Prevention of Fetal Alcohol Damage in Northern Native Communities:

1
Prevention of Fetal Alcohol Damage in Northern
Native Communities

• FASD in Lab Mice
• A Practical School-Based Approach

2
Presentation Outline

• Speaker contact info introductions
• FASD and Alaska
• Overview of an Innovative and Promising Approach
  to FASD Prevention Education in Rural Alaska The
  FASD in Lab Mice Project
• Types of Communities in which the FASD in Lab
  Mice Prevention Project was Implemented
• Prevention of FASD Facilitating the use of mice
  in the K-12 setting
• Materials and Methods of the FASD in Lab Mice
  Prevention Project
• Outline of the Approach - A Brief Description
• Video clips showing techniques for picking up
  mice, intubation procedure, euthanasia,
  laparotomy and fetal removal
• Reception and Response by Students, including
  Students with FASD
• Reception and Response by Native Communities
• Academic Outcomes
• Other Outcomes
• Lessons Learned
• Conclusion
• Questions and interactive discussion with the
  audience

3
Acknowledgements

• This project received support and guidance from
• SERRC
• Alaska Science Technology Foundation
• Yukon Flats School District
• Southwest Region School District
• USA Today
• University Alaska Fairbanks IACUC
• Anchorage Council on FASD
• Diane Malbin, Cheri Scott, Michael Baldwin
• Special thanks to the students, parents, and
  communities who participated.

4

• Steven Jacquier
• stevenjacquier_at_gmail.com
• Northern Educational Consulting Anchorage, AK
• David Gilliam
• David.Gilliam_at_unco.edu
• University of Northern Colorado, Greeley
• Judith Kleinfeld
• ffjsk_at_uaf.edu
• University of Alaska Fairbanks

5
Dr. Judith Kleinfeld

• Director, Boys Project
• Co-Director, Northern Studies Program
• Fantastic Antone Succeeds and Fantastic Antone
  Grows Up
• Rural education research in Alaska

6
Two excellent books on FASD

• In these two volumes Dr. Kleinfeld gathers
  together the experienced perspective and hard-won
  wisdom of practice contributed by parents,
  teachers, and other caregivers of children and
  youth with FASD as well as the perspective of
  children and youth with FASD themselves.

7
The Steven Dave Show!

• Steven (top) is a scientific do-gooder
  teacher in Alaskas public schools, with a
  background in international development work.
• Dave (bottom) is an internationally known and
  respected laboratory researcher and university
  professor.
• Guess which one of the two of us put this
  slideshow together?

8
Doing Battle with FASD in Alaska

• Thanks to a teacher in Middle School giving me a
  copy of Call of the Wild to read.
• Dr. Kleinfelds Teachers for Alaska progam and
  her work on FASD
• Seeing the problem of FASD firsthand and asking
  How best to prevent FASD?
• Locating and enlisting Dr. Gilliam in the effort
• Students moving it to a higher level of success
  via peer education

9
Please make sure you receive a draft copy of our
article this has the detailed numbers,
statistics, references for everything we are
presenting today (plus other info which time
precludes us presenting here). Watch this site
for the articles forthcoming publication in The
Northern Review www.yukoncollege.yk.ca
10
Romantic images and mythos of isolated far
northern Alaska Native communities
11
Pragmatic realities of a typical rural Alaska
Native village
12
(No Transcript)
13
Students commonly report that prior to their
involvement with the FASD in Lab Mice project
they had no idea whatsoever regarding these
pointsThe type of alcohol in all forms of
booze is the same ethanol, the causal agent of
FASD.The amount of ethanol in a beer is the
same as in a glass of wine or shot glass of hard
liquor (only the dilution factor with water and
presence of congeners such as color and
flavorings differs between the various
beverages).The strong solvent properties of
ethanol in water allow this form of alcohol to
pass throughout the body just as water does and
everywhere that water does, and so to act upon
and damage the central nervous system and
virtually all other developing organs.The
surprisingly large caloric energy in the ethanol
in one drink.The teratogenic action is based
on both dose consumed and developmental window of
vulnerability (in other words, a person does not
need to be an alcoholic in order to give birth to
a baby damaged by FASD if the one exposure comes
at just the wrong moment).The outcomes of
drinking during pregnancy can be clearly seen and
measured by contrasting an ethanol-exposed
treatment group against a normal control group,
and these outcomes range from pervasively subtle
yet profound to shockingly obvious damage.
14

• ScienceDaily, 05MAR2009
• Students Benefit From Depth, Rather Than Breadth,
  In High School Science Courses
• Study relates the amount of content covered on a
  particular topic to students performance in
  colege-level science classes.
• 8,310 college students evaluated.
• Reports that high school students who study fewer
  science topics, but study them in greater depth,
  have an advantage in college science classes over
  their peers who study more topics and spend less
  time on each.
• http//www.sciencedaily.com/releases/2009/03/09030
  5131814.htm

15
Students as Junior Scientists

• To really understand FASD, students need to
  genuinely deeply explore the issues over time in
  ways they find meaningful through their
  individual learning modalities.
• Becoming researchers, in this approach students
  learn about the scientific method and design an
  experiment testing the effect of alcohol on the
  developing offspring.

16
One manipulated variable

• Students are guided to design an experiment where
  all conditions are held constant between two
  groups of pregnant mice except for the single
  manipulated variable of dosing with alcohol.

17
Prevention of FASD Facilitating the use of mice
in the K-12 setting

• Careful preparation needed before a mouse ever
  arrives on site.
• Involvement of stakeholders from traditional
  Tribal Council, community elders, and parents to
  school district administrators.
• Incorporation of cultural and school needs into
  the program.
• Experimental protocol approved by Institutional
  Animal Care Use Committee of a cooperating
  institution (typically a regional university).

18
Aardvarks to Zebra fish

• Exposure to alcohol disrupts embryological
  development in organisms from sea urchins to
  humans.
• Chicks and lab rats were two animal models
  considered for this project early on, but
  rejected.
• The path led to David Gilliam at UNC and
  delightfully charismatic little black lab mice.
• B6 lab mice turned out to be ideal in almost
  every way for the purposes of this prevention
  approach.
• Photo shows Control and Treatment pups from an
  animal model of FASD in beagles Project Cork -
  Dartmouth

19
The specific ideal subject

• Not just any strain of mouse will serve for
  consistently demonstrating specific effects of
  alcohol exposure on growth and development.
• From an elderly ladys greenhouse in England to
  Bar Harbor, Maine, to Colorado, to rural Alaska
  a well-traveled line of mice!

20
C57BL/6J strain (aka B6) mice from The Jackson
Laboratory
21
Respect and Appreciation

• Students held their lab mice in high regard,
  enjoyed working with them daily, respected them
  as lab subjects, and deeply appreciated the
  learning gained thanks to the lab mice.

22
What this approach is not and should never be

• A scare tactic regarding alcohol and pregnancy
• Sensationalized, exaggerated, or distorted claims
  
• rather, this approach cultivates a careful,
  methodical, thorough examination of data
  revealing clear cause and effect relationships
  and processes involved.

23
Materials and Methods of the FASD in Lab Mice
Prevention Project

• Mice, mouse cages, bedding, mouse chow, tools,
  electronic balances, ethanol (and secure
  storage), texts set-up can be accomplished for a
  couple/few thousand dollars, depending on class
  size.
• The time and labor involved is significant and
  not to be underestimated real commitment is
  needed to undertake this prevention strategy and
  see it through properly and successfully.

24
Textbooks

• Madaras Whats Happening to My Body? books for
  girls and boys, respectively, are high-interest
  material.
• The texts were always available for parent review
  and locally approved beforehand for use at a
  site.
• Many students found these texts so useful and
  interesting they bought and kept their copies
  permanently.
• A wide diversity of supplemental materials were
  also used.

25
(No Transcript)
26
(No Transcript)
27
(No Transcript)
28
(No Transcript)
29
(No Transcript)
30

• Video clips showing techniques for
• Controlling the mouse
• Getting the (intubation) needle ready
• The gavage technique
• Caesarian section

31
Careful measurement and close observation were
emphasized throughout. Students found their
comparisons of Control and Treatment group
outcomes to be compelling evidence.
32
Older student practicing intubation technique
with deceased mouse as younger students observe.
Only after a student demonstrated 100
proficiency with intubation on dead mice would
s/he be allowed to advance to performing
intubations with live mice.
33
(No Transcript)
34
Mice are humanely sacrificed via cervical
dislocation the process is instant and painless.
35
(No Transcript)
36
(No Transcript)
37
(No Transcript)
38
(No Transcript)
39
(No Transcript)
40
Students are highly effective in holding the
interest of peers, younger students, and
community members alike when they present the
same material which causes glazed eyes and yawns
if the local teacher is talking.
41
Kinesthetic Activities for Teaching Every Concept

• Molecular Structure---Model Building
• Solvent Properties of ETOH---Price Tag Sticker
  Removal with ETOH v. Water
• Solvent Properties of ETOH---Sharpie Marker Bleed
  with ETOH v Salty Water
• Equivalents---Bottles, Cans, Shot Glasses Food
  Coloring in Water
• Energy in ETOH---Flaming Pan Demo
• Comparative Anatomy---Dissections
• Cell Types Organ Physiology---Microscopy and
  Scientific Drawing
• Data Analysis---Graphic Displays and Models
• and, of course, those perennial favorites
  skits, raps, songs, games

42
(No Transcript)
43
Student demonstrating the energy bound in the
ethanol of just one beer, glass of wine, or shot
of liquor.
44
Relevant Homework

• Homework which is meaningful and practical to the
  lives of the students reinforces and advances
  learning.
• 3x5 cards anonymous questions.
• Your homework go to www.parade.com read the
  article Eat It or Avoid it? by Joy Bauer, and
  e-mail a note to Parade.

45
Subsequent to their project participation boys
reported strong feelings regarding the role of
fathers in supporting mothers through a healthy
FASD-free pregnancy
46
Reception and Response by Students, including
Students with FASD

• Tremendously positive.
• Understanding themselves not as being bad,
  evil, stupid, dumb, weird or any other
  such pejorative but rather as people experiencing
  a brain injury was tremendously liberating for
  these students. Classmates understood other
  students in a more sophisticated way allowing
  them to interpret problems as rooted in FASD
  rather than as willful misconduct. This was the
  case for parents as well.

47

• Reception and Response by Native Communities
  Over course of ten years the FASD in Lab Mice
  prevention education project was piloted
  throughout the school year in six Native villages
  located in two culturally different regions of
  Alaska. The project was warmly welcomed
  everywhere it was offered. Students and
  communities were so excited about the project
  they wanted not only to give presentations to
  other students and elders in their own
  communities, but also to communicate what they
  had found to other Native communities as well.
  Students prepared posters and presentations,
  passed out test tubes showing defects in mouse
  pups, did slideshows and high-interest
  demonstrations. The project was demonstrated in
  this manner in an additional thirteen Native
  villages located in four different regions of
  Alaska, as well as at a number of statewide
  conferences, and to the state legislature.David
  Gilliam has achieved significant success in using
  this approach with Advanced Placement high school
  students in Colorado.

48
Academic
OutcomesStudents not only learn about the
effects of alcohol on outcomes of pregnancy via
this prevention education approach, but also
increase their mastery of significant content
knowledge and skills in reading, writing,
mathematics, social studies, economics, and
science more broadly.Students prepare written
products such as reports and posters
incorporating the numerical summaries of their
data along with descriptions of the process,
outcomes, and their conclusions. Virtually all
students showed greater gains on standardized
tests (boys as well as girls) than comparable
peers in neighboring classrooms of the same
schools and peers in villages located within the
same school district but where the approach was
not being used. Students also developed
practical job skills and effective work habits
team planning, cooperative group effort in daily
tasks, data collection and processing, report
presentation, and public speaking. The project
was enthusiastically embraced and the occasion of
much thoughtful reflection among girls yet
especially appealed to boys.
49
Other
OutcomesPractical job skillsGains in
self-esteemExpansion of cultural awareness and
reinforcement of traditional heritageAwards and
recognitions near and far alike (science fairs,
newspapers, radio, TV, books, Alaska state
legislature)Scholarships, internships, and
college acceptancesMore positive valuation of
educationRecognition of responsibility of males
as partners and parentsInterventions in
situations high FASD-outcome risk with
peersPositive changes in not only knowledge and
attitudes but also beliefs and behaviors.
50
Decisionville

• The FASD in Lab Mice project was incorporated as
  an interactive module within a CD-ROM computer
  game produced for the State of Alaska, available
  from
• RurAL-Cap

51
Lessons LearnedThe
experience of this decade-long effort suggests
the value of an FASD prevention effort in
isolated rural schools in Native communities
incorporating these crucial elements1) Kinesthe
tic involvement, rather than passive receipt of
information Students conducted a dramatic
experiment themselves.2) Emotional learning
Students cared for lab mice and saw the effects
of alcohol on fetal development, a powerful
emotional experience. 3) Meaningful and
demanding academic learning Students learned
mathematics, English, science, economics, and
social studies. The project met school goals of
increasing performance on national and statewide
standardized tests. Students also mastered a
skill set valuable to their employability and
knew it.
52
4) Local significance and practical application
Students understood why this project was relevant
to themselves and their own communities. They
were able to reconcile their previous
observations that maternal drinking did not
always cause obvious impairments with their own
observations of the unpredictable effects of
alcohol, wherein some mouse pups showed terrible
and obvious damage while many others showed
pervasive and profound yet less casually obvious
damage. 5) Involvement of respected local
elders and other community members in a school
project that wedded western scientific methods
with traditional cultural values Students
combined scientific methods with the reverence
for life and gratitude for the contribution of
animals to human welfare.6) Shift from the role
of learner to educator Students presented their
results to the community, younger students,
conference attendees, legislators, and government
officials.7) Demonstration of achievement in
ways that brought respect Students did not just
receive classroom grades. The community, their
peers, and others applauded their achievements.
53

ConclusionWhile informational campaignssuch as
including FASD prevention in health education
programs, putting up signs and posters, and
giving classroom lecturesall have their place
these approaches are of limited effectiveness in
isolated rural Native communities. The need for
FASD prevention delivering results is clear and
pressing the type of approach described here
holds promise. Weighing the personal, social, and
economic costs of FASD against the comparatively
modest expense of such a FASD prevention program,
the potential community gains and economic
savings far outweigh the expense and energy
involved.
54
Systematic research is needed on1) changes in
knowledge and attitudes of students involved in
the prevention project2) changes in test scores
and engagement in school3) increase in interest
in scientific, medical, and health education
careers4) behavior that would decrease
incidence of FASD5) long-term effects on number
of FASD-affected births.
55

• Next steps
• Design an effective evaluation component and
  measure impact in future iterations of the
  prevention strategy.
• Develop a manual and equipment set for teachers
  to use, incorporating instructional video clips.
• Thanks for listening and for everything you do
  in preventing FASD!

56
Please do not hesitate to contact us for more
information or assistance with your FASD
prevention efforts!