Introduction
Fetal Alcohol Syndrome (FAS) is one of the leading causes of birth defects in the United States. Moreover, FAS appears to be the most common cause of preventable mental retardation. (“Fetal Alcohol Syndrome”, n.d.) Each year between 5,000 and 12,000 American babies are born with the condition. (“Fetal Alcohol Syndrome”, n.d.)Thus, each year roughly 5,000 to 12,000 American children are entering into the educational system. (“Fetal Alcohol Syndrome”, n.d.) Therefore, our nations public schools should be both properly funded and prepared in the classroom to educate children with Fetal Alcohol Syndrome. (“Fetal Alcohol Syndrome”, n.d.)
Overview of Fetal Alcohol Syndrome
Fetal Alcohol Syndrome (FAS) is a collection of symptoms that when appearing together indicate the specific FAS condition. (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002) FAS is caused when by a woman's ingestion of any type pf alcohol during pregnancy. (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002) The alcohol travels through the pregnant woman's bloodstream and through the placenta to the unborn fetus. (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002) In other word's, the developing baby is also processing and metabolizing the alcohol that has passed to it from the pregnant mother. (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002) Once there is prenatal exposure to alcohol molecules do not properly adhere to each other and cells do not properly attach. (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002) The result is devastating for prenatal brain development resulting in structural deformities and an imbalance of neurochemicals. (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002) The alcohol is broken down much more slowly than an adult's body due to the small size of the fetus. (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002) The slow breakdown of the alcohol by the small developing fetus actually increases the alcohol level to points significantly higher than the alcohol level in the mother's blood. (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002)
Moreover, the alcohol remains in the developing fetus's blood longer than it stays in the mother. Women who drink four or five alcoholic beverages or more per day have a significantly increase chance that their unborn child will develop FAS. (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002) Even an average of one drink per day during pregnancy can increase a developing baby's risk of FAS. (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002) In fact, there are no studies that have demonstrated a safe level of alcohol consumption during pregnancy.( “Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002) The signs and symptoms of FAS begin with birth defects that result from a woman's use of alcohol during pregnancy. (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002) Symptoms include growing less quickly than other children, facial abnormalities (small eyes with drooping upper lids, short, upturned nose, flattened cheeks, small jaw, thin upper lip, flattened philtrum), and problems with the central nervous systems of affected children (mental retardation, hyperactivity, delayed development of gross motor skills such as rolling over, sitting up, crawling and walking, delayed development of fine motor skills such as grasping objects with the thumb and index finger, and transferring objects from one hand to the other, impaired language development, memory problems, poor judgment, distractibility, impulsiveness, problems with learning, and seizures). (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002) In addition to these signs and symptoms, children affected by FAS often display decreased birth weight, small skull size and hearing disorders. (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002) Studies show that the more numerous or severe the characteristics, the more severe the child's cognitive impairments tend to be. (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002)
Children with FAS also may display secondary conditions. These secondary FAS conditions include, but are not limited to: mental health problems such as attention deficit disorder, conduct disorders, and depression; behavior problems in the public education environment such as disobedience, truancy, suspension and expulsion; difficulty in maintain employment and living independently; higher rates of drug and alcohol abuse; and ultimately increased contact with law enforcement from their criminalized behavior resulting in numerous legal issues. (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002)
Those born with FAS may have problems controlling anger and frustration, and problems understanding the motives of others. (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002) This may lead to violent behavior. They are also prone to explosive outbursts. As a result, teenagers and adults with FAS are more likely to be involved with the criminal justice system than their peers are. (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002) Also, those with FAS can be especially susceptible to persuasion and manipulation, which may lead to unwitting involvement in illegal activities. (“Fetal Alcohol Syndrome”, n.d.), see also (Wilkemeyer, Menkari, Spong & Charness, 2002) “They simply have difficulty understanding the meaning and interrelationships of a complex world.” (Streissguth, A. P., 1997) As a result of all of the complex issues that associated with children with FAS, education children with FAS becomes incredibly difficult for school systems across the country.
History of Special Education in the United States
Historically, society viewed disabilities and the related learning difficulties were considered to be solely within children. (Thomas & Loxley, 2001) Traditionally children with disabilities were simply excluded from public schools. (Rethinking Schools Online, n.d.) They were deemed unworthy of public education. School systems dedicated zero resources and efforts to educating children with disabilities. (Rethinking Schools Online, n.d.) Families were left with very little educational alternatives other than remaining at home or institutionalizing their children with disabilities at “Special Schools.” Giangreco, M. F., Yuna, S., & McKenize, B. (2005, May/June 1). Be Careful What you Wish For...”: Five Reasons to be Concerned About the Assignment of Individual Paraprofessionals. Teaching Exceptional Children. Teaching Exceptional Children. p. 37. If the children with disabilities weren't withdrawn to home school or placed in institutions, they would simply just drop out of the educational system long before graduating from high school. By the 1930's concerned and loving families began forming advocacy groups for children with disabilities. Rethinking Schools Online. (n.d.). Retrieved from http://www.rethinkingschools.org/archive/16_03/Hist163.shtml. The Civil Rights Movement and the landmark United States Supreme Court case Brown v. Board of Education, which extended equal protection under the law to minorities, finally began to open the proverbial “doors” of public education for those with disabilities. Id.
It wasn't until the U.S. Congress passed the Education for All Handicapped Children Act, also more commonly referred to as Public Law 94-142, in 1975 that real change began in public education for children with disabilities. Id. Public Law 94-142 proved to be landmark legislation, requiring public schools to provide students with a broad range of disabilities - including physical handicaps, mental retardation, speech, vision and language problems, emotional and behavioral problems, and other learning disorders - with a "free appropriate public education." Id. Moreover, it called for school districts to provide such schooling in the "least restrictive environment" possible. Id.
Congress reauthorized Public Law 94-142 twice in the 1990s and changed the name of the law to the Individuals with Disabilities Education Act (IDEA). Rethinking Schools Online. (n.d.). Retrieved from http://www.rethinkingschools.org/archive/16_03/Hist163.shtml. The renaming and re-authorization of IDEA finally provided a legislative mandate to the nation's public schools to deliver proper education to the millions of children with disabilities who had “previously denied access to an appropriate education.” Id. Under IDEA, children with disabilities were in school, assigned to smaller classes, provided teachers trained in working with children with disabilities, interpreters for the deaf, computer-assisted technology, and special education students were allowed to spend time with other children in general education classrooms. Id.
But changes to the nation's special education services comes at a financial cost to the system. “According to the Department of Education, approximately 6 million children (roughly 10 percent of all school-aged children) receive special education services.” Id. This translates to an overall cost of approximately $51 billion a year currently. Id. Originally when IDEA was passed, the federal government was supposed to cover forty percent of the costs of the mandated services for children with disabilities. Rethinking Schools Online. (n.d.). Retrieved from http://www.rethinkingschools.org/archive/16_03/Hist163.shtml. Instead, the financial burden of funding services for children with disabilities has fallen upon the shoulders of state and local governments. Id. In fact, “the federal government has never paid more than 15 percent” of the total costs of special education services. Id. State and local governments have been the primary financial contributors to the costs associated to educating children with disabilities, contributing more than $44 billion to school districts. Id.
Estimated Costs of Special Education Services for Children with FAS
Although the overall costs of special education are relatively easy to calculate, very little information is available on the cost of providing special education services to children with FAS. See generally Bloss, G. (1994). The Economic Cost of FAS. Alcohol Health and Research World, 18(1), 53-54; The Financial Impact of Fetal Alcohol Syndrome. (n.d.). Retrieved November 16, 2014, from http://fasdcenter.samhsa.gov/publications/cost.aspx; Special Education Costs. (n.d.). Retrieved from http://www.learningrx.com/special-education-costs-faq.htm. Most, if not all, of the data related to calculating the costs of special education services to children with FAS was assembled during the 1980s and 1990s. Id. Most often the costs associated with providing special education services to children with FAS are divided into two primary categories: total annual cost of FAS to federal, state and local government and lifetime cost for each child with FAS. Id.
The difficulty in identifying the costs expended to educate children with FAS come from various different aspects of the analysis. For example experts have difficulty in agreeing on whether estimates should be based on the incidence or prevalence rate. Id. It also becomes difficult to include indirect costs such as administrative costs and research costs. Id. Simply implementing the various educational accommodations discussed herein in can come at substantial administrative costs to school systems. Finally, the collateral costs to society when children with FAS are not adequately educated are almost impossible to measure. Some experts attempt to include all of societies collateral costs such as those associated with the law-enforcement and legal contacts teenagers with FAS have. Others only include the direct costs expended by school systems With so many unknown variables in cost-estimation, current estimates of the total cost of educating and caring for those with FAS range from $0.2 to $11.7 billion. See (Bloss, G., 1994, pp. 53-54); The Financial Impact of Fetal Alcohol Syndrome. (n.d.). Retrieved November 16, 2014, from http://fasdcenter.samhsa.gov/publications/cost.aspx; Special Education Costs. (n.d.). Retrieved from http://www.learningrx.com/special-education-costs-faq.htm. This can translate into as much as $30,000 a year per student with FAS. Id. Even though the estimated costs vary substantially, the conclusion is the same – educating and caring for children with FAS is extremely expensive to society.
Funding must be a primary focus of school systems in educating children with FAS in order for them to achieve their full potential.
Effective Strategies for Public Education to Utilize with Children with FAS
As originally stated, public schools must be properly prepared to educate children with FAS. Special Education costs are constantly on the rise. “Public schools spend an average of two to three times on each student eligible for special education as they do for students without disabilities (Center for Special Education Finance).” The Financial Impact of Fetal Alcohol Syndrome. (n.d.). Retrieved November 16, 2014, from http://fasdcenter.samhsa.gov/publications/cost.aspx. Because IDEA requires schools to create an individualized education program (IEP) to meet the needs of every student with disabilities and to ensure that the student is in an environment that provides the fewest obstacles to their success, regardless of cost. Id; see also Special Education Costs. (n.d.). Retrieved from http://www.learningrx.com/special-education-costs-faq.htm.
Thus, it is very expensive for school systems to create and maintain appropriate types of educational programs for children with FAS such as physical therapy, speech therapy, behavior therapy and counseling. In addition, over the last decade, special education costs have increased because the number of students with disabilities has increased by approximately 30 percent. Id. And without an uniform state or national strategies for funding and implementing special education services, each school system is left to determine the best way to fund and implement effective educational programs for children with FAS. Id.
As such, it is vitally important to for public education to understand and implement effective methods teaching techniques for children with FAS. The behaviors described above that result from FAS are challenging to even the most patient of teachers. Children with FAS respond inconsistently to corrective methods of behavior modification. One day they may respond appropriately to positive feedback and the next day they might only respond to negative consequences. Moreover, children with FAS have significant difficulty with “cause and effect” reasoning. “Teachers must be aware that the type of brain damage that children with FAS/FAE have often leaves them unable to repeat a skill they once did with ease” Harwood, M., & Kleinfeld, J.S. (2002). Up front, in hope: The value of early intervention for children with fetal alcohol syndrome. YC Young Children, 57(4), 86-90.; see also (Baldwin, Shawn, 2005, pp. 3-58), (Giangreco, M. F., Yuna, S., & McKenize, B., 2005, p. 37). This results in educators and family members misinterpreting the student's actions as being negative behaviors, which ultimately makes any attempted interventions fail. Id.
The unique personalities of each child with FAS make the mandated use of IEPs imperative to the success of a child with FAS. The school must begin with “focused observation” of the student in order to understand how each specific individual experiences stress, relieves tension, and copes with day-to-day obstacles. Id. Knowing how a student with FAS meets their own needs and how hard the child is actually trying to meet those needs allows the school's special education coordinator to build a supportive individualized education plan that allows the child to succeed in the classroom. Rooted at the foundation of any plan should be a “multi-sensory, whole brain approach” in a “calm, nurturing, learning environment.” (Baldwin, Shawn, 2005, pp. 3-58)
Teachers of children with FAS must utilize multifaceted strategies in order to ensure proper education. Some permit the student to use “self-talk” to stay focused on the task at hand. Id. Children who are impulsive are taught how to think through all aspects of their behavior prior to initiating even the most minimal of tasks. Id. When there are inappropriate behaviors, there must be immediate consequences and reminders to change the behavior. Id. Teachers and aides must create opportunities for the students to make decisions. Even simple tasks, like allowing the students to make decisions over items or tasks such as the color of the pencil they use for each lesson increases opportunities for the student to remain focused.
One of the primary areas of focus by special education coordinators is in the area of focus or attention span. (Baldwin, Shawn, 2005, pp. 3-58). Many children with FAS have significant problems maintaining their focus for any length of time. Id. General education classrooms can be overstimulating. Id. Children with FAS need to have visual and auditory distractions reduced to a minimum in order to be successful in the classroom. Id. Classroom materials (books, pencils, paper, glue, crayons etc.) would be stored in cabinets when not in use. (Baldwin, Shawn, 2005, pp. 3-58) Decorative objects that spin or move would simply be removed. Lighting in the classroom can be lowered to create a more calm and relaxed atmosphere. Some students could be calmed by quiet background music and simply some time in a designated quiet area. Quiet areas are generally filled with blankets and pillows in the corner of the room creating a quiet place where students can have a sense of solitude. Id.
In addition to reducing or eliminating visual distractions, special education coordinators can decrease auditory distractions as well. Id. Teachers try to speak with low soft voices. Children with FAS should sit as close to the source of information as possible. Id. Students can use noise-reducing headphones. Also, utilizing non-verbal cues such as hand-signals helps limit auditory distractions during educational time. Non-verbal cues can be used not only by the teacher but also by the student. For example, the teacher and student can create a hand-signal that the student can display when he or she needs a timeout. Also allowing students to have access to stress-reducing “kushy balls” or “stress balls” that can be manipulated or compressed by anxious hands provides an appropriate outlet for physical energy. Id. These items are readily available for very low cost. In fact, the dollar aisles of almost every major department store, like Target and Walmart, have numerous stress-reducing items available. Anything that can increase the time a student remains in his or her seat ultimately increases the positive opportunities for that student to learn. Simply put, “a classroom that is well-organized and labeled with words and pictures provides a level of comfort for a student with FASD”. (Baldwin, Shawn, 2005, pp. 3-58)
However, adjustments to the visual and auditory structure of a classroom are not effective absent additional teaching strategies. Id. Because every child with FAS is unique in their responses to their environment, there must ultimately be a balancing of the adjustments so that one child's success does not come at the cost of another child's failure. For example, in the case of children with FAS that are hyperactive, special education coordinators must consider creative ways to allow these students to have some ability to move about without disrupting the attention of the other students. Id. This could include allowing those who are hyperactive to have periods of active learning where physical energy can be expended followed by stationary, quiet learning. A hyperactive student who needs the stimulation of movement could do an assignment while sitting in a rocking chair. For example, younger students could practice basic counting while jumping rope or jumping on a trampoline. More advanced mathematics could be taught in a similar manner by simply increasing the difficulty of the mathematical task such as having the student figure out how many times they can rope in 3 minutes by having the student track the number of jumps they can do in thirty seconds. These are just a few examples of the creative ways educators can include the release of energy in educational plans.
Also, children with FAS are often most successful when they have a regimented daily routine. (Baldwin, Shawn, 2005, pp. 3-58). This would include a very strict structured schedule of events, lessons, breaks, etc... Any time there were alternations or changes in scheduling should be planned and explained in detail to the students. In addition to a daily routine, children with FAS can also benefit from organizational techniques. Id. Notebooks, assignment sheets, and sticky notes can help a child with FAS find comfort in an organized day. Daily progress reports provide a certain level of accountability while also providing caregivers information on the students day. Most if not all children with FAS will need extended time-limits for homework and modified curriculum. Id.
Conclusion
By ensuring adequate funding for educating children with FAS and using the some of the many strategies described above, school systems will be able to effectively accommodate the needs of the students to ensure that the academic experience is beneficial to both student and teacher. To achieve these goals, state and local government, along with school systems and mental health providers must work together with families of children with FAS to meet each students educational needs. Only them with children with Fetal Alcohol Syndrome reach their full potential.

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