National Organization on Fetal
Alcohol Syndrome
Erin Frey, MD
NOFAS FASD K-12
PREVENTION CURRICULUM
LESSON PLANS
Fetal Alcohol Spectrum
Disorders (FASD)
Fetal Alcohol Syndrome
• First described in 1973
• Definition
– Fetal Alcohol Syndrome (FAS) is the term given
to a set of physical, mental and
neurobehavioral birth defects caused by
maternal alcohol consumption during
pregnancy
2005 Surgeon General’s Updated
Recommendations:
• Women who are pregnant should not drink.
• A woman who has already consumed alcohol
during pregnancy should stop to avoid further
risks.
• Women who are at risk for or are trying to
become pregnant should not consume alcohol.
• Health professionals should work with all
women of child bearing age to reduce risk.
FAS
Fetal Alcohol
Syndrome –only
term diagnosed by
health care
providers
ARND
Alcohol-Related
Neurodevelopmental
Disorder
PFAS
Partial Fetal
Alcohol
Syndrome
Fetal Alcohol
Syndrome (FAS)
represents only the
“tip of the iceberg”
relative to all
alcohol-related
effects
FASD By The Numbers
• 1% of all births (40,000 newborns each year).
• Lifetime cost for one individual with FAS is at
least $2 million.
• Cost to the nation up to $6 billion each year for
FAS alone.
U.S. Department of Health and Human Services
Substance Abuse and Mental Health Services Administration
2007
All
AlcoholRelated
Effects
US Census Bureau
Alcohol is a Teratogen
• An agent that interrupts or alters the
normal development of the fetus
• “Of all the substances of abuse (including
cocaine, heroin and marijuana), alcohol
produces by far the most serious
neurobehavioral effects in the fetus.”
Institute of Medicine, 1996
Manifestations of CNS Dysfunction
Associated with FAS
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Attention/memory problems
Hyperactivity
Learning disabilities
Behavior Problems
Microcephaly
Language & speech problems
Altered muscle tone
Poor fine & gross motor coordination
Mental retardation
FASD Through the Life Span
School Issues and Concerns
Developmental Overview
Early School Age
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Continued sleep problems
Making and keeping friends
Reading social cues
Boundary issues
Doesn’t understand stranger
safety
Easily frustrated/tantrums
Understanding cause/effect
relationships
Language/Speech
low receptivity/high fluency
Math problems (time/money)
Developmental Overview
School Age
• Attention and memory
problems
• Learning problems
(especially arithmetic)
• Uninhibited/impulsive
• Distractible
• Lack of organizational skills
• Developmental delays
• Poor coordination
FAS Developmental Overview
Adolescence and Adults
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Anxiety and depression
Lying and Stealing
Antisocial behavior
Poor judgment
Mood swings
Naïve - victimization
Socially inappropriate
behaviors
FAS Adolescents & Adults
Clinical Implications
•
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Poor judgment…………………easily victimized
Attention deficits………….unfocused/distractible
Arithmetic disability……….can’t handle money
Memory problems….......doesn’t learn from experience
Difficultly abstracting……..doesn’t understand consequences
Disoriented in time and space….fails to perceive social cues
Poor frustration tolerance……..quick to anger
Potential “Secondary Disabilities”
• Early school drop-out
• Alcohol and drug abuse problems
• Having children they can’t care for
• Joblessness
• Trouble with law
• Mental health problems
• Premature death
Why Teach About FASD
• Providing age appropriate education
before conception can help reduce the risk
of alcohol-exposed births.
• Schools exercise a powerful influence over
young people, making them ideal settings
to educate about the dangers of drinking
alcohol during pregnancy
• Alcohol remains the number one drug of
choice among the Nation’s youth
• Approximately 20% of sexually active teenage
girls (15-19) become pregnant each year in the
U.S.
• In 2004, the rate of past month binge drinking
among pregnant women age 15 to 17 (8.8%)
was more than twice that of pregnant women
ate 26 to 44 (3.8%).
U.S. Department of Health and Human Services
Substance Abuse and Mental Health Services Administration
2007
K-12 Lesson Plans
• What Teachers Need to Know
– Learning about Fetal Alcohol Spectrum
Disorders (FASD)
– Signs and Symptoms of FASD
– Common Identifiable Facial Features of FAS
K-12 Lesson Plans
• Sensitivity Caution
– Discussing alcohol, tobacco, and other drugs
(ATOD) with students
• Family Letter
• 12 Steps to Success For Students With FASD.
• Strategies for School Staff
• Websites and Resources
Skill Emphasis/Health Education
Standard
• Standard 2 – Students will analyze the influence
of family, peers, culture, media, technology and
other factors on health behaviors.
• 2.2.1. Identify how the family influences personal health
practices and behaviors
• Standard 8 – Students will demonstrate the
ability to advocate for personal, family, and
community health.
• 8.2.1. Make requests to promote personal health.
• 8.2.2. Encourage peers to make positive health choices.
Teaching Steps
1.
Read the Story
Read the Karli and the Star of the Week book to students.
Karli and the Star of the Week
• A colorfully illustrated story book that
teaches youth to be tolerant and accepting
of all individuals regardless of their
capabilities or disabilities.
• 31 Pages
2. Discussion and Group Activity
a. Ask students what they think about the story.
b. Ask students to recall the disorder, Fetal
Alcohol Syndrome, discussed in story.
c. Ask students to think of something special
about themselves
d. Ask students to think of something special
about someone else and one of their
classmates
e. Ask students to share something they need
help with
3. Conclusion – Poem
Skill Emphasis/Health Education
Standard
• Standard 1 – Students will comprehend concepts related
to health promotion and disease prevention.
• 1.5.1. – Describe the relationship between healthy behaviors and
personal health.
• 1.5.2. – Identify examples of emotional, intellectual, physical, and
social health.
• Standard 5 – Students will demonstrate the ability to use
decision-making skills to enhance health.
• 5.5.1. – Identify health related situations that might require a
thoughtful decision.
• 5.5.3. – List healthy options to health related issues or problems.
• 5.5.5. – Choose a healthy option when making a decision.
• Standard 7 – Students will demonstrate the ability to
practice health-enhancing behaviors and avoid or reduce
health risks.
• 7.5.1. – Identify responsible personal health behaviors.
• 7.5.2. – Demonstrate a variety of healthy practices and behaviors
to maintain or improve personal health.
• 7.5.3. – Demonstrate a variety of behaviors to avoid or reduce
health risks.
• Standard 8 – Students will demonstrate the ability to
advocate for personal, family and community health.
• 8.5.1. – Express opinions and give accurate information about
health issues
• 8.5.2. – Encourage others to make positive health choices.
Teaching Steps
1.
2.
3.
4.
Nutrition and Health Choices
Harmful Substances
Nutrition and Human Development
Effects of Alcohol, Tobacco, and Other
Drugs (ATOD) on the Developing Fetus
5. Discuss Fetal Alcohol Spectrum Disorders
Activity #1 – CHOICES FOR A
HEALTHIER LIFE
Grade 3
Activity #2 – Healthier Living
Word Search
Grade 4
Activity #3 – Healthier Living
Crossword Puzzle
Grade 4 or 5
Skill Emphasis/Health Education
Standard
• Standard 5 – Students will demonstrate the ability to use
decision making skills to enhance health
• 5.8.1. – Identify circumstances that can help or hinder healthy
decision making.
• 5.8.6. – Choose healthy alternatives over unhealthy alternatives
when making a decision.
• Standard 7 – Students will demonstrate the ability to
practice health-enhancing behaviors and avoid or reduce
risks.
• 7.8.2. – Demonstrate healthy practices and behaviors that will
maintain or improve the health of self and others.
• 7.8.3. – Demonstrate behaviors to avoid or reduce health risks to
self and others.
• Standard 8 – Students will demonstrate the ability to
advocate for personal, family, and community health.
• 8.8.1. – State a health enhancing position on a topic and support
it with accurate information.
• 8.8.2. – Demonstrate how to influence and support others to
make positive health choices.
Teaching Steps
1. Define Fetal Alcohol Spectrum Disorders
2.
3.
4.
5.
(FASD)
How Common is FASD?
Reinforce A Strong No-Use Message
Describe How FASD Can Affect the Brain
What Are the Symptoms of FASD?
Activity #1 – Short-Term
Memory Challenge
In Class Activity
Activity #2 – FASD Community
Advocacy Project
Long-Term Assignment
Activity #3 – Question and
Answer
In Class Activity
Activity #4 – How Much Do You
Know About Alcohol and
Pregnancy?
In Class or Take Home Activity
Sheet or Quiz
Activity #5 – Brain Structure and
Function Identification Exercise
In Class Activity or Homework
Skill Emphasis/Health Education
Standard
• Standard 1 – Students will comprehend concepts related
to health promotion and disease prevention to enhance
health
• 1.12.1. – Predict how health behaviors can impact health status
• 1.12.4. – Analyze how genetics and family history can impact
personal Health
• Standard 4 – Students will demonstrate the ability to use
interpersonal communication skills to enhance health and
avoid or reduce health risks.
• 4.12.1. – Utilize skills for communication effectively with family,
peers, and others to enhance health.
• 4.12.2. – Demonstrate refusal, negotiation, and collaboration
skills to enhance health and avoid or reduce health risks.
• Standard 5 – Students will demonstrate the ability to use decisionmaking skills to enhance health.
• 5.12.1. Examine barriers that can hinder healthy decision making.
• 5.12.2. – Determine the value of applying a thoughtful decision making
process in health related situations.
• 5.12.7. – Evaluate the effectiveness of health-related decisions.
• Standard 7 – Students will demonstrate the ability to practice healthenhancing behaviors and avoid or reduce risks.
• 7.12.1. – Analyze the role of individual responsibility for enhancing
health
• 7.12.3. – Demonstrate a variety of behaviors to avoid or reduce health
risks to self and others.
• Standard 8 – Students will demonstrate the ability to advocate for
personal, family and community health.
• 8.12.2. – Demonstrate how to influence and support others to make
positive health choices.
• 8.12.3. – Work cooperatively as an advocate for improving personal,
family and community health.
Teaching Steps
1. Define Fetal Alcohol Spectrum Disorders
2.
3.
4.
5.
6.
(FASD)
How Common Is FASD?
Reinforce A Strong No-Use Message
What Is Considered A Drink?
What Role Do Partners, Friends and
Family Members Play?
View the Law & Order: SVU Video
Activity #1 – Discuss the Video
Classroom Activity
Activity #2 – Alternative Ending
To Law & Order: SVU Video
Homework Assignment
Activity #3 – Alcohol and
Pregnancy Decision Making
Case Studies
Activity #4 – How Much Do You
Know About Alcohol and
Pregnancy
Activity Sheet/Quiz
Alcohol-Related
Birth Defects
100% are
preventable
You can help educate a new
generation and keep them free
from alcohol exposed
pregnancies.
Erin Frey, MD
Program Director
National Organization on Fetal Alcohol Syndrome
900 17th Street NW, Suite 910
Washington, D.C. 20006
Phone: 202.785.4585 ext. 203
Fax: 202.466.6456
frey@nofas.org
www.nofas.org