School Solutions: Strategies for Success in the Classroom

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School Solutions Strategies for Success in the
Classroom

• Gregory Bailey, Ph.D.
• Christine Schmidt, Psy.D.

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Overview

• Discuss the common difficulties substance exposed
  children exhibit in the classroom
• Introduce the External Brain
• Present practical strategies for managing these
  difficulties

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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

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Primary Difficulties of Prenatally Exposed
Children

• Cognitive Development
• Executive Functioning
• Self-Regulation
• Behavior
• Sensory Processing Problems
• Communication Development
• Motor Skills

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The Impact of PSE on Cognitive Development

• Cause-Effect Thinking
• Organizational Capacity
• Social Information Processing
• Patterning
• Inconsistent Knowledge Base

• Information Processing
• Memory
• Abstract Reasoning
• Concept Formation
• Visuospatial Processing

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Executive Dysfunction

• Attention concentration
• Distractibility
• Organization
• Forethought, planning, problem-solving
• Cause effect thinking
• Working memory
• Abstract reasoning (Concrete thinking)
• Transitions

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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)

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Self-Regulation

• The capacity to modulate mood, self-calm, delay
  gratification, and tolerate transitions in
  activity

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Behavioral Dysregulation

• Poor attention to tasks
• Distractibility
• Impulsive behavior
• Hyperactivity
• Aggression

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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

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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

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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

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The Teachers Toolbox

• The External Brain
• Prevention vs. Intervention
• Strategies for Classroom Management

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Changing the Environment

• Much easier to change the current circumstances
  than to change the students characteristics
• Evidence indicates that the classroom environment
  can contribute considerably to behavior and
  learning problems

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Introducing the External Brain

• Compensate for brain damage by acting as an
  External Brain

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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

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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

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Practical Strategies for the Classroom
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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

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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

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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)
• Dont unexpectedly change the environment

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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

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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!

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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

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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, Ill never finish all of
  this!

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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

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Creating a Picture of Time
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Visual/Pictorial Schedule
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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

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Attention Retention

• Ensure child is listening prior to direction
• Eye contact, touch, say childs name
• Multi-sensory teaching
• Use movement, visuals, songs
• Break instructions into small pieces
• Remember that for students with FAS, knowledge is
  inconsistent and variable dont assume prior
  knowledge!
• Have child repeat back instructions in their own
  words

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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, Ill 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)

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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

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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

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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

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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

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Intercede Impulsivity

• Recognize Executive Dysfunction
• Teach Habits
• Use concrete examples to signify the students
  turn
• Use a signal to indicate when to start (bell)
• Give complete directions before handing out
  materials
• Always remind child to self-check work

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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

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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

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• The
• best
• discipline
• is
• prevention

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Self-Esteem

• All of our brains work differently
• Model this concept with actions and words
• De-stigmatize areas of deficit
• Emphasize areas of strength

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Self-Esteem

• Frequent praise for positive behaviors
• Praise effort, not results
• Catch the child being good

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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 11 support during
  tests
• Underline important directions 1 instruction at
  a time!

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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

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