Mathematics intervention for children with Fetal Alcohol Spectrum Disorders
Dr. Carmen Rasmussen
University of Alberta
Executive Summary
Background
Children with Fetal Alcohol Spectrum Disorders (FASD) display a variety of
neurobehavioral impairments including deficits in executive functioning
(Rasmussen, 2005), intellectual ability, attention, processing speed, language,
visual-spatial abilities, academics, learning, and memory as well as structural and
functional brain damage (see Kodituwakku, 2007, for a review). Math, in
particular, is a significant area of deficit in children and adults with FASD
(Rasmussen & Bisanz 2009). Mathematics deficits have been documented
consistently in both longitudinal and group-comparison studies, even after
controlling for many confounding variables including IQ. Children with prenatal
alcohol exposure (PAE) and/or FASD appear to have a specific deficit in
mathematics, because they have more difficulty in mathematics than in other
cognitive domains and because mathematics is more highly correlated with the
amount of alcohol exposure prenatally than are other cognitive skills (see
Rasmussen and Bisanz, 2009 for a review).
Recently, Kable, Coles, and Taddeo (2007) developed and evaluated a 6-week
math intervention program called the Math Interactive Learning Experience
(MILE) program for children aged 3-10 years with FASD. The MILE program
consists of individualized math tutoring with a focus on math skills as well as
cognitive functions such as working memory and visual-spatial skills, which are
involved in mathematics. Children in the math intervention group showed more
improvements in math performance than children who received standard
psychoeducational services, and these effects were maintained 6 months later
(Coles, Kable, & Taddeo, 2009). This study is the first to demonstrate
improvements in math among children with FASD.
Purpose
The goal of this project was to conduct a replication and extension of the MILE
program with a sample of Alberta children with FASD or prenatal alcohol
exposure (PAE). We examined whether children with FASD or PAE in the MILE
intervention program would improve in mathematics compared to children in a
different social skills intervention.
The research team in Alberta (Drs Rasmussen, Pei, Andrew) collaborated with
the researchers who developed the MILE program in Atlanta, Georgia (Drs
Coles, Kable, and Taddeo) on this project. This study was not only a replication
of the MILE study conducted by Kable et al., (2007) and we made many key
changes. We conducted a social skills intervention with children in the
comparison group instead of having a ‘no intervention’ control group. We
included different pre- and post- measures of mathematics achievement,
including assessments of more specific mathematical skills, are we are
investigating effects of the intervention on other related domains (e.g., working
memory, visual-spatial abilities) that were not included in Kable et al. (2007). Our
intervention was typically conducted in the schools in collaboration with local
school boards, or at the participants home (if parents preferred this) instead of in
a laboratory setting as in Kable et al. (2007).
Methods
Seventeen children aged 4 to 9 (mean 6.9 years) have fully completed the MILE
program, which is ongoing. Of these, 7 have a diagnosis of an FASD and 12
have confirmed prenatal alcohol exposure (PAE) but no have a formal FASD
diagnosis. Eleven children (5 FASD, 6 PAE) were enrolled in the MILE program,
and 6 (2 FASD, 6 PAE) were in the social skills program. Participants were
assigned to groups based on matched demographic characteristics (age,
diagnosis, IQ, mathematics pre-test score, and gender) as closely as possible,
and did not differ significantly on any of these characteristics. Participants were
tested on a variety of cognitive and behavioral measures both pre and post
intervention.
Results
Data analysis is on-going and some data it still being collected. Thus we have
only analyzed pre and post changes on the mathematics measures so far. From
pre- to post-test, children in the math intervention group exhibited an average
gain of 14.27 raw score points on the Key Math, compared to 1.50 raw score
points in the social skills group. This represented a statistically significant
difference, F(1, 16) = 5.244, p < 0.05. On average, children in the math
intervention group improved their mathematics standard score by more than half
a standard deviation, a finding that was not observed in the social skills group.
The mathematics subtests which showed the greatest changes in the
mathematics group included those representing basic mathematic skills (e.g.,
geometry, numeration, measurement), which were the focus of the MILE
intervention.
Significance
Improving mathematics in children with FASD or PAE is directly relevant to The
Centre’s mandate to provide evidence-based service and improve the well-being
of children, their families and communities in Alberta and Canada. Mathematics
skills are important for both educational and occupational success. Even basic
living skills such as telling time and counting money can be impacted by poor
math skills and limited understanding of numbers. Improvement of core primary
difficulties in FASD or PAE (e.g., mathematics, working memory) could also lead
to improvements in secondary disabilities.
Further Research
We are currently applying for further funds to continue data collection for this
phase of the study and to extend the study to two other phases.