Fetal Alcohol Syndrome: Special Education Case Study & Lesson Plan

About the Child: Pietro's Profile and Learning Needs

Pietro is a 7-year-old boy whose biological parents are Argentine and Colombian. He was born approximately six weeks prematurely because of his mother's consumption of alcohol throughout the duration of her pregnancy. According to medical reports, his mother did not consume heavy quantities of alcohol, but she did consume nominal amounts on a regular basis — roughly one to three times a week, nearly every week. Pietro's parents put him up for adoption when he was approximately one year old. He was brought to a Catholic orphanage outside of Buenos Aires, where visiting child development specialists from the United Kingdom and the United States were performing charitable work. It was under their care that Pietro was first formally diagnosed with Fetal Alcohol Syndrome (FAS).

Pietro was subsequently adopted by a Puerto Rican and Argentine family residing in New York City. His adoptive family consists of a mother, father, and older sister named Tamara, who is 11 years old. The whole family lives together in the same home. Both parents work, but the nature of their professions allows them to work from home part time as well as in the field part time. Tamara attends a normative middle school. The family also has a network of immediate family, extended family, neighbors, colleagues, and friends.

Compared to other children his age, Pietro does not have as much language or social skill development as his peers. Activities that require many steps or an extended procedure upset him. He may cry, throw objects, or hide inside or underneath objects to cry or be quiet. Sometimes he will stop talking, go limp, and become extremely unresponsive. He expresses a desire for friends verbally to his teachers, specialists, and family, but often works and plays alone. Pietro can talk but has a limited vocabulary. He occasionally repeats himself and may use the same word as a substitute for other words that do not share the same meaning. His handwriting is not as clear as that of his normative peers, but he enjoys drawing and shows some skill in the arts. Pietro often requires one-on-one attention or assistance from his teachers and other support staff. Most of his sessions with specialists and therapists are individual. He also participates in both individual and group counseling with his social worker during school hours.

Pietro remembers living in South America, but only vaguely. He knows he was not born in the United States and he understands the difference between his biological family and his adoptive family. Because of this awareness, Pietro demonstrates a keen interest in geography. His favorite subject in school is Social Studies. His experiences and interests also explain his desire for friends — he wants to socialize with children his own age. He plays with his sister at home and occasionally joins her when she has friends over for a playdate. Pietro learns much of how to be a friend and how to be a kid from Tamara. He also demonstrates interest and skill in other school subjects. Compared to his normative peers, he processes information more slowly and needs additional prompting for information retention. When pictures accompany text, or when Pietro is allowed to illustrate instructional content, he is much more likely to recall the material.

Pietro sees a physical therapist, occupational therapist, speech-language pathologist, and social worker as prescribed in his Individualized Education Plan (IEP). He is physically smaller and less physically developed than his normative counterparts. Over the course of the school year, Pietro has improved in terms of grip (holding objects including writing instruments), muscle endurance (he helps carry and pass out lunches to other students during lunchtime), and finer dexterity, as evidenced by his improvement in the arts and his ability to play his PSP.

Pietro learns best with a combination of styles. He is a visual, kinesthetic, and experiential learner. Auditory instruction alone is minimally to moderately effective for Pietro; when combined with a visual aid or physical activity, his retention and learning increase. Pietro is moderately adaptable. When changes to his routine are introduced in advance by people he likes or trusts, the transition is smoother. He needs constant reminders, and his teachers and specialists sometimes use a special calendar to help him remember upcoming events. He constructed the calendar with the help of his sister and parents. It features stickers and pictures that he can place on it as visual reminders of an upcoming change. The calendar stimulates his creative interests and abilities while also promoting development in executive functioning.

Pietro's parents are very well informed about his medical and personal history. They stay in regular contact with his teachers and therapists and schedule regular appointments with physicians, dentists, optometrists, and submit Pietro for biannual psychological evaluations. It is clear he lives in a loving home. His parents are occasionally frustrated by Pietro's limitations that cause social difficulties, because he is a very friendly and loving boy who struggles to maintain friendships. This is an issue they address in school, in therapy, and at home. His parents also participate in actual and virtual support groups for parents of children with FAS. As Pietro approaches his eighth birthday, his parents, therapists, and teacher hope to improve his memory, his speech, and his socialization.

References

Abel, E. L. (1980). Fetal alcohol syndrome: Behavior teratology. Psychological Bulletin, 87(1), 29–50.

Abel, E. L., & Sokol, R. J. (1987). Incidence of fetal alcohol syndrome and economic impact of FAS-related anomalies. Drug and Alcohol Dependence, 19, 51–70.

British Columbia Ministry for Children and Families. (1999). Parenting children affected by fetal alcohol syndrome: A guide for daily living. The Society of Special Needs Adoptive Parents, British Columbia.

Fast, D. K., Conry, J., & Loock, C. A. (1999). Identifying fetal alcohol syndrome among youth in the criminal justice system. Developmental and Behavioral Pediatrics, 20(5), 1–3.

Mattson, S. N., & Riley, E. P. (1998). A review of the neurobehavioral deficits in children with fetal alcohol syndrome or prenatal exposure to alcohol. Alcoholism: Clinical and Experimental Research, 22(2), 279–294.

Streissguth, A. P., Bookstein, F. L., Barr, H. M., Sampson, P. D., O'Malley, K., & Young, J. K. (2004). Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. Developmental and Behavioral Pediatrics, 25(4), 1–11.