TOUGH KIDS AND SUBSTANCE ABUSE
TOUGH KIDS
HOME PAGE
About
TOUGH KIDS
Sample
Lesson
What is
FAS / FAE / ARND?
Internet
Resources
Addictions Foundation
of Manitoba
National Institute
For Drug Abuse
The ONESTEP Approach: Redesigning the Environment for Students with ARND/FAS/FAE

Four steps should be taken into account for every interaction when dealing with students with ARND, FAS or FAE: These are:

   1. Forewarn,
   2. Anticipate,
   3. State, and
   4. Enact.

This process is easy to remember because the initials of these steps are FAS and E. Letís take them one-by-one:

1. Forewarn...
the student of changes to the studentís surroundings, so that the student is ready for the change and will not be overwhelmed by the newness of the introduced person, concept or object.

2. Anticipate...
the studentís reaction to the introduced person, concept or object.

3. State...
the nature of the change about to occur. Introduce the person and explain why this person is in the room. Name the object and show it to the student and explain its purpose or use. Once the nature of the change is understood, explain your expectations of the studentís behaviour. Tell the student how to react to the change.

4. Enact...
the change in the studentís world.

THE O.N.E. S.T.E.P. APPROACH

We have identified seven environmental factors that need to be addressed when relating to students with FAS/E. They are as follows:

   1. Outlook
   2. Needs
   3. Environment
   4. Sensory Stimuli
   5. Time and Transition
   6. Expectations
   7. Processes



THE O.N.E.S.T.E.P. APPROACH

This is what we call The O.N.E. S.T.E.P. Approach to preparing the studentís surroundings. This acronym is no accident, for every task and learning experience should be broken down into its components, so that changes and learning can be presented to the student O.N.E. S.T.E.P. at a time.

Several strategies to redesign environments can be defined for each component.


Outlook...

1. The student with FAS/E is neither damned nor doomed. With appropriate interventions, the student can be successful.

2. Each student can learn, is always learning, and can assume increased self-control.

3. Disregard the concept that naughty behaviour must be corrected. See behaviour as an attempt by the student to communicate.

4. Ensure your attitude is calm and gentle, yet firm.

5. Recognize brain organicity; that is, a student with FAS/E is not necessarily reacting by choice. There may be a neurological basis to the displayed behaviour.

6. Never assume the student understands. Check it out.

7. Donít address behaviour until you are willing to follow through.

8. Move from perceiving willful misconduct to recognizing organicity.

9. Pity or sympathy can be disempowering for any student. Accept the student as a person.

10. Focus on the studentís mis-interpretation of the situation rather than mis-behaviour.

11. Never take mis-interpretation personally. Donít "over" react.

12. Support the studentís strengths. Focus on strengths, not gaps.

13. Use a non-punitive, non-ego-damaging approach when working with the student.

14. Ensure the student is made to feel valued by every member of your staff.

15. Do not back the student into a corner. Always ensure the student has a respectful and appropriate way out of a situation. Remember a student with FAS/E may need additional time to process verbal cues.

16. Acknowledge that parents, families or caregivers of your students are doing the best they can according to their abilities, resources, skills and their present circumstances.


Needs...

1. Provide structure, but not control.

2. Ensure the studentís needs are incorporated into the structure.

3. Determine the studentís individual needs, functioning level, history, etc. Never assume or generalize. Focus on the student.

4. The student may not innately recognize or know how to express feelings. Label all emotions with simple language. You must deliberately teach recognition and understanding, and show the student how to express feelings and help the student develop verbal skills for expressing feelings.

5. Disregard standards based upon chronological age and preconceived assumptions about what the student "should" be doing.

6. Time-out areas or chairs should be used non-punitively and in a non-judgmental manner, so the student can learn to use time-out constructively and positively when feeling agitated.

7. Recognize power struggles, disengage, de-escalate and re-evaluate the situation; then create a new approach. Always give the student a respectful way out.

8. Do not limit lessons to one sense modality. Recognize that the student may have difficulty translating experience from one sense to another and may not see connections that seem obvious to you. For example, a student may not know how an object tastes, sounds or feels when presented with only one other sensory modality, such as how the object looks. Use sight, sound, touch, taste, smell, emotion and action modalities together. A multi-sensory, concrete approach is usually the most effective teaching strategy.

9. Monitor TV watching. Choose non-violent and not-too-scary-programs. Some students may have difficulty differentiating real from pretend.

10. Use short, simple directions. Describe one task at a time.

11. Give one direction. Complete the task. Then give the next direction.

12. No one is perfect. Recognize your own shortcomings as well as the studentís.

13. Do not use figures of speech, euphemisms, vague or misleading slang. For example, name emotions such as "anger" and "frustration" instead of using phrases such as "getting my goat", "under my skin" or "bugging me".

14. Although some students have wonderful senses of humour, they may not recognize teasing. Tease carefully, with positive intent and respect. If in doubt, donít do it.

15. Model how to cope with anger and frustration in performing a task, instead of emphasizing perfect mastery of the task. Ensure the student develops a coping strategy in frustrating situations.


Environment...

1. Avoid clutter. The studentís physical environment must be safe, organized, consistent, predictable and comfortable. Have a place for everything and keep everything in its place.

2. Design the classroom in terms of the studentís needs, not the teacherís.

3. The studentís environment should be based on simple, consistent, safe and predictable routines.

4. Place furniture far enough apart to ensure safe and easy passage between objects. Avoid creating crowded or congested areas. Do not place any student in a high traffic area, such as beside the pencil sharpener, or close to entrances or exits.

5. Provide individual desks, carrels or table and chair for each student. Group tables can be used as long as individual desks are available to which the student can "retire" from an activity or work alone. Limit group sizes with consistent teams.

6. Respect the student and teach the student to respect other studentsí spaces. Label the desks with the studentís name and/or picture. Put a photograph of the student on the studentís "space", such as a cubby, desk or locker, etc.

7. Keep students that do not get along with each other separated. Place an adult between them, and ensure their personal spaces are respected.

8. Dramatic role-playing is useful in supporting social interaction.

9. Larger groups or people can cause a student with FAS or FAE to become agitated. Limit the number of people in the studentís immediate space to small groups or pairs. If avoidance is impractical, then be sure to Forewarn Students of the impending presence of a large group. Anticipate the studentís reactions and ensure enough adults are available to assist the student. Tell the student how to act when confronted by the group. Be sure to provide adequate supervision of the student and remind the student of how to behave when in the group.

10. Separate areas by barriers such as shelves or room dividers. Keep areas contained, and avoid creating large unstructured areas.

11. Provide the student a quiet space: a carrel, loft, or quiet cave (appliance box or tent), safely away from general activity.

12. Put objects away when not in use. They will act as distractions to the student, and impair the studentís ability to focus upon a specific task. Place them out of sight behind curtains or screens if no cupboards are available. Tape pictures to each storage container or cupboard displaying the objects stored inside to help engage the student in organizing the area. Keep chaos and messiness to a minimum.

13. Provide the minimum number of tools needed to complete the task. For example, only a few crayons, not a full range of 64 colours at once.

14. Food preparation centres and other centers with complex tasks may be too over-stimulating for the student at first. Gradually build the studentís tolerance for higher levels of excitement.

15. Store items together by type, not size or space, for example, hats on shelf, coats on hooks, footwear in a footlocker.

16. Use matching colours and shapes to identify consistent categories. For example, associate green circles with "go" or red octagons with "stop", etc.

17. Use physical reminders of where students need to be. For example, place masking tape or foot shaped stickers in line at the doorway to help students remember how and where to line up. To help students to remember how to sit in circle, arrange seat cushions in a circle or place hula-hoops or rug samples on the floor to define each studentís space. Outline boundaries with masking tape.

18. Predictable environments are perceived as safe and secure.

19. Establish continuity by forming partnerships to collaborate with parents and other professionals in the system.

20. Create a community of caring adults for each student.

21. Empower caregivers to provide home environments consistent with the schoolís.


Sensory Stimuli...

1. Acknowledge a studentís central nervous system as a component of who the student is. Think of movement as extra energy not hyperactivity.

2. Some students have sensitivity to a particular stimulus. Be aware of the studentís reaction, and be prepared to forewarn the student of the source, and/or remove the cause of their discomfort.

3. The student may have a tendency to become easily over-stimulated, and may either shut down or lose control.

4. Individualize the amount of stimulation based upon what the student can tolerate and build tolerance slowly and respectfully.

5. Some students find sunglasses or earphones useful to minimize excessive light or sound. Environments should allow a student to choose dim quiet, calm spaces over bright, colorful, loud, and chaotic areas and can help the student to become skilled at recognizing what they need when.

6. Recognize each studentís individual tolerance and triggers, and anticipate the onset of the studentís threshold of loss of control. Do not allow the student to reach and cross that threshold. Intervene before that point. Pay attention to factors such as hunger, thirst, blood sugar, time of day, or fatigue.

7. Encourage safe multi-sensory exploration using music, art, dance, etc.

8. Students respond very well to manipulatives: water, sand, texture boards, bubble wrap, etc.

9. Sign language and other speech therapy techniques are useful with all students, even with hearing students.

10. Slow rhythmic clapping is a good way to focus attention.

11. Rhythm is a very effective way to reinforce memory. Clapping to rhythmic directions, even singing and "rapping", can help the student to retain information.

12. Use consistent labels for objects, engaging categorical descriptors rather than the specific. For example, always use the word "shoes" instead of mixing "boots", "runners", "footwear", "rubbers" or "Nikes".

13. Visual cues, such as picture cards of hands washing above the sink, help remind students of tasks to be performed, and where to perform them. If possible, obtain a reference of Mayer-Johnson symbols as their graphics have proven to be very effective in conveying ideas. As always, photographs are a very good cue to use for students with ARND.

14. Begin all conversations with the studentís name, and make eye contact with the student.

15. Some students with FAS/E may need the added security of a weighted vest or a backpack filled with books to help anchor themselves.

16. Occupational therapists can be your best friends. Check with them if you think a student may need some help regulating physical needs.


Time and Transition...

1. Some students may have difficulty sequencing and recognizing the beginning, middle and end of a task.

2. Monitor the time each student spends on a task and very gradually foster the studentís increased attentiveness to the task at hand.

3. Development and learning may be sporadic. A student may excel in some areas and be delayed in others. Be prepared to go over past lessons until the student understands their content.

4. Provide consistent staffing as much as possible.

5. Limit people transitions. When they occur, walk through transitions with the student, forewarn the student of the change and consider the studentís apprehension during the transition.

6. Where possible, avoid traditional grading assessments of the studentís performance. Use positive reinforcement of success.

7. Make transitions based on the studentís needs, not the schoolís.

8. Modify timelines for achievement based on the studentís abilities not predetermined standards.

9. If using learn-by-doing strategy, for example cooking, remember that the student will need very small steps. Initially, the student may not be able to sequence more than one or two instructions in the right order.

10. Students may have difficulty associating a past situation with todayís events.

11. Long-term memory may be stronger than short term.

12. Digital clocks are easier to interpret than dial clocks.

13. Set out Daily Schedules. Always display then in the same place, in the same manner and style. Draw or cut out simple pictures to illustrate daily events and time of day when they occur. As always, photographs are the most effective.

14. Stick Post-it notes marked with times of specific events on the wall next to the clock as useful reminders of when to do certain things, such as leaving to catch the bus. If possible, use pictures in conjunction with the written word to illustrate these events.

15. Try to avoid using conventional temporal descriptions. Use more concrete indications to time an event. For example, say, "We will read this book after we eat lunch," instead of "We will read this book at one oíclock."

16. Use a range of time for an event marker when using digital time. If an event is expected at 10:00, be sure to tell the student that this event can be at 9:59, 10:00, 10:01, 10:02 or 10:03. If the time 10:00 is missed, some students may not realize that 10:01 indicates 10:00 has just recently passed, and then may wait until the next 10:00 occurs (twelve hours away).

17. Use egg timers to mark the passage of time. It is easier to envision time left by watching sand pouring through an hourglass.

18. Simple jingles or tunes can help to predict transitions by reinforcing visual or other auditory cues. Use language games.

19. When changes occur, involve the student in the process and support the student during the transition.

20. Teach to the studentís developmental level, not to chronological age.

21. Support structure without disempowering the student. Maintain the order of events in the studentís day.


Expectations...

1. The student with FAS/E is neither damned nor doomed. With appropriate interventions, the student can be successful.

2. Expectations should be:

   a. Always consistent at home, at school, with caregivers, on the bus, etc.

   b. Based on each studentís unique characteristics, not generalizations.

   c. Clear, simple, fair and concise

   d. Delivered with the recognition that the student may not be able to conform to them immediately.

3. Expectations may need to be modified or individualized, but do not have to be discarded.

4. Teach self-regulation strategies and expect the student to recognize his own needs and emotional triggers. This process will be gradual and different for every student.

5. Expect slow, small increments of change.

6. Expect relapses in mastery and memory, and anticipate setbacks.

7. Some students may master a task and lose it many times.

8. Support success, but do not punish "slips".

9. Forget "should be" and determine "what is".

10. Listen and learn from the student.

11. Encourage positive self-description.

12. Expect frustration, but minimize it by stopping the student before the threshold of frustration is reached. Take time out before the student returns to the task. Be sure to use this opportunity to teach the student self-management.

13. Expect "inappropriate" behaviour. Ask yourself what the student may be trying to communicate, or what needs they are trying to meet, rather than how to modify such behaviour. For example, self-stimulation, such as nose rubbing with the heel of the hand might be addressed with a distraction, replacement with physical action, but should not be automatically ignored or punished.

14. Re-evaluate expectations and goals for the individual. Clarify whose needs are being met by those goals.

15. Appropriately modify goals without compromising or limiting the studentís potential.

16. Be specific with your praise. Say, "You coloured that page very well" instead of "Good work!"


Processes...

1. All activities should be designed to help the student experience success.

2. Use personalized greetings and farewells for each student every day both at home and at school.

3. Be sure to describe an action while engaged in it.

4. Reduce interruptions and distractions such as people coming in and out, announcements over the PA, etc.

5. Reduce surprises. Always establish and remind the student what will happen next.

6. Reduce emphasis on competition.

7. Reward the studentís accomplishments.

8. Avoid power struggles. Always give the student a respectful way out. Give the student time to process verbal cues.

9. Use multi-age groupings with developmentally appropriate learning.

10. Visual and auditory cues to teach sequence are useful. Cartoon style pictures can accompany multi-step tasks. Big pictures displayed on laminated cards can be used to teach linear steps. Photographs are most effective.

11. Keep simple daily sequences in exact, predictable order. For example, always take hats, overcoats, gloves and shoes off in the same order each time the student comes into the room. Maintain the order of events in the studentís day. Basic chores are learned more easily if the order of the steps never varies. For example, dishwashing might always be sequenced as: "Turn on the cold water; turn on the hot water; pour in dish-washing liquid; shut the hot water off; shut the cold water off; put dish in sink," and so on.

12. All meal times, feeding times, and personal care activities, such as dressing, washing, toiletry, etc. should be warm, supportive, nurturing and non-stressful experiences.

13. Never associate food with reward and punishment.

14. Maintain eye contact when giving directions. If possible, demonstrate, or use hand-over-hand or gestures to deliver instruction.

15. Some students have difficulty predicting upcoming events and connecting cause and effect. Reinforce sequences in stories, movies, etc. with pictures, objects or music.

16. Use speech expansion techniques in very gradual increments. For example, if the student says "Coat," say "Hang coat." If the student says, "Hang coat hook?" Say, "Yes, Hang coat on hook!" Only expand the phrase by one or two words at a time.

17. Match your communication level to the studentís. (If the student uses two word phrases, do not bombard the student with long complicated sentences. For example, say "Hang coat hook", not "Gerald, would you please put your coat on that blue hook over by the door as soon as you can?")

18. Be specific. Use "Hang your coat on the blue hook," not "Put your coat away."

19. Be as concrete as possible. Some students with FAS/E are very literal and may not be able to understand subtlety, inflection, nuance, sarcasm, irony or double meanings.

18. Demonstrate and if necessary, use "hand-over-hand", or "walk-on-my-feet" techniques.

19. Encourage story telling, but do not interrupt a student in mid-story, because the student may have to return to the beginning of the story to continue.

20. A whole-language approach usually works better than phonics to teach reading.

21. If a student has difficulty reading with the amount of text on the page, make a reading window to mask the book off. Cut a square or rectangle from the centre of a blank heavy paper. Place the paper over the book to cover all the text except the small area the student is trying to read. Move the window as the student reads.

22. Always establish new coping methods before removing old ones.

23. Assure integration of culturally relevant values, traditions, art, music, stories, etc.

24. Use what the student recognizes in the immediate world to get your ideas across, not some unfamiliar object with which the student may not have any real experience. Teach skills in the context of the studentís natural environment.

25. Keep student in line of sight at all times when on field trips, and try to manage a one-to-one ratio of adults to students on outings.

Copies of “TOUGH KIDS AND SUBSTANCE ABUSE” can be ordered from:
The William Potoroka Memorial Library, 1031 Portage Avenue, Winnipeg, Manitoba, CANADA, R3G 0R8
TEL: (204) 944-6233, FAX: (204) 772-0225