The effects from prenatal alcohol exposure (PAE) can cause a range of neurobehavioral deficits that impact learning and functioning in school. As a result, children affected by PAE have diverse learning needs and may experience problems in school. Educational planning needs to be developed in accordance with the children's individual cognitive and learning profiles. Interventions need to focus on habilitation of the underlying deficits that influence learning within the context of an academic or school skill. Caregivers require information on how to advocate for their children's needs. Additionally, families, school personnel, and other professionals require training on the impact of PAE on development, learning, and school functioning. Using a comprehensive and collaborative approach to provide the necessary educational care for children with fetal alcohol spectrum disorders (FASD) may lessen the risk of academic and school failure.
The current case study describes the longitudinal assessment of a young child diagnosed with Partial Fetal Alcohol Syndrome and pervasive developmental disorder-not otherwise specified. The patient participated in an applied behavior analysis (ABA)-based Verbal Behavior treatment program to target communication impairments and functional skill deficits. Because ABA-based interventions have demonstrated efficacy in improving levels of functioning across various developmental disabilities, it was reasonable to assess the clinical utility of these same strategies when applied to a patient presenting with fetal alcohol spectrum disorder and associated developmental delays. The current study relied on quasi-experimental single-subject design methods to measure treatment outcomes and to inform clinical decision making. Dependent measures in the study included standardized, norm-referenced assessments of cognitive and adaptive functioning, as well as behavioral data collected throughout treatment to measure gains across skill areas. Outcomes included rapid skill acquisition across several areas of functioning (e.g., expressive and receptive language, visual-performance, and adaptive emotional/behavioral functioning). The impact of treatment on global areas of functioning will be reported. Keywords applied behavior analysis, fetal alcohol syndrome 1 Theoretical and Research Basis for Treatment Early and intensive intervention rooted in applied behavior analysis (ABA) is a widely utilized and researched area in the treatment of individuals with developmental disabilities. Defined as the scientific study of the effects of environmental variables on socially significant behavior, the field of ABA is devoted to assessing and treating socially significant behaviors to produce behavioral and developmental improvements (Cooper, Heron, & Heward, 2007).
Fetal Alcohol Spectrum Disorders (FASD) has been estimated to affect as many as one in 100 children. Children with prenatal alcohol exposure may exhibit physical alterations and compromised cognitive functioning. The neurodevelopmental deficits associated with FASD range from global intellectual impairments to specific processing deficits, and learning disabilities that can hinder academic performance and adaptive functioning. The purpose of this chapter is to provide an overview of the impact of FASD on children's education, and to present a brief summary of the evidence-based programs and other interventions that may support better educational and behavioral outcomes for alcohol-affected children.
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This case study describes the outcomes of a Saturday community intervention program for children suspected of or affected by prenatal exposure to alcohol who exhibited learning deficits. Five children participated in the program and received individualized interventions designed to address learning and academic deficits in either reading or mathematics. Often children affected by prenatal alcohol exposure exhibit deficits with executive processes, including metacognitive functioning, that interfere with learning. Instruction to improve metacognitive skills was incorporated into the intervention programs. The metacognitive training was adapted from the Math Interactive Learning Experience (MILE) and targeted the children's skills to plan, organize, shift, and evaluate problem solving strategies. Standardized tests of nonverbal reasoning and academic achievement were administered before and after the children received interventions to measure progress. The results indicated that four of the five children who participated in the program showed clinically significant gains with scores increasing from the borderline or low average to the average range on measures of nonverbal reasoning, reading comprehension, or mathematics reasoning. One child showed no gains on measures of nonverbal reasoning and reading. A variety of factors including age, cognitive profile, session attendance, and access to special education and other intervention services may have influenced the child's progress. Overall, the case reviews suggest that the interventions show promise to remediate learning problems of children affected by prenatal alcohol exposure in a community setting.
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