"ADHD" and "FAS" presentation review

submitted by Jill Katrin

March 14, 2000

Grade Contract Assignment for Second Semester

Last fall I attended a workshop about ADHD, (Attention Deficit Disorder with Hyperactivity,) and this spring I attended a workshop about FAS, (Fetal Alcohol Syndrome). I learned a wealth of information at these workshops. Both presenters discussed the history, characteristics, symptoms, assessment, and interventions for these physical disorders. What surprised me the most after attending these two workshops is the similar behaviors characteristic of both disorders. I will begin this review by giving a brief description along with common symptoms and characteristics.

The "ADHD" workshop I attended was presented by Geoffrey C. Ammerman. He has twenty years experience as a psychologist, and he has made over 900 evaluations of patients. He has had a lot of experience with patients with ADHD. He talked about it being a chemical disorder in the brain. He also said it was previously called "Minimum Brain Dysfunction." Todays researchers are finding that ADHD is not a disorder of attention, but rather as a developmental failure in the brain circuitry that underlies inhibition and self-control. This loss of self-control in turn impairs other important brain function crucial for maintaining attention. Russell A Barkley states,"ADHD may arise when key brain circuits do not develop properly, perhaps because of an altered gene or genes."

ADHD involves two sets of symptoms: inattention and a combination of hyperactive and impulsive behaviors. These behaviors are concerns in the classroom when students display them significantly more than their peers do. Mr. Ammerman discussed four different types of ADHD: Inattentive, Hyperactive, Mixed, and Adult Residual. The following list provides characteristics of these four types.

Attentive Form: Fails to give close attention to details; difficulty sustaining attention; does not seem to listen when spoken to directly; does not seem to follow through on directions or instructions; and has difficulty organizing

Inattentive Form: Avoids, dislikes or is reluctant to engage in tasks that requires a sustained mental effort; often loses things; is easily disttacted; and often forgetful.

Hyperactive Form: Often fidgets; up and down in their seat when being seated is expected; often runs around and engages in dangerous climbing; complaints of restlessness; often on the go; and talks excessively

Impulsivity: Blurts out answers before questions are completed; difficulty waiting turns; and often interrupts or intrudes in conversations or games.

Ammerman spent a lot of his presentation answering questions and concerns from the audience concerning medications. Many parents were frustrated with regulating the medications their children were taking. He said this is crucial and the amount the child should be taking depends on his/her body weight as well as the type of ADHD. As a rule he said .3 mg of medication to 1 kg. of body weight is used. He said Ritalin and Dexedrine are the two drugs most readily used. Many parents were concerned about the side effects using the drugs. A parent of a student diagnosed with ADHD last year felt it was a losing battle if she put her child on meds as well as if she didnt. She wanted the best for her child, but was unsure about the side effects. Alternatives to medication were also discussed such as diet and behavior management plans.

Some interesting information I came upon is as follows: Children of a parent who has ADHD have up to a 50 percent chance of experiencing the same difficulties; boys are at least three times as likely as girls to develop ADHD; many studies estimate that between 2 and 9.5 percent of all school-age children worldwide have ADHD; and ADHD can persist into adulthood.

What are some things parents and educators can do to help students with ADHD?

7 increase the external use of prompts and cues about rules and time intervals

7 anticipate events for children with ADHD

7 break future tasks down into smaller and more immediate steps

7 use artificial immediate rewards

7 have a consistent and predictable schedule

FAS - (Fetal Alcohol Syndrome)

FAS is caused by exposure to alcohol during pregnancy. The presenter for FAS presentation was Lynne Friggard of Arc Northland, Duluth, Minnesota. She discussed the facial characteristics, age-level symptoms, sexuality issues, criminals in prisons and strategies to use with students assessed with FAS of FAE (Fetal Alcohol Effects). She began her presentation by cracking an egg into a clear glass and adding one tablespoon of Everclear alcohol to it. Within seconds the white part of the egg was turning white. She showed us an egg after it had been in the Everclear for about six hours. It was completed hard-boiled. This demonstration sure got my attention. She talked about how Minnesota is rated fourth nationally with people diagnosed with FAS, and northern Minnesota has the most diagnosed cases due to alcohol consumption in the area. She discussed how drinking in the first trimester of the pregnancy can cause the most damage. Between 50,000 and 375,000 babies are born per year with FAE. The alcohol dehydrates the brains cells causing it to form differently. The brain does not separate into hemispheres, and the inside of the brain appears "holey." The alcohol eats away the cells. The Hippocampus part of the brain is greatly affected by alcohol. This part organizes your brain and provides us with recall of information. As a result, FAS kids have difficulty remembering what happened previously. They do not understand consequences for their behaviors and do not show remorse. FAS is the leading cause of mental retardation.

Common facial characteristics are: eyes set apart, low set ears, slit eyes, short turned up nose, small lower jaw, thin upper lip, small head circumference, and epicanthal folds. These facial characteristics are most readily identifiable in early childhood.

Common symptoms of people with FAS/FAE include: attention deficits, memory deficits, hyperactivity, difficulty with abstract concepts, poor problem solving skills, difficulty learning from consequences, poor judgment, immature behavior, and poor impulse control.

People with FAS/FAE need to be specifically taught values and feelings. They need to be taught the same thing over and over again because of their difficulty with remembering what they learned. They need to be taught to the appropriate developmental/emotional level versus their chronological age. She stressed how most people with FAS/FAE operate at a much younger developmental level compared to their age. Other strategies to help peole with FAS/FAE include: using visuals such as pictures, puppets, face blocks; tactile prompts; role playing situations which are causing problems; practicing body language; practice of verbal responses; short concrete steps; and arranging a self-calming area by providing soft lighting, limit sound, separate place.

She said, "You cant change people with FAS/FAE internally, you need to help them externally." Hopefully, the above strategies with the classroom environment will help aid students with this disorder. She also talked about the high percentage of adults with FAS/FAE in prisons. They often repeat the same crime over and over because of lack of understanding and consequences. Their brain doesnt allow them to remember their behavior. Research discoveries with this disorder will help identify these characteristics in adults and how they can be helped.

As a final point, it is important to keep a sense of humor, a sense of empathy and understanding as educators in helping these children to promote positive outcomes.

-- Anonymous, March 14, 2000