What is FASD?
FASD stands for Fetal Alcohol Spectrum Disorder; FASD is now the recommended diagnostic term.
There are two types of FASD diagnoses:
with sentinel facial features: small eyes, smooth philtrum (area
between nose and upper lip) and thin upper lip. All three features must
be present, along with atypical brain function.
- FASD without
sentinel facial features: no identifiable facial features (as listed
above) but presence of atypical brain function.
function: when considering an FASD diagnosis, the assessment team looks
for significant impairments in at least three of the following areas:
- Motor skills;
- Academic achievement;
- Adaptive behavior, social skills, social communication;
- Affect regulation (includes anxiety, depression and mood dysregulation);
- Executive functioning (judgment/planning, organization, impulse control, self-monitoring, hyperactivity);
- Neuroanatomy/Neurophysiology (brain structure and functioning);
- Sensory (not monitored to the same degree but still considered important to understanding a student's brain functioning).
behaviors or characteristics can include: fatigue (may show as
over-activity, irritability, tantrums); easily frustrated; fearfulness;
rigid, resistant and argumentative; aggressive; easily overwhelmed,
disengaged; poor self-concept, feelings of failure and low self-esteem;
isolation (few or no friends); self-aggrandizing (attempts to make self
look good); disengaged, shut down; and sadness. Source: Diane Malbin
Tertiary characteristics (the cumulative effect of
chronic frustration and failure, often preventable) include: school
truancy and school problems; trouble at home, running away; out of
control; delinquent, criminal involvement; self-harm, mental health
issues; drug/alcohol problems; problems with employment; multiple
diagnoses. Source: Malbin and Streissguth.
Diagnosing a child with FASD
When a child is considered as possibly having FASD, a formal assessment must take place before any diagnosis is made.
An assessment can take place only if these three criteria are met:
- There are identified developmental/ learning/ behavioural concerns for the student.
- There is knowledge of prenatal alcohol exposure from a reliable source.
- The student's guardian has given consent for assessment.
Alcohol exposure is a risk but not a diagnosis for FASD.
Manitoba FASD Centre handles referrals and makes formal diagnoses for
all WSD students. They work in partnership with WSD clinicians,
educators and other professionals to assess students.
assessment team is a multidisciplinary group that includes: Manitoba
FASD Network diagnostic coordinators; social workers; developmental
pediatricians; geneticists; psychologists; speech-language pathologists;
occupational therapists; an FASD educator; manager and administrative
A student's FASD diagnosis document will also include a
list of the students learning strengths and interests. These can range
from "good at using my hands" to "good at computer." These strengths
will become part of the students' learning profile, which is a pathway
the student and their support team will develop and follow throughout
their school days.
The fundamental belief is that FASD students can and will learn.
want to work from a strength-based approach that will help the teacher
plan and work best with that student," said Dorothy Schwab, an
occupational therapist with the Manitoba FASD Centre. "The onus is on
the adults to do the changing to accommodate the child in that classroom
and set them up for success."
With the number of
professionals/experts involved, and with the FASD Centre serving all of
Manitoba, it can take 18-24 months for an FASD diagnosis.
In the mid-90s, the Point Douglas-Winnipeg Regional
Health Authority collected data that indicated there would be a
relatively high number of four year olds suspected with FASD or on the
FASD Spectrum that were going to be attending David Livingstone
Community School. Working with the Ann Ross Day Nursery and Mount Carmel
Clinic, WSD created the first FASD-specific classroom at David
Livingstone, called the Bridges program.
That initial half-day
kindergarten program has since grown into three FASD classrooms at both
David Livingstone and Shaughnessy Park, an intermediate classroom at
Luxton (Grade 4 to 6), a Grade 7/8 classroom and a Grade 9/10 classroom
at St. John's High School, and Grade 9/10 and Grade 11/12 classrooms at
"This whole program began because we had the data
that showed there was a need. And that need has expanded into 11
classrooms," said FASD Support Teacher Kirsten Varey.
the start, students in the elementary Bridges program learn about FASD
and how their brains function: from how they learn to how they feel.
learn about the zones of regulation and the feelings of each zone,"
said Lindsey, a student at David Livingstone. "If we're in the red zone,
we're mad, if we're in the yellow zone we're feeling down, and if we're
in the green zone, we're ready to go."
A classroom supporting students with an FASD diagnosis is typically clutter-free and distractions are kept to a minimum.
To help students focus, educators use low lighting and sometimes soft instrumental music. The rooms are painted a calming blue.
are tools that every classroom could use," said teacher Carla Mason.
"Sometimes you have to think outside of the box in terms of what a
traditional class is supposed to look like."
By the time FASD
program students move from Grade 8 to high school, they will have
already created a personal learning profile with Ms. Varey.
the learning profile can take from six to eight months to complete, the
result is a document that summarizes students' feelings about
themselves, their strategies for learning success, scenarios that
interfere with their learning and other important information that can
be shared with other high school educators and support workers.
learning profile is a continuation of learning about themselves, but
more importantly, it's a self-advocacy tool," Ms. Varey said. "The
people who read these documents get a lot of valuable information about
how to teach, support and encourage the students to be the best they can
The secondary FASD Passages teams at R.B. Russell—which
includes educational assistants, teachers, administrators, guidance
counselors, resource teachers, psychologists, social workers—meet
monthly to discuss students' strengths and challenges.
important aspect of the Passages program is connecting students with
supports that will continue once they leave high school.
is that the students are set up to be successful for after they leave
here," said Andrea Johnson, a teacher at R.B. Russell's Passages
program. "That means supported work experience and teaming up with
agencies that will support them as adults."
Following high school,
some students have moved on to university, Red River College and full
time jobs, while others struggle after school is done.
little in the way of long-term data when it comes to adults with FASD in
Manitoba; while such data collection can be difficult, WSD FASD program
team members would like to see that change. They would also like to see
more government-based resources for teens and adults with FASD.
"We don't always know that part of the story," Ms. Varey said.
"It's a lifelong thing. The students are coming to terms and understanding this is how their life is going to be."