¶ … Fetal Alcohol Syndrome Special Education

About the Child

Pietro is a 7-year-old boy. His biological parents are Argentine and Colombian. He was born approximately six weeks prematurely because of his mother's consumption of alcohol throughout the duration of her pregnancy. According to medical reports, his mother did not consume heavy quantities of alcohol, but she did consume nominal amounts on a regular basis, such as one to three times a week, nearly every week. Pietro's parents put him up for adoption when he was approximately 1-year-old. He was brought to a Catholic orphanage outside of Buenos Aires. There were visiting child development specialists from the United Kingdom and the United States performing work at the charity, and it is under their care where Pietro was first formally diagnosed with FAS. Pietro was subsequently adopted by a Puerto Rican and Argentine family residing in New York City, NY. His adoptive family consists of a mother, father, and older sister, Tamara, who is 11 years old. The whole family lives together in the same home. Both of the parents work, but because of the nature of their professions, they are able to work from home on a part time basis as well as work in the field on a part time basis. Tamara attends a normative middle school. The family also has a network of immediate family, extended family, neighbors, colleagues, and friends.

Compared to other children his age, Pietro does not have as much language or social skills as his peers. Activities that require many steps or an extended procedure upset Pietro. He may cry, throw objects, or hide inside or underneath objects to cry or be quiet. Sometimes he will stop talking, go limp, and become extremely unresponsive. He expresses desire for friends verbally to his teachers, specialists, and family, but often works and plays alone. Pietro can talk, but has limited vocabulary. He occasionally repeats himself and may use the same word to substitute for other words that do not have the same meaning. His handwriting is not as clear as his normative peers, but he enjoys drawing and shows some skill in the arts. Pietro often requires one on one attention or assistance from his teachers and other support staff. Most of his sessions with his specialists/therapists are one on one. He does have both individual and group counseling with his social worker during school hours.

Pietro remembers living in South America, but only vaguely. He knows he was not born in the United States and he understands the difference between his biological family and his adoptive family. Because of this awareness, Pietro demonstrates keen interest in geography. His favorite subject in school is Social Studies. His experience and interests also explain his desire for friends. He wants to socialize with children his age. He plays with his sister at home and occasionally is able to play with her while she has a friend(s) over for a playdate. Pietro learns much of how to be a friend and how to be a kid from Tamara. Pietro demonstrates interest and skill in other school subjects. Compared to his normative peers, he processes information more slowly and needs additional prompting for information retention. When there are pictures to accompany the text, or if Pietro is allowed to illustrate instructional content, he is much more likely to recall the content.

Pietro sees a physical therapist, occupational therapist, speech pathologist and social worker as prescribed in his IEP. He is physically smaller and less physically developed than his normative counterparts. Over the course of the school year, Pietro has improved in terms of grip (holding objects including writing instruments), muscle endurance (he helps carry and pass out lunches to other students during lunch time), and finer dexterity (as evidence by his improvement in the arts and his ability to play his PSP).

Pietro learns best with a combination of styles. He is a visual, kinesthetic, and experiential learning. Auditory is minimally to moderately effective alone for Pietro. In conjunction with a visual aid or physical activity, his retention and learning increase. Pietro is moderately adaptable. When changes to his routine are introduced to him in advance by people that he likes or trusts, the transition is more smooth for him. He needs constant reminders and sometimes his teachers & specialists use a special calendar for Pietro to help him remember. He constructed the calendar with the help of his sister and parents. There are stickers and pictures that he can place on the calendar as visual reminders of an upcoming change in his life. The calendar stimulates his creative interests/abilities as well as promotes development in executive functioning.

They stay in regular contact with Pietro's teachers and therapists. They schedule regular appointments with health care professionals such as physicians, dentists, optometrists, as well as submit Pietro for bi-annual psychological evaluations. It is clear he lives in a loving home. His parents are occasionally frustrated by Pietro's mental limitations that cause him to have social problems because he is a very friendly and loving boy that has difficulty maintaining friendships. This is an issue they work on in school, in therapy, and at home. His parents are also a part of actual and virtual support groups for parents with children with FAS. As Pietro approaches turning 8 years old, his parents, therapists, and teacher hope to improve his memory, his speech, and his socialization.
Lesson Plan for Pietro -- Social Studies

Objective -- provide instruction about the Americas; students will be able to identify at least 3 different countries throughout the Americas on a map; students will categorize facts about a country; students will share something they learned or something that attracts them to a particular country in the Americas.

Materials -- atlases, large world map, pictures of countries on printer sized paper; pencils, crayons, colored pencils, markers, blank paper; computer and Internet

Procedure -- Provide a brief introduction to the lesson about the geography of the Americas. Show a short documentary found online about the Americas, shown with English subtitles. After the film, verbally recapitulated the film. Ask students basic recall questions to demonstrate information retention and to share opinions. Students are already sitting in groups of 2-4 students. Assign a teacher or assistant teacher to each group of students as they perform the exercise. Allow for independent work, but also encourage interdependence when one child is excelling or behind the rest of the group. Before presenting to the class, students will practice sharing their work to each other in their small groups. Class will come back together when most students are done or close to completion. Teacher will call on just a few students to share with the class.

About the Disease

Fetal Alcohol Syndrome (FAS) refers to the range of growth, mental, physical, and other problems that manifest in infants when a mother consumes alcohol during any point during her pregnancy. There are distinct patterns of mental and physical defects that developed in the fetuses with higher levels of alcohol consumption (of the mother) during gestation. Though in some countries such as the United States of America, there exist health care professionals that advise women that a minimal amount of alcohol such as wine is permissible during certain stages of pregnancy, bodies such as the Surgeon General of the U.S.A., the U.S. National Library of Medicine, the Mayo Clinic, and the Centers for Disease Control and Prevention (CDC), wholly recommend that pregnant women should not consume any amount of alcohol during any point of her pregnancy. FAS is a 100% preventable disease and does not occur in women who refrain from alcohol consumption.

Everything that a mother consumes passes along to her fetus through the placenta, including alcohol. FAS can result in stunted fetal development and lower birth weight. Children with FAS have essentially suffered brain damage while in utero. Their damaged neurons and other brain injuries have a range of results including psychological instability, behavior problems, facial disfigurations, and other forms of physical deterioration.

Concern over the deleterious effects of alcohol on the developing fetus can be traced back to the time of Aristotle, who observed that drunken women often bore children who were feebleminded (Warner & Rosett, 1975). Although this observation has been rediscovered several times hence, most notably during England's gin epidemic of the 18th century (Warner & Rosett, 1975), it was not until the early 1970s that the relationship between prenatal exposure to alcohol and birth defects drew serious scientific and medical attention. (Abel, FAS, 1980

Just as in adults who consume alcohol, FAS affects the central nervous system of the fetus. A critical difference, which may be obvious but nonetheless important, is that the difference between the damage alcohol produces on the nervous system of an adult and a fetus is that the likelihood of permanent damage increases exponentially and the damage is done is far less time for the fetus. Brain damage in the fetus affects aspects of cognitive functioning such as memory, attention, impulse control, and a…