School Solutions: Strategies for Success in the Classroom

1. School Solutions: Strategies for Success in the Classroom Gregory Bailey, Ph.D. Christine Schmidt, Psy.D. (C) Children's Research Triangle, 2007

2. Overview • Discuss the common difficulties substance exposed children exhibit in the classroom • Introduce the “External Brain” • Present practical strategies for managing these difficulties (C) Children's Research Triangle, 2007

3. The Effects of Alcohol on the Developing Brain • Alcohol can damage: • Pre-frontal cortex • Cognition, Executive Functioning • Hippocampus • Memory • Corpus Callosum • Integrating Information, ADHD • Limbic System • Emotions • Basal Ganglia • Motor Coordination (C) Children's Research Triangle, 2007

4. Primary Difficulties of Prenatally Exposed Children • Cognitive Development • Executive Functioning • Self-Regulation • Behavior • Sensory Processing Problems • Communication Development • Motor Skills (C) Children's Research Triangle, 2007

5. Information Processing Memory Abstract Reasoning Concept Formation Visuospatial Processing Cause-Effect Thinking Organizational Capacity Social Information Processing Patterning Inconsistent Knowledge Base The Impact of PSE on Cognitive Development (C) Children's Research Triangle, 2007

6. Executive Dysfunction • Attention & concentration • Distractibility • Organization • Forethought, planning, problem-solving • Cause & effect thinking • Working memory • Abstract reasoning (Concrete thinking) • Transitions (C) Children's Research Triangle, 2007

7. Problems with Abstract Reasoning • Substance exposed children are very concrete • Lack an understanding of concepts like time, money, honesty, ownership • May lead to learning problems (math, reading) (C) Children's Research Triangle, 2007

8. Self-Regulation The capacity to modulate mood, self-calm, delay gratification, and tolerate transitions in activity (C) Children's Research Triangle, 2007

9. Behavioral Dysregulation • Poor attention to tasks • Distractibility • Impulsive behavior • Hyperactivity • Aggression (C) Children's Research Triangle, 2007

10. Social Dysregulation • Emotional/behavior/thought dysregulation create problems in: • Noticing & interpreting verbal & non-verbal social “cues” • Learning social conventions & implementing them appropriately • Understanding consequences of behavior (C) Children's Research Triangle, 2007

11. Sensory Processing Deficits in processing and modulating incoming sensory information FAS/FASD students are more or less sensitive to stimuli Lower threshold = Easily overwhelmed Higher threshold = Under-responsive Treated through Occupational Therapy with a Sensory Integration focus Classroom accommodations available to facilitate attention and on task behavior within the classroom (C) Children's Research Triangle, 2007

12. Impact of Sensory Processing Problems • May result in considerable agitation and discomfort (both physical & emotional) • May increase distractibility and irritability • Disruptions often lead to impairments in social, emotional and cognitive functioning (C) Children's Research Triangle, 2007

13. The Teacher’s Toolbox • The External Brain • Prevention vs. Intervention • Strategies for Classroom Management (C) Children's Research Triangle, 2007

14. Changing the Environment • Much easier to change the current circumstances than to change the student’s characteristics • Evidence indicates that the classroom environment can contribute considerably to behavior and learning problems (C) Children's Research Triangle, 2007

15. Introducing the External Brain • Compensate for brain damage by acting as an “External Brain” (C) Children's Research Triangle, 2007

16. The External Brain • Change the environment, not the child! • Consistent across all contexts • Plan, structure, organize, predict • Respect the child and her capabilities • Help develop self-regulation • Willful behavior vs. neurological deficits • Multi-Sensory Learning (C) Children's Research Triangle, 2007

17. Prevention Vs. Intervention • Identify triggers and causes of over-stimulation • Look for cues that the child is feeling overwhelmed • Model calm, organized behavior • Use intervention when child is calm and in control • Defer discussions of misbehavior until the student is calm (C) Children's Research Triangle, 2007

18. Practical Strategies for the Classroom (C) Children's Research Triangle, 2007

19. The Classroom Environment • Plain walls • Avoid mobiles/hanging items • Soft lighting (no fluorescents!) • Cover lower part of windows • Limit number of students in a specific area • Limit wide open spaces by providing visual or physical boundaries (furniture) • Label classroom areas with pictures & words (C) Children's Research Triangle, 2007

20. Desk and Work Areas • Keep work areas clean, except for the materials being used • Use preferential seating, middle of first or second row, facilitating teacher eye contact • Place positive peer models around student (C) Children's Research Triangle, 2007

21. Desk and Work Areas • Help student organize personal space (baskets) • Place student across from teacher in circle • Eye contact to engage visual and auditory channels • Tape picture goal/rule to desks (for all students) • Don’t unexpectedly change the environment (C) Children's Research Triangle, 2007

22. Rah-Rah Regulation! • Avoid power struggles, provide choices • Provide a quiet, safe place in home/school • Equip with beanbags, soft pillows, soothing music, squeeze toys, chewy toys/foods (C) Children's Research Triangle, 2007

23. Rah-Rah Regulation! • Emphasize cause and effect thinking: • Avoid punitive consequences • Emphasize natural consequences • Reframe (i.e., time out = cool down) • Administer consequences in small doses • Discuss the behavior and problem solve! (C) Children's Research Triangle, 2007

24. Nothing More Than Feelings • Frequently label your own emotional state • Identify feeling states in your child – be the external brain! • Gradually encourage children to label their own emotions – praise them for using their words in lieu of behaviorally acting out or internalizing • Use visual metaphor for “just right” behavior • i.e., speedometer, stop light, thermometer (C) Children's Research Triangle, 2007

25. Transitions • Allow child to feel a sense of completion prior to transitioning to next task • Adapt work to minimize frustration and anxiety • Break work into small amounts • Shorten time of work • Decrease the feeling, “I’ll never finish all of this!” (C) Children's Research Triangle, 2007

26. Transitions • Provide warning and preparation for transition times • Assist child to devise organizational strategies for transition • Create a picture of time • Hourglass, paper chain link, pictorial schedule (C) Children's Research Triangle, 2007

27. Creating a Picture of Time (C) Children's Research Triangle, 2007

28. Visual/Pictorial Schedule (C) Children's Research Triangle, 2007

29. Organization • Keep tasks simple and short • When school or an activity starts, review activities/goals • Provide explicit, concrete, brief instructions • Avoid abstract directives or expressions • Encourage parents to organize clothing and school supplies the night before • Emphasize thinking skills • How did you figure that out? • Model the process by thinking out loud (C) Children's Research Triangle, 2007

30. Attention = Retention • Ensure child is listening prior to direction • Eye contact, touch, say child’s name • Multi-sensory teaching • Use movement, visuals, songs • Break instructions into small pieces • Remember that for students with FAS, knowledge is inconsistent and variable =don’t assume prior knowledge! • Have child repeat back instructions in their own words (C) Children's Research Triangle, 2007

31. Attention = Retention • Provide lesson/story outlines at beginning of the lesson or activity • Discuss what to listen for, prior to reading a story • Encourage child to compare, describe, pay attention to details (i.e., after I finish reading the story, I’ll ask you to tell me everything you can about the boat) • Ask questions that cue memory • Use multi-sensory learning (i.e., close your eyes and picture the scene in your mind) (C) Children's Research Triangle, 2007

32. Memory Aides • Pictorial cues of classroom/home routines, paired with words • Educational toys, computers, books • Reinforce immediate memory – ask questions • Refocus attention after a disruption • Cues and prompts (i.e., multiple choice) • Happy moods = greater retention (C) Children's Research Triangle, 2007

33. Multi Sensory Learning • Provide opportunities for multi sensory learning • Songs • Pictured Lists • 1 step instructions • Charts of daily routines • Incorporate learning into daily life • Rely on routines and rituals for comfort, memory consolidation, and predictability (C) Children's Research Triangle, 2007

34. Sensory Strategies for Self-Regulation • Allow controlled opportunities for sensory input • Fidget toys, water bottles (with straws), sugar free gum • Use visual metaphor for “just right” behavior • Provide frequent breaks with motor movement • Provide a quiet, safe place for times of dysregulation • Equip with beanbags, soft lighting, soft pillows, squeeze/fidget toys, chewy toys (C) Children's Research Triangle, 2007

35. The Hyperactive Child • Limit the type and number of new situations • Recognize the signs of meltdown and avert • Build relaxation time into the routine • Avoid long periods of desk work • Do not withhold recess, gym, or recreation times • Build in frequent breaks with motor activity • Avoid or plan for over-stimulating breaks in routine (C) Children's Research Triangle, 2007

36. Intercede Impulsivity • Recognize Executive Dysfunction • Teach “Habits” • Use concrete examples to signify the student’s turn • Use a signal to indicate when to start (bell) • Give complete directions before handing out materials • Always remind child to self-check work (C) Children's Research Triangle, 2007

37. Social Relationships • TEACH relationship skills • Social manners, how to make friends, greetings and goodbyes, social boundaries • Use interactive methods, i.e., role plays, books, puppets • Structured and short play dates • Pair child with a positive peer role model • Convene small “lunch bunch” with school counselor to teach social skills (C) Children's Research Triangle, 2007

38. Interventions • Be firm, not punitive • Consistently adhere to rules • Wait until the child is calm and deescalated • Avoid debates, just state the rule • Positive/negative reinforcement works for some children with PSE, but not all • Use “cool down” space, not “time out” • Learn what the child values (C) Children's Research Triangle, 2007

39. The best discipline is prevention (C) Children's Research Triangle, 2007

40. Self-Esteem “All of our brains work differently” • Model this concept with actions and words • De-stigmatize areas of deficit • Emphasize areas of strength (C) Children's Research Triangle, 2007

41. Self-Esteem • Frequent praise for positive behaviors • Praise effort, not results • Catch the child being good (C) Children's Research Triangle, 2007

42. Written Assignments • Keep work sheets simple and uncluttered • Avoid timed tests • Closely monitor independent work times • Avoid “why” questions • Use “how,” “who,” “what,” and “where” • Avoid essay tests, or provide 1:1 support during tests • Underline important directions – 1 instruction at a time! (C) Children's Research Triangle, 2007

43. School and Home • Small increments of independent work • Frequent rewards and praise for even small approximations to success • Underline key words • Create brief lessons • Keep written and verbal info simple • Ask child to repeat instructions to ensure understanding • Repeated practice and exposure to learning (C) Children's Research Triangle, 2007

44. (C) Children's Research Triangle, 2007