FASD (Foetal Alcohol Spectrum Disorder) is a condition that's estimated to affect as many as autism, can lead to emotional and behaviour issues in the classroom, but can be very difficult to identify. So how can we recognise - and support - children with the condition?
In today's School Behaviour Secrets, we explode some of the myths about FASD, look at the surprising facts and figures about drinking in pregnancy, and share how you can support pupils affected by this issue in your school.
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Show notes / transcription
Simon Currigan 0:00
And when you see a brain scan of a child with FASD, why you'll often find is there appears to be like buckshot, there are lots of holes and gaps across the brain. This is areas where there should be brain cells and neurons and that's going to affect the child's ability to engage in all sorts of aspects of life as they grow older. In short the impact is it's brain damage.
Hi there. I'm Simon Currigan and welcome to this week's episode of school behaviour secrets. We're broadcasting live from behaviour towers, which was once described by the British architectural society as lamentable and that's before we covered it in satellite dishes. I'm joined as ever by my co host, Emma Shackleton. Hi, Emma.
Emma Shackleton 1:19
Simon Currigan 1:20
Emma I'd like to start by asking you a question
Emma Shackleton 1:23
Sticking with the formula. I see.
Simon Currigan 1:25
Yeah, I like to be predictable. According to a survey by pregnacare What were the top three foods craved by pregnant women?
Emma Shackleton 1:33
Well, I reckon in no particular order something junk foodie like fried chicken, and then ice cubes and coal. I've heard that some women really crave Eating coal when they're pregnant.
Simon Currigan 1:49
Emma Shackleton 1:49
a lump of coal full of minerals apparently. I'm not recommending that people do this. But yeah,
Simon Currigan 1:55
The survey said chocolate, fruit and ice lollies.
Emma Shackleton 1:59
Simon Currigan 2:00
And the self reported weirdest cravings included boiled eggs with horseradish, grated carrots mixed with ketchup, and a banana and ready salted crisp, toasty. So I think what we've learned here that pregnant women are dangerous.
Emma Shackleton 2:16
How does this relate to today's episode?
Simon Currigan 2:19
Well, in today's episode, we're going to look at FA S D, which is a condition that can seriously affect a developing foetus in the womb, when its mother drinks alcohol and alcohol is another substance that many women report is difficult to resist. During pregnancy, we're going to look at the exact figures in a moment about how many women do drink during pregnancy. And I think you'll find them really surprising but surprising in a bad way. They certainly surprised me when I was researching this topic.
Emma Shackleton 2:47
And we know of course that drinking alcohol during pregnancy can lead to complications that go on to affect the child's ability to learn, regulate their emotions and integrate successfully into school. But before we get into the detail listeners, please share this episode with three of your friends or colleagues who just like you are committed to improving children's lives and experience in school people who you think would benefit from hearing this podcast. All you've got to do is open your podcast app hit the share button and you'll be able to send them a direct link.
Simon Currigan 3:22
So let's twist open the fountain pen of learning reach into the bulging pencil case of knowledge and prepare to insert that shiny new ink cartridge we call behaviour.
Emma Shackleton 3:33
So let's start by asking what exactly is FA SD? FASD stands for foetal alcohol spectrum disorder. So it is a spectrum of conditions just like autism is a spectrum. foetal alcohol spectrum disorder includes lots of conditions like Foetal Alcohol Syndrome-FAS. Alcohol related neurodevelopmental disorder-ARND. Alcohol related birth defects ARBD. Foetal alcohol effects-FAE and Partial Foetal Alcohol Syndrome, that's PFAS.
Simon Currigan 4:15
Now the big thing to know about foetal alcohol conditions is there is no cure for them and no medication. So what are the diagnosis rates for kids with FASD? So let's start by comparing them to kids who have autism. Autism rates prevalence is about 1% 2% of the population 2% of the top end, the problem with FASD is there aren't any accurate figures available. The World Health Organisation estimates the figures at about 1% but the numbers vary depending on the research you look at. There was a US study that screened 6600 kids and when they looked at their behaviour and they looked at their emotional difficulties and looked at the range of difficulties they had, they found that 3% of those kids qualified for diagnosis of FASD
Emma Shackleton 5:02
interestingly, during a screening process conducted by Bristol and Cardiff University up to 17% of children had symptoms consistent with foetal alcohol spectrum disorder. This is not the same as a diagnosis. A diagnosis requires intensive time with an F ASD medical professional.
Simon Currigan 5:22
So getting concrete figures on this is difficult. But so let's have a think about how many women drink during pregnancy. And I found these statistics really surprising drinking in pregnancy is a really common so in another study, up to 79% of women reported drinking some amount of alcohol at some time during their pregnancy. And this was consistent with other studies that have been conducted in the UK about drinking during pregnancy.
Emma Shackleton 5:48
And it's really important to note here that not every woman who drinks during pregnancy will give birth to a child with FA SD because it depends on other factors such as the quantity of alcohol consumed, and the mother and child's ability to metabolise alcohol. So of those women who drank a by one in 67, will give birth to a child with FASD
Simon Currigan 6:15
surveys found looking at different social classes that it was middle class women who were most likely to drink during pregnancy. And the UK has the fourth highest prevalence of drinking during pregnancy in the world. I'm not sure this is a sort of top 10 that we should be happy to be a part of. Ireland came out top at 60% Belarus came out 47% Denmark at 46%. UK came out of 41% and Russia came out 37% and those statistics are from the World Health Organisation. And of course, another reminder that the current advice is that there is no safe amount of alcohol you can drink during pregnancy.
Emma Shackleton 6:53
Let's have a look now then about how alcohol actually affects foetal development. Here's the science bit. So the alcohol that the mother drinks crosses the placenta and interferes with the development of the foetus because the foetus doesn't have a fully developed liver, it can't filter out the toxins like its mother can. And the result is that the toxins damage brain cells and the child's developing nervous system.
Simon Currigan 7:21
So as the brain cells are developing in the foetus, the alcohol kills them off. Or if those brain cells survive, once they have grown, those neurons move to the wrong part of the brain, which disrupts brain development. And when you see a brain scan of a child with FASD, what you'll often find is there appears to be like bookshop, there are lots of holes and gaps across the brain. This is areas where there should be brain cells and neurons, and that's going to affect the child's ability to engage in all sorts of aspects of life as they grow older. In short, the impact is it's brain damage.
Emma Shackleton 7:56
So alcohol interferes with development of this specific part of the brain called the frontal cortex. And most of the human frontal cortex is made up of the prefrontal cortex. This bit deals with executive functioning skills, so things like emotional expression, problem solving, memory, language, and judgement, among others.
Simon Currigan 8:21
So let's think about what that means then the parts of the brain that are supposed to be there to help manage those functions are actually missing. It also interferes with the hippocampus, the part of the brain whose main function is related to memory and particularly long term memory. But that's not all. There are lots of other areas that can be affected. One of the key ones is the corpus callosum, which is the part of your brain that organises the signals that pass from one side of the brain to the other. So it's a bit like a traffic policeman organising how the messages from one side of the brain interacts with the other, making sure they get to the right place. If that signal finds it hard to get to the correct part of the brain on the other hemisphere, or gets cut off prematurely or ends up going to the wrong place that can impact on how your brain functions and processes information.
I'd just like to take a pause for a moment and say that if you're finding this podcast useful, then you're going to love what we've got waiting for you in our inner circle programme. The inner circle is your one stop shop for all things behaviour. It's a comprehensive platform filled with videos, resources and behaviour inspiration to get you unstuck with classroom behaviour. We've got training resources on de escalation, supporting kids with anxiety support strategies for conditions like autism, ADHD, and PDA. practical ways of helping pupils deal with strong emotions, assertive behaviour management techniques for managing the whole classroom, setting out your classroom environment for success, resetting behaviour with tricky classes and more. Our online videos walk you through practical solutions step by step, just like Netflix, you can turn an inner circle subscription on or off whenever you need to, with no minimum contract Plus, you can now get your first seven days of inner circle for just one pound. Get the behaviour answers, and you've been looking forward today with inner circle, visit www.beaconschoolsupport.co.uk And click on the inner circle picture near the top of the homepage for more information.
Emma Shackleton 10:30
Thinking about what we've just said that and about those connections being interrupted, what would that look like in terms of behaviour in the classroom, as we've already said, FASD can affect different parts of the brain. So children with FASD will all present in their own unique way. But there are a set of behaviours that are linked to FASD conditions. And one of those is impulsive behaviours. So those children might do things like frequently calling out or interrupting, or saying the first thing that pops into their head, often children with FASD might tell lies, they're not thinking through the implications of what they're saying. So a thought pops in, they voice that thought, without thinking of the consequences of that. Also, you're probably going to see in-attention, so a real lack of ability to focus on one thing at a time or to maintain focus for any sustained period of time. So these are the children that you might see flitting from one activity to another, with quite a short concentration span or a short interest in each of those activities. There are also likely to be difficulties with language and communication, and also problems with absorbing information and retaining what they've learned. These are all key skills in building up learning, building the foundations for learning. And often children with FASD have difficulties with organisation and understanding the passage of time
Simon Currigan 12:05
Related to what Emma said already, there's difficulty learning from experience, we've touched on being able to absorb information and retain it, but also learn from experience in terms of social situations in terms of learning from my behaviour, if I do behaviour x, it results in Y, that means we're going to have to do lots of over learning and not assuming that children have picked up learning experiences. Just because they could do it in a lesson on Monday doesn't necessarily mean they're going to be able to do it on a lesson on Tuesday. But also you see issues around emotional regulation, and social interaction. You might be listening to this and thinking this sounds very familiar. And in some aspects, the symptoms that children with FASD often present are very similar to the issues faced by children with autism, or ADHD or attachment or other conditions have a similar role.
Emma Shackleton 12:54
And this is the problem, isn't it? So many of those conditions have got overlapping symptoms, and that's why it can be so difficult to get an accurate diagnosis. And there is a common myth to dispel here. Actually, it is commonly believed that FA SD affects facial development leading to a thin upper lip, a smooth philtrum and small eye openings. This is sometimes the case. But in reality those facial features are only present in one in 10 children with the disorder and it really depends on what stage in the pregnancy the mother was drinking. So FASD may often get misdiagnosed as ASD, or attention deficit hyperactivity disorder. foetal alcohol spectrum disorder is often referred to as the hidden disability.
Simon Currigan 13:44
So when we're thinking about strategies, how we can support these children in the classroom, what we have to bear in mind is because that brain damage varies from child to child, the pupil's needs are going to be individual to the specific child and the programme of support that we need to put in place is going to be based around their specific individual needs. So this means doing assessments looking at their individual needs, and then putting into a mixture of support strategies that are specific to them. Often no support strategies will look like a mixture of autism and ADHD support strategies, with lots of overlearning to support with retention over time.
Emma Shackleton 14:23
And of course, apart from FASD there are many other causes of challenging classroom behaviour as well. So if you're working with children with challenging behaviour, and you're not sure why they're acting that way, we've got a download that can help. It's called the SEN Handbook, and it will help you to link behaviours that you're seeing in the classroom with possible causes, like autism and ADHD.
Simon Currigan 14:48
The idea here isn't for teachers to make a diagnosis. We're not qualified to do that. But if we can link behaviours to possible causes quickly, it means we can get the right help in place and get Early intervention strategies in place. It's a free download, go to www.beaconschoolsupport.co.uk Click on the free resources tab and you will find a download for the handbook near the top. I'll also put a link in the episode description.
Emma Shackleton 15:13
Next week we'll be talking to Gavin Oattes. He's worked with some of the biggest organisations in the world on personal development, he reveals the process he uses with schools to drive positive behaviour change. Starting from the school's core values all the way through to behaviour change in the classroom,
Simon Currigan 15:31
I really enjoyed recording that interview as well as having great insight. Gavin also uses a lot of humour when he's talking to get his point across to make sure you get that interview, open your podcast app right now. Now at this point, you could have a formal sit down meeting with the app, give it a performance review, setting some stringent targets about downloading all future episodes of school behaviour secrets. And so you'll be monitoring its movement towards those targets with a formal rank rating system where you could tap the subscribe button or follow as it's now called in Apple podcasts. And you'll get easy access to all past and future content, the choice is yours. For what it's worth. I personally found most apps to be unreflective during performance reviews.
Emma Shackleton 16:12
So if you like what you've heard today, please leave us an honest rating and review on Apple podcast that helps other teachers or parents just like you find the show. I hope you have a brilliant week and we'll see you next time on school behaviour secrets. Bye now.
Simon Currigan 16:27
(This automated transcript may not be 100% accurate.)