This guide is designed for every educator (e.g., teachers, special education teachers, resource specialists, speech and language specialists, school nurses, psychologists, and occupational therapists) who works with K-8 elementary and middle school level students. The guide addresses the impact of prenatal exposure to alcohol and how it affects the K-8 grade student. Many educators believe they do not have students in their classes who have FASD, and they may even wonder why this guide would be useful in their own teaching and classroom management.   Alcohol is the most commonly abused substance in the United States.  Despite health warnings, 20% of women drink alcohol while knowing they are pregnant. Therefore, it is not surprising that there is a high incidence of children (2-5%)  in the United States with FASD and they are likely present in every classroom.

The most conservative estimate of the prevalence rate for FAS is 3 in 1,000 (or 0.3%); while the combined incidence of FASD is 2-5 in 100 (or 2-5%).  In some populations, those rates are even higher. FASD occur with more frequency each year than does Down’s Syndrome, Cystic Fibrosis, Spina Bifida, and Sudden Infant Death Syndrome combined. Students with prenatal exposure to alcohol are in our classrooms.  Educators have taught and are teaching students with FASD.   While a small percentage of these students have been diagnosed with one of the FASD, most of these students remain unidentified.  Some students have physical characteristics indicative of FAS, most of the FASD students look like their peers.  They seem “perfectly normal,” yet they have a “hidden disability”. Teachers are often baffled by the puzzling, and sometimes unexpected, behavior and learning difficulties these students exhibit.  Working with these students can be frustrating and discouraging.  Teachers find traditional learning theories and standard teaching practices ineffective for the FASD student.   These students want to please their teachers, but they end up feeling like failures.  There is a societal lack of awareness and understanding of FASD.  These unidentified students are often misunderstood.  Many reasons are attributed to the lack of success for these FASD students.

“He just doesn’t try.”
“He’s so capable, but he’s an underachiever.”
“There’s just not any motivation, unless it has to do with something he’s interested in.”
“She doesn’t listen…just tunes me out.”
“Her family life is very chaotic. The parenting skills are weak.”
“I’ve never met anyone more stubborn.”
“She’s the class clown, always looking for attention.”

The reason many FASD students are not capable of meeting age appropriate academic or behavioral expectations is through no fault of their own. They have organic brain damage, due to prenatal exposure to alcohol. While not all children whose mothers drink alcohol during pregnancy are affected, those who are affected must cope with lifelong consequences. These children do not grow out of FASD, and there is no cure.

Yet, there is reason for hope.  FASD students can and do learn.  In fact, FASD students are capable of leading productive and successful lives.  Recognition of their disabilities and early intervention are critical in order to provide a meaningful and positive learning experience for these students.  Elementary school may be the first time in a child’s life when the effects of fetal alcohol exposure are noticed.

Although students with FASD have a broad range of differences, they also share very specific behaviors and learning styles.  Only when teachers understand the unique profile of the FASD student can they can begin to work effectively with their students who have been identified.  This profile may also alert educators to students who have not been identified with FASD, but who seemingly have many of the same behaviors and learning patterns. Educators can then seek outside help for a correct diagnosis for these students.  Fetal Alcohol Spectrum Disorder requires a medical diagnosis even though there are no biochemical tests to confirm the disorder.

There are devastating secondary disabilities that manifest themselves when students have not been identified with FASD and have not received an educational program addressing these needs. These secondary disabilities are currently quite prevalent with FASD teenagers. They range from mental health problems, trouble with the law, alcohol and drug problems, sexual inappropriateness, school truancy, and homelessness to other alarming difficulties. These problems are a huge burden to the individuals, their families, as well as to society.  Early recognition of FASD is the greatest factor in safeguarding against the onset of secondary disabilities.

I would like you to know that it isn’t easy having FAS[D]. That it’s hard in school. I need someone to explain things in a way I’ll understand.
(P. Lasser, 1999)

Understanding FASD: A Comprehensive Guide for Pre-K-8 Educators is a resource for educators who work with children with FASD. The goal of this guide is to equip educators with an overall understanding of FASD. Normal brain development and the effect of prenatal exposure to alcohol on brain development are discussed. This leads educators to understand the academic and behavioral challenges the FASD student faces. The guide outlines the profile that these students present and provides effective instructional strategies to assist teachers.  Initially teachers may be overwhelmed when learning about the profile these students present, due to their extensive challenges and difficulties. Teachers may be overwhelmed further when presented with the multitude of strategies proposed here for students with FASD.

“How is it possible to implement all of these strategies?”
“These students present too many learning difficulties. I can’t possibly help them!”
“What about the other students in my classroom? I won’t have time to work with them.”

Upon further reflection teachers will realize these are the students who are already consuming the most effort and energy. The FASD students are the constant targets of teachers’ worry. Now, with the proper understanding and sensitivity to FASD we can stop “spinning our wheels,” and begin helping these students effectively. The educator’s job will be made easier.

Of all the community’s institutions, the schools are most advantageously situated to influence the lives of people with FAS[D]. If schools are responsive to the challenges presented by these students, the students’ lives can be greatly enhanced. If the schools fail to respond appropriately, these students can face tremendous obstacles.
(Streissguth, 1997)

Teachers will discover that many of the suggested strategies will be appropriate for other students in the classroom who do not have FASD, but who exhibit similar behavioral issues. The strategies outlined in the guide will be effective for students struggling to keep up in class and for those with learning disabilities. Students who are learning English as a Second Language will also benefit from many of these suggestions. Teachers do not have to implement all of these strategies at once. The guide is designed to be a practical resource. Teachers will decide which suggestions will be best to implement for their FASD students and for their classroom.

Educators involved with FASD students should attend Student Study Team (SST) meetings. Student Study Team reports in the guide provide educators with a positive and successful SST model. The information from the reported SST often leads to the development of an Individual Education Plan (IEP). Sample IEPs of students with FASD are presented in the guide for the educator. Educational summaries are presented along with common short and long-term goals. Educational resources and strategies are outlined to accomplish these goals. Teachers can use these sample IEPs to assist in developing meaningful and attainable IEP goals for their students. Students can work on educational goals in a supportive environment, where their disabilities are understood and they can strive for success.

In addition, the Educational Plan can establish valuable documentation for these students as they progress on to the next grade level and as they transition from the education system. With this legal document as a guide, students have the opportunity to remediate their primary disability, avoiding secondary disabilities and improving the outcome of their lives.