Behavioral Issues and Fetal Alcohol Syndrome: What Special Education Teachers Should Know

While the exact prevalence of fetal alcohol syndrome is not known, the Centers for Disease Control and Prevention estimates that between 0.2 to 1.5 children out of every 1,000 live births have the condition, which is caused by alcohol consumption during a pregnancy. Fetal alcohol syndrome is the most severe type of fetal alcohol spectrum disorder; other fetal alcohol spectrum disorders include alcohol-related birth defects and alcohol-related neurodevelopmental disorder. When the mother consumes alcohol, it is passed on to the fetus across the placenta. Greater harm to the fetus results if the mother drinks during the first three months of the pregnancy, binge drinks, or if she consumes large amounts of alcohol, according to MedlinePlus.

In utero exposure to alcohol can result in damage to several areas of the brain, including the cerebellum, cerebrum, cortex, thalamus, neocortex, hypothalamus, corpus callosum, hippocampus, basal ganglia and septal area. As a result, children with fetal alcohol syndrome can experience several different complications, including learning disorders, behavior problems, delayed development, coordination problems and vision difficulties.

Special education teachers may come across children with different behavior problems due to fetal alcohol syndrome, which may impact school performance. For example, the Mayo Clinic notes that children with fetal alcohol syndrome can display symptoms similar to attention deficit hyperactivity disorder (ADHD), such as a short attention span, poor impulse control and hyperactivity. While some of the symptoms of ADHD and fetal alcohol syndrome may be similar, a 2009 study published in “Alcoholism: Clinical and Experimental Research” that tested 33 children with fetal alcohol syndrome, 30 children with ADHD, and 34 children without any disorders; found that the behavior problems associated with fetal alcohol syndrome are more severe. The problems with attention may also be accompanied by learning difficulties. The Texas Department of Family and Protective Services points out that children may have poor organization skills, problems with abstract concepts, and issues with memory. The severity of these symptoms varies by child.

Some children may have extreme nervousness, while other children may display fearlessness. Teachers may notice that children with fetal alcohol syndrome have poor socialization skills, which can affect their ability to make friends their own age. Fetal alcohol syndrome may also result in stubbornness, irritability and passiveness. The Texas Department of Family and Protective Services adds that other behavioral problems seen in fetal alcohol syndrome include social withdrawal, being teased or bullying other children, poor self-image, and problems with sexuality and truancy.

Because children with fetal alcohol syndrome may experience developmental delays, they may qualify for the Individuals with Disabilities Education Act (IDEA) and special education services. Special education teachers can use different strategies to help with the behavioral problems caused by this disease. The Substance Abuse and Mental Health Services Administration suggests the “eight magic keys,” which help when working with students with fetal alcohol syndrome. These strategies include using concrete terms, being consistent with language and environment, using repetition to help with short-term memory problems, establishing a routine, preventing overstimulation by using simplicity, being specific, and using structure and supervision.

To monitor and change certain behaviors, teachers may want to use a Daily Behavior Report Card. This behavioral technique is used with other conditions, such as ADHD. With the Daily Behavior Report Card, the teacher and parents decide on a behavior to work on. The child gets a reward (positive reinforcement) when she does the appropriate behavior. Have the child choose her reward — not only does this add to her motivation, but the Texas Department of Family and Protective Services notes that encouraging decision-making is an effective strategy when working with a child with this condition. The organization adds that the reward should be changed often to keep the child's interest. The behavioral goals can be altered depending on the child's progress, and the Daily Behavior Report Card format allows teachers and parents to be on the same page.

Different therapies outside of the classroom may also help with the behavior problems. For example, if a child is having problems interacting with other children, she may benefit from friendship training. In this type of training, the child learns how to join others who are playing, as well as dealing with conflicts. Other treatments for behavior problems in children with fetal alcohol syndrome involve the parents — the Centers for Disease Control and Prevention states that parent-child interaction therapy or parenting and behavior management training may help reduce these issues. Teachers can communicate with the parents and therapist about what techniques are helping the child and if they can be implemented in the classroom as well.