'"4%CHILDWELFARE.CA The Caregiver Curriculum on FASD

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1 '"4% & Child Welfare Community of Practice '"4%CHILDWELFARE.CA The Caregiver Curriculum on FASD FASD and Behavior: Understanding Dismaturity Curriculum Development Team: Dorothy Badry, PhD, RSW Jamie Hickey, BA, MSW (c) Faculty of Social Work University of Calgary Project Funder: Public Health Agency of Canada ( )

2 FASD and Behavior Module 4.2 Behavioral Challenges and FASD: Understanding Dismaturity

3 How to use this module Open in PowerPoint or PowerPoint viewer Click the Slideshow tab then click the From Beginning menu buqon that appears below Use your mouse to click on the arrows and items on the slides to navigate For longer modules, terms that appear in blue within the table of contents with an underline can be clicked to navigate the module.

4 How to use this module, conrnued The main navigaron buqons work like this Go back to the very start Go back Go to the Table of Contents Go forward Go to the end of this module

5 How to use this module, conrnued There are also 2 special navigaron buqons This buqon will return you to a list if you are asked to click to learn more about different topics This buqon will return you to the main chapter if you click on a colored box to see an example

6 Table of contents ParenRng a Child with FASD in Care Developmental Age and Dismaturity ShiWing the View of Behavior Service Delivery to Children with FASD Achieving the Best Outcomes Review Curious to Learn More?

7 A diagnosis of FASD Many condirons exist under the umbrella of FASD The purpose of diagnosis is to seek treatment or idenrfy strategies that will improve the condiron of the individual The basic ethical foundaron within public health, of ge[ng diagnosis is to provide treatment

8 ParenRng a child with FASD in care, or within families: Is a complex journey Physically, mentally, emoronally and spiritually Requires crearvity and innovaron Involves awareness of how best to meet the needs of the child Requires support for both the child and the caregiver

9 Children with FASD can have parrcular vulnerabilires: Developmental delays owen presenrng as immaturity Neurobehavioral problems as a result of brain damage from prenatal alcohol exposure Physical health problems (as idenrfied by a medical doctor) EmoRonal health problems mental health

10 Behavior For children with FASD behavioral challenges exist A brief explanaron for this is related to that parrcular damage in brain funcron occurred as a result of prenatal alcohol exposure This is a permanent disability and owen idenrfied as an invisible disability

11 FASD, developmental age and maturity/ immaturity: Neurodevelopmental disorders What are some of the challenges experienced by children that are related to FASD? AQenRon difficulres - easily distracrble, difficulres in moving/transironing from one task to the other, challenges solving problems in the moment, challenges in being flexible, low tolerance for change, impulsivity, vulnerability to peer influences, challenges with memory, lack of consistency, appears disorganized, lack of follow through on instrucrons, acrng much younger than their developmental age, difficulty in understanding consequences of acrons. Sources Fetal Alcohol Syndrome ConsultaRon EducaRon and Training Services, Inc. Providing an AlternaRve Paradigm for Understanding Behaviors. Online Address: hqp:// BenneQ, B. Life stages and transirons. In: Jonsson, E., DenneQ, L., & LiQlejohn, G. (2010). Fetal Alcohol Spectrum Disorder (FASD): Across the Lifespan: Proceedings from an IHE Consensus Development Conference Wiley- Blackwell ( ).

12 FASD, developmental age and maturity/immaturity Why is this so challenging? Children with FASD have many needs. The well being of children relies on aqachment, security, nurturing and safety as they develop and grow. Children come into care owen due to protecron needs related to addicrons, substance abuse, neglect and trauma. When children experience any trauma, and neglect, disruprons in their development occur When children come into care they experience a profound shiw in their life and even very young children have experienced grief and loss

13 Belief systems and assumprons regarding behavior A belief that children will listen to the adults in their lives An expectaron that children will do what they are told That establishing consequences for children who appear to not be listening is reasonable That with enough care and love children s behavior will improve

14 An invisible disability is hard to see and harder to understand FASD is owen referred to as a brain based disability OWen there are no visible physical characterisrcs that suggest a child with an FASD diagnosis has a disability, parrcularly in the way that most people perceive disability within society This presents a challenge for most people because it is hard to fathom that a child who looks okay, is not okay.

15 Children with FASD: Challenge those assumprons Need parental figures in their lives to be the best that they can be Require those adults in their homes, schools and communires to provide structure, rourne and supervision ALWAYS Are at risk without structure, rourne and supervision

16 FASD, developmental age and maturity/immaturity When children are in a safe and secure environment, we hope and expect that life will seqle down Dismaturity is a consequence of FASD and caregivers have to shiw their thinking about the behavioral issues they encounter. What is the fundamental shiw required?

17 ShiWing the view of behavior for children with FASD We need to see these children as hurt, not bad. (Donna Debolt, FASD Consultant, 2013) ShiWing the way children s behavior is perceived is crircal in changing the response to the behavior When you ask the child Why did you do that? and get the response I don t know. that is likely the truth for that child

18 Belief systems and assumprons regarding behavior in children A belief that children will listen to the adults in their lives An expectaron that children will do what they are told That establishing consequences for children who do not listen is reasonable That with enough care and love children s behavior will improve Children with FASD challenge these assumprons

19 FASD, developmental age and maturity/immaturity Children with FASD are owen close to their peers in relaron to physical development A child with a full diagnosis of Fetal Alcohol Syndrome, may have significant physical and developmental delays that are obvious and these children are owen provided some form of service within the developmental disability world without quesron When a child does not have physical signs of a disability the behavioral and emoronal symptoms of the disability may be difficult for others to understand

20 FASD, developmental age and maturity/immaturity For children with FASD who appear physically to be the same age as their peers there are many challenges One problem is that peers, family and adults owen have the same expectarons for this child because the child looks their age It is difficult to fathom a 15 year old boy acrng like a 7 year old It is difficult to see a 12 year old girl having a tantrum like a 4 year old

21 Children with FASD: Challenge the assumpron that they will act their physical age that is why understanding dismaturity is helpful it reframes the perspecrve Need parental figures in their lives to be the best that they can be Require those adults in their homes, schools and communires to provide structure, rourne and supervision ALWAYS Are at risk without structure, rourne and supervision

22 FASD, developmental age and maturity/immaturity Why is this so challenging? All the history that comes with the child is owen unseen by the caregivers. Children with FASD have many needs. The well being of children relies on aqachment, security, nurturing and safety as they develop and grow. Children come into care owen due to protecron needs related to addicrons, substance abuse, neglect and trauma. When children experience any trauma, and neglect, disruprons in their development occur When children come into care they experience a profound shiw in their life and even very young children have experienced grief and loss as does their family despite the challenges that resulted in a placement in care

23 What are persons with FASD at risk for in the community? High risk of abuse due to willingness to be accepted by peer groups willing to do anything to be accepted by peers Vulnerability to those who would take advantage May not recognize when a situaron is dangerous DistracRbility may effect safety Lack of understanding by systems

24 Next steps Future hopes The crircal nature of the relaronship of the worker to the child and the foster home needs Rme and aqenron Caseworkers and foster parents must work collaborarvely Minimizing life and placement disrupron for children with FASD in care is crircal The decision making regarding children with FASD is complex and needs a supported decision making framework Contact with biological family must be considered from a long term framework

25 What is important in the delivery of service to children with FASD in care? Providing a safe and secure home that is stable Using strengths- based language: Talk about what the child can do, not what they cannot Hopes, visions for the future and dreams Belief in ability, talents, competency, change Believing in the individual Ge[ng the help needed to care for the child will help support long term placement stability

26 Achieving the best outcomes In the document: Lifeguard Strategies for SupporRng Adolescents and Adults Affected by FASD (2006) the following are idenrfied as lifeguard strategies for the person with FASD EssenRal Beliefs everyone has a giw Required A[tudes oprmism, inquisirve and acceprng Successful Approaches structure with a strengths based focus

27 Achieving the best outcomes In the document: Lifeguard Strategies for SupporRng Adolescents and Adults Affected by FASD (2006) the following are idenrfied as lifeguard strategies for the person with FASD CommunicaRon strategies speaking and listening Environmental adaptarons adjust the environment in a way that works for the child Find this document and read the full details: hqp:// network- resources/

28 Recap and acrvity Reflect on the informaron provided in this module. Think about your perceprons and understandings of the child s behavior. Talk with someone who you can safely share these thoughts with. Explore the ways you can be supported on this journey over Rme. Who can you talk to? Understanding FASD as owen an invisible disability helps in reframing some of the challenges. Keep involved with a support system for the child and for yourself.

29 Curious to learn more? Check out these videos from the Alberta FASD Learning Series: Internet Safety: PredicIng the Youth - hqp:// feature=player_embedded&v=3kxazgpzyxs Winning the BaLle With FASD: A Family Success Story - hqp:// feature=player_embedded&v=kcydm0ip- _s Environmental ModificaIons - hqp:// feature=player_embedded&v=- a5gc07cykk

30 The Caregiver Curriculum on FASD Title: Caregiver Curriculum on FASD (Fetal Alcohol Spectrum Disorder) 2014 Author: Dorothy Badry & Jamie Hickey in collaboraron with the Tri Province FASD Research Team Format: pdf and Power point - online topics and modules on the website fasdchildwelfare.ca Publisher: Faculty of Social Work, University of Calgary; Faculty of Social Work, University of Manitoba & Children s Aid Society of Toronto- Child Welfare InsRtute This project was funded by the Public Health Agency of Canada. ISBN Use of Material: This material can be freely shared and used with acknowledgment using the citaron below. CitaIon: Badry, D., Hickey, J. & the Tri Province FASD Research Team (2014). Caregiver Curriculum on FASD. Online: fasdchildwelfare.ca; Faculty of Social Work, University of Calgary; Faculty of Social Work, University of Manitoba & Children s Aid Society of Toronto- Child Welfare InsRtute. Funder: Public Health Agency of Canada.