1. Professionals without Parachutes: Building Communities of Practice to Support Students with Fetal Alcohol Spectrum Disorders (FASD) Jacqueline Pei, Ph.D., R.Psych. Department of Educational Psychology University of Alberta Tracy Mastrangelo Program Coordinator Wellness, Resiliency and Partnerships

2. Today’s agenda  Welcome and Introductions  Invitation to collaborate.  Small Group Discussions:  What have been your experiences?  Break  “FASD and the Brain”  Lunch  Small Group Discussions:  Applying a new lens: Revisiting our experiences.  Wrap-Up  Summarizing a new approach and establishing steps for action, reflection, and communication.  Exit Pass

5. Today’s goals  Building a shared understanding.  What have been your experiences? Challenges?  What is FASD?  Establishing a process based understanding.  Re-examining our challenges through our new shared understanding  How can we apply a new process based approach to support the needs of students with FASD?

6. Goals moving forward...  Have the opportunity to continue to apply a process based approach using the “ARC” framework  Build a relevant and meaningful community of practice to support your work with students with FASD  Contribute to our understanding of how to intervene with students with FASD by sharing successes and hurdles

7. A new approach to professional learning: Professionals without Parachutes

10. Let’s talk!  What have been your experiences? What are your biggest/most difficult challenges when supporting individuals with FASD?  In your groups, please discuss your challenges and use the flipchart to list and rank order top 3 (approximately 45 minutes).  One spokesperson per group to report back, please list all names on your flipchart paper

13. Beginning with a shared understanding: FASD and the Brain

14. What is Fetal Alcohol Spectrum Disorder (FASD)?  Brain injury to the developing brain  Caused by alcohol exposure in utero  May look different in different individuals  A “consistent pattern of inconsistencies”

15. How is FASD diagnosed?  Three considerations:  Prenatal Alcohol Exposure  Facial Dysmorphology Brain Impairment

16. The impact of alcohol  Brain injury:  Language  Memory  Adaptive function and social communication  Academics  Executive functions  Attention  Intelligence  Motor functioning  Affect Regulation

17. The impact of alcohol  On developing structures  On the processes of functioning  On emotional regulation

18. Alcohol is a teratogen - it kills brain cells during development  (diagram courtesy  Wendy Comeau)

19. Developing Structures  Structures and function are affected at a basic level of development

20. Developing Structures  Is scattered  The developing brain: a complex process of cell growth, division, migration, differentiation, and so on.

21. Developing Structures  That said, the impact is compounded at higher levels of brain development  Reptilian brain – basic survival and self- defense  Limbic brain – processing emotions, critical to learning and memory  Neo-cortex – synthesis and complex thought

22. Developing Structures

23. From Structure to Processes of Function What does the FASD brain look like?

24.  12 year old Male Control  IQ 130  98 th percentile for reading  12 year old Male FASD  IQ 74  1 st percentile for reading White matter Grey matter  Looks the same even though we know the child with FASD is clearly impaired

25.  OK  Not OK  Lebel et al 2008 ACER White matter microstructure

26. Emotional Regulation  We know:  Adverse early life experiences sensitize or prime the stress system → Hyper-reactivity to subsequent, even mild, stressful life events.  Repeated stress over the life course will ultimately result in a maladaptive cascade of neurobiological events → increased vulnerability to illnesses, including to depression, anxiety and substance use disorders (Weinberg 2012)

27. Emotional Regulation  We also know:  Stress, per se, does not cause mental health problems  Pre-existing HPA abnormalities may be a major contributory factor to some forms of depression, anxiety and substance use disorders (Weinberg 2012)

28. Emotional Regulation in FASD

29. In summary: The impact of alcohol  There is clear evidence of brain injury due to alcohol that is diffuse and impacts many different systems  This injury has a significant impact on day to day function  Therefore, FASD may often be an invisible disability … …yet has very visible consequences

30. Adverse outcomes may include: Streissguth et al. (1996) longitudinal study  Measured secondary disabilities among 415 individuals (6-51 years old) with FASD.  More than 90% had mental health problems  Other secondary disabilities: inappropriate sexual behaviors, disrupted school experience, trouble with the law, alcohol and drug problems

32. Let’s talk!  Applying a new lens. In your groups, please return to your list of challenges and discuss:  What are the possible root causes?  What is the underlying function of the behaviour?  What are alternative explanations for theses challenges?  Use the flipchart to brainstorm your answers (approximately 45 minutes). One spokesperson per group to report back.

34. Moving Forward…  We may see an uneven pattern of performance that varies between individuals: FASD is a complex disorder with multiple influences, at bio psychosocial levels of function  So how do we respond to this variation?  Move from a script to improvisation based on understanding of underlying brain and resulting behaviour  That said some structure can still guide our improvisation

35. ARC model of practice R eflection C ommunication A ction

37. Goals moving forward...  Have the opportunity to continue to apply a process based approach using the “ARC” framework  Build a relevant and meaningful community of practice to support your work with students with FASD  Contribute to our understanding of how to intervene with students with FASD by sharing successes and hurdles

38. Next steps:  Build an action plan to support your community of practice  Who will be a part of your community?  How will you meet? Please plan to interact at least 3 times between now and our next workshop day in May  Do you have a WRaP success coach to help facilitate your community?  What are your personal goals? How will you be intentional and what actions will you take between now and our next meeting?

43. Take time to take care of YOU!

44. Contact Information Jacqueline Pei, Ph.D., R.Psych. Departments of Educational Psychology and Pediatrics University of Alberta Email: jpei@ualberta.cajpei@ualberta.ca Tracy Mastrangelo Program Coordinator WRaP Program Email: tmastrangelo@gsacrd.ab.catmastrangelo@gsacrd.ab.ca Website: www.wrapschools.cawww.wrapschools.ca Resources: www.engagingalllearners.cawww.engagingalllearners.ca