an adverse impact on those who consume alcohol and their families. Fetal Alcohol Syndrome (FAS) is associated with heavy alcohol consumption by mothers during pregnancy and this alcohol consumption damages the child. Physical malformations in Children with FAS include short eye openings, flattened middle face, thin upper lip and a small jaw as well as a flat nasal bridge and minor ear anomalies (Block, 2000, pp. 20 – 30) and (Kodituwakku, 2007, pp. 193 – 199). In addition to the indications of growth retardation, evidence of central nervous system abnormalities and heart and skeletal defects has also been noticed in children who have been exposed to alcohol prior to birth. Pre – school children with FAS exhibited verbal, perceptual and fine or gross motor deficits as well as intellectual deficits. These children are hyperactive, distractive, impulsive and unresponsive to verbal caution as well as being fond of receiving a lot of attention. Physical and mental damage is likely to be more severe with higher levels of alcohol consumption and pregnant women in the United States are advised to abstain from alcohol, while those in the United Kingdom are often told not to consume more than one drink a day (Room, 2005, pp. 1999). However, the worldwide incidence of FAS has been estimated to be in the range of about 2 per thousand births (Itthagarun, 2007, pp. e20). Although children with FAS have a handicap as compared to normal children, they have to be taught as best as possible to live in the real world with others. Thus, inclusive education is likely to offer the best available alternative for all those who have to live together to function together and to better understand each other, unless severe disability in a child makes this impossible. However, those who have to contribute towards providing an inclusive education must understand a child’s limitations as a result of FAS and what can be done to improve inclusion for everyone. This brief essay presents a discussion of the impact of FAS on a child that is afflicted with this condition and what can be done to improve the inclusive school and class room environment as well as the teaching of a language, such as the English language, for such children. The Effects of Foetal Alcohol Syndrome on School Age Children and their Behaviour School age children with FAS present attention, memory, language, learning and motor deficit with impaired global functioning (Kodituwakku, 2007, pp. 193 – 199). Such children often present a behavioural phenotype, which refers to a characteristic pattern of motor, cognitive, linguistic and social observations that can be consistently associated with their FAS disorder. Attention and speed of information processing is poor and FAS children have poor executive skills, or a lack of ability to indulge in conscious goal oriented skills. Thus, FAS children have problems holding goals in working memory and a lack of ability to inhibit goal-irrelevant responses. A deficiency in verbal and non-verbal has been noticed and it is difficult for such children to alter behaviour in response to reinforcement. Language deficiencies that have been noticed include deficiencies in naming, word comprehension and in grammatical and semantic abilities. Thus, an impaired language processing ability presents itself in such children. Visual perceptual tasks that demand an integration of information is also deficient in such children. Ability in mathematics and number processing is poor as compared to normal children, with damaged learning and memory ability as a result of damage to the hippocampus region of the brain. Damage to the vibrissal somatosensory cortical barrel network of the brain makes it difficult for FAS children to indulge in complex movements (Powrozek, 2005, pp. 135 – 136). Although FAS and Dyslexia are different, children with these afflictions have a similar response to eye blink conditioning which measures the response of the child’s eye to external stimulus, including puffs of air to the coronae (Coffin, 2005, pp. 389 – 391). This suggests damage to identical regions of the brain apart from additional damage to other regions. Methods have been devised to gauge the severity of the syndrome, but these require specialist medical investigations (Calhoun, 2007, pp. 169 – 170). Long waiting lists currently exist at specialist clinics in Western countries to diagnose if a child has FAS (Mitten, 2003, pp. 37). FAS children are likely to be distractible, restless and lack persistence in class with poor social and adaptive skills as well as poor emotional functioning leading to mood disorder (Kodituwakku, 2007, pp. 197 – 199). Negative life outcomes are possible, with psychiatric illness and legal problems and although FAS children can adjust to daily routine, they find it difficult to adjust to complex social demands and change. It was noted in a study in the United States that over 90 % of children over 6 years of age with FAS experienced mental health problems and 60 % of those over twelve years were either expelled or voluntarily dropped out from school (Mitten, 2003, pp. 40). About 60 % of children with FAS over twelve years old were convicted of a crime and about 50 % were institutionalised in in-patient programs. A substantial percentage of children with FAS had problems with alcohol, drugs or inappropriate sexual behaviour. However, these problems can be the result of a lack of awareness and understanding about FAS and how to deal with children with FAS. It has been observed that living in a stable and nurturing home, being diagnosed with FAS and receiving assistance, not having frequent moves and not being a victim of violence helps children with FAS. Lifelong support and interventions have been recommended for those who have been afflicted by FAS and these include sheltered living, job training, ongoing employment supervision, help with money and life management and presentation of positive role models. Thus, it is clear that those who have a handicap through no fault of their own can be helped to live more normally in a caring society. The next section presents a discussion about what can be done to make a school and a classroom more inclusive for children with FAS and how they can be better assisted to learn a language, such as the English language. Effective Language Teaching and Inclusion for Children with FAS Inclusion requires that the needs of a child with disabilities be addressed within the classroom and the school (Kalberg, 2007, pp. 278 – 284). Educators and parents must understand that inclusion is a matter of decency and that children with disabilities are after all only children who have to be taught to become independent adults so that they can live out their lives that were presented to them in the best possible way. Studies have suggested that those children with disabilities who were taught in inclusive environments were better able to function independently (Willis, 2007, pp. 15 – 17). Children with FAS often come to the attention of teachers and the school administrators because they present abnormal learning and behavioural outcomes and not because they have been diagnosed as having FAS or other cognitive disabilities. Thus, it is appropriate to try to establish a learning profile for such a child by determining their IQ measure, achievement measure and adaptive measure, something that is often done in most schools. However, it is also possible to decide about a child’s attention, verbal learning and recall, verbal memory, auditory memory, spatial memory, auditory processing and verbal processing abilities by presenting them to specialists for testing if possible. The previously mentioned tests are likely to indicate to a teacher and the school what special needs a child has and how these needs may be fulfilled. It has to be understood that only about 50% of children with FAS can be described as being mentally retarded and a vast majority of such children have intelligence levels that are within the normal intelligence rang, making them ineligible for any special programs. However, although medical models do assist, these medical models must be supplemented with teacher observations that are directed towards the teacher getting to know a child that is in their care (Reid, 2005, pp. 23 – 28). It is important that a teacher try to understand what interests a child, or the child’s emotional motivation, the child’s persistence for various tasks, their willingness to assume responsibility for their learning, the child’s structure or organization of the child’s life and if the child reacts positively to the imposition of organizational structure. Also important is to determine how a child reacts to feedback and their metacognition or ability to assess themselves internally. Figure 1: A Child with Fetal Alcohol Syndrome (Itthagarun, 2007, pp.e20 – e23) A child’s social interactions, its ability to communicate and the child’s cognitive modality preferences including the type of instructions that the child likes, impulsiveness or reflective personality and sequential or simultaneous learning etc are also important. Physical mobility, times for alert periods and nutritional as well as environmental needs should also be noticed. A child’s skills, attention, independence, social interactions, functional language, behaviour and strengths and interests are important in devising an inclusive teaching strategy (Kalberg, 2007, pp. 282 – 285). An inclusive education teacher is expected to assist a child to learn by devising ways in which learning can be more attractive and fun for the child so that the child responds with interest and attention (Wills, 2007, pp. 62 – 108). As an example, children with attention disorders often learn mathematics better when they are listening to soft or classical music and depending on the type of cognitive limitation a child has, they are more likely to respond better to visual projection, surprises or reading interesting books such as the classics of the English language including Moby Dick, Treasure Island and The Three Musketeers etc. Getting the children involved, playing games, physical activity in the classroom, surprise and novelty in presentation, visualization and trying to get other students to help with teaching can make a difference. Teaching is much more than just recitation of prescribed texts, it is about making others understand and it is also about caring. This means that sincere and honest efforts are required by teachers and teachers are also required to notice if a child is receiving the right nutrition. If a teacher is to get to know their pupils well then looping or the practice of letting a class stay with a single teacher for extended periods, such as two years, can be effective in the junior years. Technology can make a difference because of the interest that it generates and the ability to provide interaction. Rehearsal training can assist children with FSA because such children have a poor working memory and rehearsal can refresh the decaying store of short – term working memory (Looms, 2008, pp. 114 – 115). Children who are about 7 years old are most suited to rehearsal training and it is likely that as children grow older their ability to memorize will improve. Inclusive schools should have other support staff, such as school psychologists who can move between classes to observe, meet with teachers and children and provide suggestions or improvements. A detailed discussion about teaching English to dyslexic children has been presented in (Reid, 2005, pp. 30 – 60). Although dyslexia is a different disability from FSA, it has to be understood that the nature of cognitive deficiency and damage in the two conditions is somewhat similar. This means that it is possible to try to apply a number of ideas presented in the previously mentioned book to children with FSA. A description of interventions that were tried for teaching English to children with FSA in South Africa have been described in (Adnams, 2007, pp. 405 – 413). A number of literacy components with varying principles of teaching, as presented below, were tried for one hour a week on FSA children and a noticeable improvement in the language outcomes was observed. Table 1: Principles, Methods and Materials used in an Intervention Program for Improving Language in Children with FSA (Adnams, 2007, pp. 408) The use of tape recorded stories, preferably the more interesting ones such as the classics, the use of rhythm techniques such as clapping to attract and to maintain attention, the use of art and illustrations and the use of electronic spell checkers have been mentioned in a set of recommendations prepared by British Columbia Ministry of Education for teaching children with FSA (British Columbia, 1996, “Language Development”). Practice and coaching type of teaching can assist in the teaching of the English language to children with FAS and this technique is summarized in the table below. The book (Klingner, 2007, Chapters 2, 3 and 4) presents a comprehensive discussion about teaching reading and comprehension, which are essential elements of English, to students with disabilities and it is possible to develop insights about teaching from this resource. Enhancing word recognition skills, the use of textbooks on tape, the use of high interest and low vocabulary books, the use of cloze tasks for the development of syntax, the use of tape recorders and the use of typed handouts when copying from the blackboard is difficult have been mentioned as being useful (Siegel, 2003, Chapter 18). Table 2: Transactional Strategies for Practice and Coaching Instruction (Klingner, 2007, pp 140) From what has been presented, it is clear that a caring, dedicated and learned teacher can improve the chances of lifelong success for a child with FAS even in an inclusive environment. It has to be understood that the disabled child is not at fault because of their disability and it is the society and the individual who are tested as a result of a child’s disability. Conclusion Prevention is always better than cure and any pregnant mother should properly consider what is likely to happen to her child if alcohol was to be consumed during pregnancy. Clearly, the punishment that can be inflicted on a child for a passing pleasure is far too harsh and this means that every effort should be made to cease alcohol consumption during pregnancy. However, a caring and knowledgeable community can make a difference to a child with a disability and thankfully the incidence of FAS is relatively low, but preventable. Bibliography/ References 1. Adnams, C. M., Sorour, P., Kalberg, W. O., Kodituwakku, P., Perold, M. D., Kotze, A. et al. (2007). Language and literacy outcomes from a pilot intervention study for children with fetal alcohol spectrum disorders in South Africa. 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Wills, Judy. (2007). Brain Friendly Strategies for the Inclusion Classroom. Association for Supervision and Curriculum Development, USA. Read More