WHAT ARE FETAL ALCOHOL SPECTRUM DISORDERS?

FASD is an umbrella term describing the range of

effects that can occur in an individual whose mother

drank alcohol during pregnancy. These effects may

include physical, behavioral, mental, and/or learning

disabilities with possible lifelong implications.

Childen do not grow out of the disorders.

FASD is not a diagnostic term. It includes conditions

such as:

• Fetal alcohol syndrome (FAS)—a pattern of

neurologic, behavioral, and cognitive deficits, as

well as specific facial features (smooth philtrum,

small palpebral fissures, thin upper lip)

• Alcohol-related neurodevelopmental disorder

(ARND)—neurologic abnormalities such as

problems with memory and motor skills

• Alcohol-related birth defects (ARBD)—defects

in the skeletal and major organ systems

Imaging studies have shown structural changes in

various regions of the brain. These include thinner

or absent corpus callosum, reduced basal ganglia,

and smaller cerebellum.1

 These changes contribute

to a lack of understanding that manifests

behaviorally. For example, persons with FASD may

have difficulty with executive function and have

trouble with problem solving and planning.

HOW ARE STUDENTS AFFECTED BY FASD?

Students with FASD may have many learning

challenges, such as:

• Visual and auditory processing problems

• Difficulty with reading comprehension

• Memory problems

• Sensitivity to sensory input

• Attention deficits

• Problems with social behaviors

• Problems following multiple directions or rules

• Difficulty with math and abstract reasoning

• Inability to understand cause and effect

• Difficulty organizing tasks and materials

Due to auditory processing problems, these students

may not respond to traditional teaching methods,

such as lectures. They may act out in frustration

because they do not understand what is going on.

They may “melt down” due to sensory overload and

may fidget a lot. They may struggle in math class.

Most do not learn from punishment because they

cannot generalize rules. In addition, many have

impulse control problems. Children with FASD

typically lack social skills, such as listening, asking

for help, waiting their turn, and sharing.

• John, a 5th grader, constantly returns late from recess.

• Susan, a fourth grader, acts out in the lunch line, screaming and kicking.

• Peter, a second grader, cannot do addition problems on worksheets.

Lazy? Uncooperative? Victims of poor parenting? No. These students

may have fetal alcohol spectrum disorders (FASD). Some of the most

challenging students in schools today have FASD. Many have no

formal diagnosis but their grades and behavior indicate a problem.

FETAL ALCOHOL SPECTRUM DISORDERS:

TIPS FOR ELEMENTARY SCHOOL TEACHERS

WHAT YOU NEED TO KNOW

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration

Center for Substance Abuse Prevention

www.samhsa.gov
HOW CAN WE RECOGNIZE FASD?

FASD may be difficult to spot. In fact, many students

with FASD are undiagnosed or misdiagnosed. Most

people with FASD do not have facial anomalies. 

Some have low IQs but many have normal or aboveaverage IQs.

If a student exhibits behavior or learning problems,

you might want to suggest psychoeducational testing.

These tests can help identify central nervous system

dysfunction. The information also can provide a

foundation for a diagnosis by a physician trained in

FASD. It is important to provide a supportive,

nonjudgmental environment. Encourage parents to

talk about possible FASD, seek a diagnosis, and share

the results with the school.

HOW CAN WE HELP STUDENTS WITH FASD?

Every child is different, and much of what works with

students with FASD may be learned through trial and

error. Here are some general tips for working with

students with FASD:

1. Use literal terms. Avoid words with double meanings,

slang, and idioms (e.g., “school of hard knocks”).

Do not use metaphors and similes.

2. Be consistent. Use the same words for key phrases

and oral directions.

3. Repeat, repeat, repeat. You may need to reteach

information multiple times.

4. Follow a routine. Routines help students with FASD

know what to expect and decrease their anxiety.

5. Keep it simple. Students with FASD learn better in

a simple environment with few distractions. Oneon-one or small groups work best when possible.

6.Be specific. Say exactly what you mean. Give

directions step by step. Break large tasks into smaller

tasks. Use pictures, charts, or other visual aids. Show

the student what to do.

7. Provide structure. Structure helps students with

FASD make sense of their world.

8. Supervise. Students with FASD can be naive and

gullible and lack social skills. They need constant

supervision to develop patterns of appropriate

behavior.

In addition, recognizing the underlying reason

for challenging behaviors can help in

developing strategies. For example:

• John does not process the passage of time. Use

daily reminders, such as music, a peer mentor, or a

teacher prompt.

• Susan is often overstimulated. Have her stand at the

front or back of the lunch line so that she is not

stuck between other students. Eating in a quiet room

with a small group and an adult would help.

• Peter cannot add numbers in his head. Use

manipulatives, such as blocks.

WHERE CAN I LEARN MORE?

For more information, see:

• “8 Magic Keys: Developing Successful Interventions

for Students with FAS,” by Deb Evensen and Jan

Lutke, fascenter.samhsa.gov/gg/fact_sheets.cfm

• Resources for Educators, depts.washington.edu/fadu

• British Columbia Ministry of Education,

www.bced.gov.bc.ca/specialed/fas

REFERENCES

1. Mattson, S.N.; Schoenfeld, A.M.; and Riley, E.P. 2001.

Teratogenic effects of alcohol on brain and behavior. Alcohol

Research & Health 25(3):185–191.

06/04

REMINDER FOR TEACHERS AND PARENTS

If you’re pregnant, don’t drink. If you drink, don’t get pregnant.

For more information, visit fascenter.samhsa.gov or call 866-STOPFAS.