One of the big questions around FASD is what can be done? We know there isn’t any cure, there is disagreement about treatments and there is controversy about medication. However, if we ask what is our biggest concern toward our children impacted by FASD, we tend to say coping. In the research I have heard recently, I keep hearing what doesn’t work, but rarely hear what does work. I have seen in numerous cases what does work is constant reflection on strategy effectiveness.
In laymen’s terms, it is basically using science methods to understand behaviour. If we accept the premise that all behaviour is communication, then we use experimentation and constant reflection to determine what that communication is. If I ask my son to turn the TV off and he yells at me, I document the event, time, place, circumstances, and language. If this event keeps happening every time I ask, I will change something and see if it is any more effective. If I run out of alternatives, then I am going to ask someone else such as a counselor for suggestions.
Interestingly, this is not a new strategy for special education. Back in 1994, when I was writing my Master’s thesis, I referred to the fact the most effective reading programs were the ones that continually used the scientific method to determine effectiveness. My family also consistently reflect on our lives. Any time we attempt something new, we will evaluate how well we did. If I make cookies and they taste awful, I will go back to the recipe and try and figure out what I did wrong. If I put an IKEA table together and have parts left over, I will go back and figure out why. I am constantly thinking about the most efficient way to drive from one place to another. When I break down these behaviours into each part, then experiment with different ways to discover the most efficient, I will eventually find successes. I believe this is why my daughter Cassie loves the cooking shows because every chef I have seen is constantly using reflection to create the best possible dish. Cassie, at some level, recognizes the familiarity of it. Whenever Sky or Jacob can verbalize why they acted the way they did, they are using reflection to discover this.
However, the key is identifying the variables responsible through experimentation. Rarely can our children verbally communicate these variables. We know when Sky is short-tempered, Cassie is crying and Jacob is yelling, something is wrong. We will start tracking their day to find out what has them out of sorts. We know anxiety leads to bad decision making, too much talking overwhelms them, rapid changes make them confused, and boredom leads to impulsivity. We know all of this because we have consistently used reflection to detect the pattern. And through experimentation, we have discovered strategies that work for them in those situations. It is also important to note that these five concepts will work through the lifespan, but the way we apply them changes with age or with particular situations. It is also important to recognize a strategy may work once but then fail to work later due to a slight change in the situation. Therefore, it is constant reflection.
1 1) Discrete Trial Teaching is basically simplifying it. Focus on one thing, accomplish it, then move onto the next thing. My children don’t understand time so they just keep going step by step until it is done.
2 2) Naturalistic Teaching or Discovery Learning. I love this one. Basically, look at their strengths and use them as much as possible. My son is great with his iPad so we use loads of apps to help him manage his emotions, watch videos, voice text his writing, use pictures to describe and listen to stories.
3 3) Pivotal Response Therapy takes naturalistic learning a step further. We deliberately tap into strengths to manage one specific identified behaviour from using reflection. My daughter Sky really struggles with speaking to strangers. But if an unknown fair judge asks her about her cow, she can be very articulate.
4 4) Token Economy or Bribery – Yes, it works if you can find the right motivator. If I tell Sky or Jacob I will let them have a favorite snack if they do what I ask, they will do it.
5 5) Contingent Observation or Good modeling- We actively seek and encourage relationships with peers who provide good modeling for them. And we are discovering if these friends are consistent in their relationship with our children, everyone tends to do well.
There are other strategies obviously, some of which will work and others that clearly do not. For us, though, these five have proven to be very effective. The key, though, is not to give up. My old basketball coach used to say the only way we lose is if we quit. Otherwise, we just didn’t have enough time. So just don’t quit and you will find the solution. You may use twenty different strategies before finally finding the one that works for your child. But there is, most certainly, at least one that will work.