A new kind of teaching
By Carol Sanders

Program at David Livingstone School embraces kids with fetal alcohol syndrome
The Winnipeg Free Press
Sun, Mar 4, 2001
A little girl fills up a white plastic baby bathtub with snow that she's found in front of David Livingstone School. It's 8 a.m. on a frigid school day. She doesn't know it, but she's part of a groundbreaking experiment that's gaining attention across North America.

In the toughest part of Point Douglas, a prototype for integrated schooling for children with fetal alcohol syndrome is blossoming. It has made national headlines and its principal is kept hopping sharing the information being gathered about how to teach kids who, until recently, have been written off as unteachable or "bad."

David Livingstone School started its Bridges program six years ago. A cluster of children with FAS at the Anne Ross Day Nursery across the street were preparing to start kindergarten at David Livingstone and the school realized it had better be prepared.

"How do we meet the needs of these kids?" was the question, said Angeline Ramkissoon, principal of the school that has 385 students. "There was very little knowledge of what FAS is," she said.

The program developed using trial and error.

"There are no textbooks. The regular behaviour management approach doesn't work," Ramkissoon said in her office, where classical music plays in the background and wire mesh covers the tiny window.

The school puts on FAS workshops for other teachers in the division. It has organized a conference in April with one of the leading experts on teaching FAS kids. The following weekend, Ramkissoon is booked to speak at an FAS conference in Saskatoon. Educators are clamouring for information about how to help their students, she said.

"The kids don't understand consequences or cause and effect," said Ramkissoon.

And they won't grow out of it.

"The needs of the kids are lifelong." Estimates are that each FAS child will cost society an extra $2 million in his or her lifetime. School, health, and social challenges resulting from alcohol exposure in the womb don't go away and Ramkissoon's school is trying to give the children "accommodation skills" to help them navigate.

Most five-year-olds can sit still for 20 minutes, follow three instructions, and take turns. These kids can sit still for five to 10 minutes, follow one instruction and it's "my way or no way."

When Dani started kindergarten in the fall, she would scream for half an hour and then not say a word -- she was an elective mute.

Now she's speaking in full sentences and beams when "Susan" praises her for using her external brain to put on her hat, coat and boots. An "external brain" is what Dani and other people with FAS need for the rest of their lives to survive. For some it's another adult, lists, or strategies. In Dani's case, it's a chart with pictures that show the steps involved in dressing to go home.

In Bryant's classroom, the visual "time bombs" that overstimulate the children have been removed. The bookshelves and activity areas are covered with pale blue sheets. The lights are dimmed. A little carpeted fort with pillows and blankets in the corner provides refuge from the activity of the room. It's called the bunny hole.

Squares are painted on the floor to show them where to line up when it's time to go home. They sit on mats during story time to help them sit in their own personal space. They're urged to speak in full sentences. And there's repetition -- lots and lots of repetition. "Teach, repeat, reteach," is Bryant's mantra. A skill taught one day may not be retained to the next or generalized into another setting. Directions are simple and direct and choices are limited.

FAS kids have a hard time changing activities and locations, so they need plenty of notice to make transitions. Abstract concepts such as time, ownership and money are difficult for them, too. Bryant sets a special timer and announces that in five minutes it will be story time. She'll remind them several times before the timer runs out.

Kaitlin works out with Mr. Mouth -- speech pathologist Kathy Gerylo's hand puppet that she uses to lead mouth exercises with the children.

Kids born with FAS often have weak oral motor skills, says Gerylo. Especially the tongue. Mr. Mouth gets the kids to move their tongues from side to side. It's tricky for these kids, who have to be reminded not to move their heads at the same time.

The exercises should help them make the gradual transition to Grade 1, where they'll spend part of the day in the Bridges room and part of the day in an integrated classroom.

"Integration is amazing," said Sharon Anderson-Devine. "The other students are so protective and they help the other kids."

Like most teachers, she once had every inch of her classroom walls covered with teaching aids and art.

"The only thing I had missing was a disco ball," she laughed. That changed as she started to experiment with what works best for alcohol-affected kids.

She has the "bunny hole" for kids who need a break from the classroom. "They just go. They don't take advantage of it. If someone is in it, they wait on a chair for their turn."

Water bottles are labelled and placed on a table so the FAS kids don't have to leave the room for a drink.

"They'd wander out of the building." Just five of the kids in her class have been formally diagnosed with FAS.

Upstairs, Jim Hadaller blends life skills into the Grade 3-6 Bridges program for kids with alcohol-related disorders. There are nine students in the program that offers a shorter school day, a low-stimulus environment with a structured daily routine. They learn about their disability and what kind of special strategies they'll need to live.

When they leave David Livingstone for good, they're on their own.

"There's no support when they walk out that door," said Ramkissoon.

Students moving into middle school often can't hack the transition to a new, less-structured environment -- add to that the normal adolescent problems and it's a recipe for failure, she said.

Many drop out. Some end up in trouble with the law. Some may end up with alcohol and drug problems. Too many will end up ricocheting through the system for the rest of their lives, Ramkissoon said.

There is talk of a Grade 7 program starting at the neighbourhood's middle school. Hadaller hopes so for the kids sake.

It's a pivotal time in breaking the cycle that's responsible for an increase in FAS cases, he said. Kids who understand their disability, how they got it and what they need to live productive lives are less likely to grow up having more children with FAS.

In the fight against FAS, knowledge is power and he's more than willing to spread it around.

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