12 Aug

Fetal Alcohol Spectrum Disorder is a condition that has been recorded as ‘the most prevalent of all birth defects in the USA, out numbering all other pupils with Special Educational Needs’ and yet in the UK the impact on education is little understood and at the time of writing very few people working in education know of its existence. Figures for the UK suggest that it is much more common than Autism and ADHD combined. With many pupils and students its affects are significant barriers to learning.

As an experienced and senior teacher, I had no knowledge of the condition until about 2008 when we had fostered a family for 4 or 5 years. We then became the girls Guardians and they left the care system, however the damage caused by alcohol exposure in the womb continued to have significant effects and still does.

In the journey that we have all been on since the girls first moved in with us what has become increasingly clear is that a number of the students that I taught or was responsible for were likely to have been affected and it had a disproportionate effect on the learning environment that I was able to create. My wife worked in residential social care and it also became apparent to her that large numbers of the young people she was working with also might have been affected, but no one knew.

Had I known more about FASD when I was in the classroom then I like to think that I would have been able to help those who I now think were affected to achieve more than they did.

This is to help you to understand a little about FASD in order to be better able to answer any questions that your students have.

One of your own questions may well be ‘How can I better provide a learning environment that allows affected students to achieve more?’ The National Organisation for FASD has produced a guide for teaching those affected which may be of professional interest http://www.nofas-uk.org/TeachingAStudentWithFASD_FIN%20REV.pdf and will give you some initial pointers to developing a classroom and practice that better supports those affected. A national training programme is also being developed to support professionals working with those affected and more details can be obtained by emailing outreach@seashelltrust.org.uk

The impact of FASD is caused by the effect alcohol has on the growing foetus while in the womb. Because of its poisonous nature alcohol can affect any and everything that is developing in the womb. That is the physical structure of the baby as well as the way the brain physically develops and makes neurological links.

Regrettably, the placenta does not stop any of the alcohol that is in the woman’s blood stream passing to the foetus. Even more regrettably the level of alcohol in the fetal blood stream can remain significantly higher than in the mother’s blood for longer. The foetus does not have an operational liver and relies on the mother’s liver to process the alcohol. Therefore, clearing the fetal blood replies on the transmission of blood back across the placenta and this is a gradual process.

The real challenge for everyone in education is that every presentation is different. Many of our students appear not to have any physical signs that they have been affected. The impact is hidden and becomes a real puzzle for those in the classroom.

What happens in the womb is a complex interaction between the amount of alcohol consumed, when it is consumed, the metabolism, nutrition, health and well-being of the mother, her support and welfare environment and even social factors like levels of poverty. This explains why the presentations are so variable. In short, any feature of development can be affected in different ways according to the conditions that are found in the mother’s body while pregnant.

This is why no one can suggest a safe limit for drinking other than zero. The sobering educational fact is that we are unlikely to know how many young people in each school are affected.

UK research indicates that there appears to be far more significantly affected young people in the cohort who have experiences the are system. This should not be surprising but may be a little misleading because currently, so few individuals are assessed.

Successive global research programmes suggest that around 90% of individuals who are affected have no outward physical indicators that they have FASD. This means that the condition only really comes to light when traditional classroom strategies to boost attainment start to fail and the student struggles to remember what they have been told in the past. As a teacher this is incredibly frustrating because in the classroom, we build on foundations that we and other teachers have laid in the past.

The real key to success is re-framing the expectations that you have for the affected young people. This is not dumbing down or expecting them to fail, but it is about providing realistic targets and more support to allow them to achieve. The NOFASD publication already mentioned will provide plenty of guidance for you.

Two other observations for you to take forward. Living with FASD is tiring for both the person who is affected as well as the family that they live with. For those affected they are trying hard to conform to the expectations that society (and the school) has of them and the brain is working harder to attempt to do this. Often those affected are exhausted.

The effects that are seen at school are not always repeated at home and often parents and carers will describe challenges that are far greater than those at school and behaviours that repeat themselves far more frequently. In addition, too many carers have also needed to become the expert to advocate for their child as so few professionals are aware of the condition and its affects. Parents and carers really want the best for their child and often will have some of the answers. It is vital for progress to be made to work collaboratively with them

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