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Fetal Alcohol Spectrum Disorder is three times more prevalent than autism


The Center for Disease Control estimates that up to one out of 20 (that’s 5%) Americans suffers from the effects of exposure to alcohol in utero.

A recent research in 4 communities estimated that the numbers are on average about 6.5 percent. 

One of twenty is a lot of people. It can be any of your students or clients or friends and loved ones.  

There is no amount of alcohol that is considered safe for a fetus. The consequences are very broad, and may include, among other things,  

  • Poor memory
  • Poor reasoning, judgment, organization and planning skills
  • Difficulties with attention, hyperactivity
  • Learning disabilities, difficulty in school (often with math)
  • Speech and language delays
  • Poor coordination
  • Impulsivity
  • Anxiety

The list is longer, but I specifically wanted to touch on those elements that HANDLE can address. My colleagues and I have worked with people with FASD and we’ve seen improvements. Sometimes dramatic ones.

How do we address these elements? Gently, respectfully, non-judgmentally, and with an individually tailored home program of movement activities. Specifically, activities that address interhemispheric integration are an important component.  

Other supports need to be in place, such as regular routines, physical and mental health care, understanding that learning from consequences doesn’t really work, advocacy, watching out for bullies, addressing the learning disabilities and making accommodations as needed in the school curriculum. One of my favorite resources is www.FASDNorCal.org.


“I don’t want to be touched. Please don’t touch me.” 

I saw this online. Perhaps you've seen it too. A 10 year old boy with autism returned to his school in Florida for a standardized test in April, six months after having being suspended for hitting and kicking a paraprofessional, leaving scratches and marks. Police officers handcuffed him and took him to spend the night in juvenile hall. He was charged with felony battery.

You can read more on CNN here and watch the video here.

I don’t know this child, but this incident gave me a lot to think about.

  1. “I don’t want to be touched. Please don’t touch me.” Here’s a child who has learned – possibly with much effort – to advocate for himself. He’s aware of his sensitivity and he can politely ask others to be considerate and not assault him. And then he’s handcuffed and escorted to the police car. What does he learn from this? Perhaps helplessness. Perhaps that explaining doesn’t do any good, and that fighting back is his only recourse. It doesn’t surprise me that back in November he hit and kicked when the paraprofessional attempted to remove him from the classroom.  
  2. Why else would a 10 year old boy with autism attack a teacher? If not self-protection from a perceived threat, perhaps he was suffering sensory overwhelm (which is often easier to prevent than to recover from), or low blood sugar levels.
  3. Would penalties make a difference in his outbursts? Hmmm, now that he’s traumatized, I doubt he’d be dealing more effectively with his environment and the people in it.
  4. Is the solution moving him to a different school? Maybe. I looked up his school, Okeechobee Achievement Academy. The following is an excerpt from the message from the principal: “Our teachers’ use a wide variety of researched based methods including; Behavioral Tools, peer coaching, autism training, counseling and community partnerships to help each student realize their potential.  It is hard work that requires lots of the three Ps;  patience, persistence, and perseverance. Our mission is to provide our students a positive, stimulating, and safe learning environment that promotes the development of individual responsibility, acceptable social skills, and academic growth. Upon returning to their former schools, our students will be able to make appropriate decisions and experience success in completing their education.” I don’t care to comment on the language imprecisions. What I learned here, however, is that this is a school in which children (probably problematic ones) spend a while, in hope that behavioral tools, peer coaching, autism training and counseling will help them behave better. 10-year-old Johnny, apparently, “had been given plenty of opportunities to change his behavior and has not.” Well, with all due respect to the good people offering coaching and counseling, this often doesn’t work as well as one would hope. It’s been my experience that when the problems are physiological or neurodevelopmental in the first place, they may need to be addressed as such.  
  5. Is the solution home schooling? Perhaps, but I can tell you about my friends who feel unsupported, isolated and financially strapped when there isn’t a school that meets their children’s needs.
  6. I have to step back and ask the bigger question: what if he weren’t autistic at all? Is a 10 year old mature enough to realize the wrongfulness of his conduct? Is he able to act accordingly? Is he able to understand the legal process he is subjected to and his legal rights? He isn’t, and he won’t be for years.

Please share your thoughts.  


What's so hard about de-stressing?

Think of a task you’re facing that gets you out of your comfort zone. Perhaps it’s filling an online application, replacing the sink in your bathroom, climbing a rock, cooking a Thai dinner, or picking up the phone and calling your legislator to voice your opinion about current matters. Listen to your body, watch your breathing. Don’t concern yourself right now with the eventual results, just with that knot in your stomach, the feeling of incompetence, the distractions (“Maybe I’ll wash the dishes first and then come back to this.") Beat yourself up for a little while. If you’re counting on asking a friend to help, does this make you feel worse about yourself? Now think of a task that you feel completely at ease with, perhaps filling an online application, replacing the sink in your bathroom, climbing a rock, cooking a Thai dinner, or picking up the phone and calling your legislator to voice your opinion about current matters. Piece of cake. Do you tap yourself on your back because you can do it? Quite possibly not.

I could go from here to asking you to not judge yourself or others. I could point out that our expectations of ourselves and of others dictate when we, or they, feel competent or not. Maybe I’ll do that some other time. Where I want to go today is to that physical feeling of anxiety. The protective posture, the indigestion, the shallow breathing or the drying of the mouth.

It won’t help to ask you to “take it easy”.

There are many ways to get out of the “fight or flight” mode because there are so many ways to get into it. When the stressors differ, the solutions may need to be different too.

Perhaps climbing a rock is hard because it makes you dizzy. There could be other reasons, of course. Suggesting that you run around the block to ease your tension may not help.

Perhaps cooking a Thai dinner is hard because you’ve injured your fingers before when cutting veggies. Suggesting that you relax yourself by knitting may be unappealing.

Perhaps calling your legislator is hard because your auditory processing, especially over the phone, is challenging. Listening to a meditation tape may not be helpful at all for winding down.

Maybe filling an online application is hard because your eyes don’t team well, in which case relaxing by reading a good book may not be your first choice.

Perhaps replacing the sink in the bathroom (and the cabinets and their handles and the faucet and the plumbing, ugh, don’t ask) is tricky because you have a hard time planning ahead or following step-by-step directions. Maybe what you really need to wind down is a massage and not to sit on the porch with a logic puzzle.

All of us, at every level of function, can become anxious with certain tasks because something about how our bodies and nervous systems work – the senses, physical coordination, balance, brain communication – isn’t efficient. We can relieve the tension by avoiding projects that challenge us, by finding ways to wind down without further tasking those areas of challenge, or by gently supporting those functions that aren’t working well. The detective work involves learning about what’s hard as well as what is easy.


Letting Go

Over the years he’s been labeled autistic and learning disabled, among other things. That didn’t stop him from working towards achieving his goals, including those that seemed to me unattainable, like driving or completing an AA degree (almost there). He’s 26 now, and his mind is set on volunteering in Africa for a few months. He’s been overseas before, but never too far from friends or family, so I was able protect him by proxy if needed. But finding him supports in rural Ethiopia is a big challenge for me, and my anxiety increases as the date of his trip approaches.

I can do little things, like make sure he gets vaccinated, and arrange for flights with only one stop and enough time to get from gate to gate. But as volunteering in an impoverished region goes, phone connection will be scarce and internet unreliable. My mind races from one “what if” to another, and then hits the brakes. No, there won’t be rabid bats or bullies or stomach aches… and that pretty Ethiopian girl he’s been chatting with online is a real person, and a nice one. Right?

I’m not a helicopter mom. I’ve said “yes” as often as I could, and kept my cool in the face of most disasters (“I hear you, honey, I get that the oven is on fire. Just call the fire department. They’re good at this”). But I feel like I’m stretching now like I’ve never been stretched before, and I try to advise myself to take a few deep breaths and let go. Find that fine line between protecting and supporting -- and allow him to be the brave and adventurous person that he can be.

I tell myself that in a way I’ve been fortunate. He’s been open to learning lessons about life for much longer than most young people: He wonders if he did something wrong or if his friend had picked a fight; he wants to understand why I voted the way I did – and then makes his own choices. We watch movies together (currently Ethiopian ones) and pause to discuss them. He’s been kind and generous and honest to a fault. He delights in every independent living skill he masters, like balancing his checkbook.

He’ll be okay. If he doesn’t fit in with the volunteer group he won’t be crushed. He’s built resilience. He’ll work as hard as always and have pride and satisfaction in that. He’ll wait for weeks, if needed, to post his photos on social media: he’s learned patience. He’ll make new friends: he’s always trying. He won’t be shocked by the differences in culture and environment, because he already knows that the transition and adjustment will take a while, and he trusts that he’ll adjust. His challenges have made him strong. I just need to remember that.


Body language: who is your audience? 

We tend to think of body language in terms of the non-verbal communication that we share with one another. We think of people who have difficulty understanding non-verbal communication, and wonder whether this has to do with their ability to notice changes in another person’s facial expression or posture. Perhaps they notice but cannot interpret the gesture, because they are unable to reproduce the same gesture themselves. Low muscle tone may be the culprit. Sometimes we think of body language in terms of the messages we unconsciously send with our facial expressions (scorn? judgment?) that a person may understand even if he or she cannot understand our words.

But there’s another very important component to body language: When your body assumes a posture or expression, your own body and brain are listening.

In her inspiring TED talk,  http://blog.ted.com/10-examples-of-how-power-posing-can-work-to-boost-your-confidence/ Amy Cuddy talks about the difference between postures of powerful people and of those who are not. Powerful people are more optimistic, confident and assertive, and are able to think more abstractly; their testosterone levels are higher (“dominance hormone”) and their cortisol levels are lower (stress hormone).  

Cuddy explains the research behind power postures. Put your hands on your hips, or raise your arms as if you’ve just won a race. Or lean back into your seat and put your feet on your desk. Seriously, try it. Research has shown that positioning yourself in a power posture for two minutes can make a difference in how you perform in front of an audience, how you do in a job interview, how much stress hormone is running in your system (some 25% less). A friend tells me he’s used this with his students before their musical performances and it works. The opposite is also true – sit in a self-protective position, rolled in, and your confidence will wane while your stress increases.

You and I can easily use this tool, taking on a powerful posture for two minutes. But let’s take it another step – perhaps this technique can help a vulnerable, stressed person you are trying to assist? Perhaps a friend, a loved one, a child, a student, even one who may be unable to understand this concept, can learn to spend a little while in a posture that gives him or her a message of strength, confidence, leadership, a posture that would reduce the stress?

I’m going to try this. Will you join me? I’d love to hear from you if you see results.