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This paper tells the story of how one school leveraged the expertise of a family to build an equitable collaboration that transformed the educational experiences of Jake, a fifth-grade student with Fetal Alcohol Spectrum Disorder (FASD). Personal accounts from 3 teachers, 2 administrators, and a parent illustrate the power of leaning into relationships to gain knowledge and compassion for reaching some of our most vulnerable students. The major themes that emerge across their reflections include: the power of families and educators working together, the need for FASD training, and the need to re-evaluate the systemic structures that are in place. Their insights illustrate the importance of nurturing teachers to collaborate with families, to take pedagogical risks, and to advocate for their neurodiverse students.

Background: Australia has limited supports to help families where Fetal Alcohol Spectrum Disorder (FASD) impacts children and young people. National Organisation for Fetal Alcohol Spectrum Disorder Australia (NOFASD), in conjunction with the University of Otago, New Zealand, piloted and established a 7-week online program to assist caregivers to develop strategies and supports to help their families live well in a disabling society. Method: The online program, Families Linking with Families (FLWF), was delivered to 88 caregivers. They participated in the weekly 90-minute online program of talks, activities, and interactive conversations. A brief evaluation was undertaken. Results: Participants reported high levels of satisfaction with the content and helpfulness of FLWF. FLWF helped caregivers increase their knowledge of, and skills in, parenting children with FASD, and equipped caregivers to nurture positive peer-to-peer relationships. Conclusions: Specialist FASD caregiver education and support programs are beneficial for caregivers who care for children and youth with FASD. Further research through a randomised control trial could establish the efficacy of the program.

Background: Narrative discourse, or storytelling, is used in daily conversation and requires higher-level language and social communication skills that are not always captured by standardised assessments of language. Many autistic individuals and individuals with fetal alcohol spectrum disorders (FASD) have difficulties with both social communication and language skills, and narrative discourse analysis offers an ecologically relevant approach to assessing those challenges. Aims: This study investigated narrative discourse in individuals with autism and FASD, as well as an age- and sex-matched comparison group. Methods and Procedures: Narratives from 45 adolescents and adults, 11 with autism, 11 with FASD and 23 age- and sex-matched comparison participants were elicited using a wordless storybook. They were then transcribed orthographically, formatted to the Systematic Analyses of Language Transcript (SALT) convention and scored based on the SALT Narrative Scoring Scheme (NSS), a standardised language analysis protocol. In addition to the NSS total score, which assesses the overall structure and cohesion of the narratives produced, local and global measures of language ability were also employed. The local language measures included the number of mental state and temporal relation terms produced, while the global language measures included mean length of utterance, total different words, total words, total utterances, rate of speech, the number of mazes (e.g., repetitions, 'um', 'uh' or self-corrections) per total word and the NSS total score. Outcomes and Results: Using the SALT "Language Sample Analysis" tool, our results revealed that on global language measures, group differences were found on rate of speech, number of mazes per total words and the description of conflict/resolution in the narratives produced. The autism group produced significantly more mazes per total word and scored higher on the NSS conflict/resolution category score compared to the FASD and comparison groups. Both the autism and FASD groups spoke at a lower rate than the comparison group. On local language measures of narrative production, all groups were comparable, on average. Conclusions and Implications: While many aspects of narrative discourse in the autism and FASD groups were similar to each other and to the comparison group, we observed group differences on global measures of narrative production and significant individual variability within groups, suggesting that narrative abilities considered at an individual level may provide important clinical information for intervention planning. Future research should also consider additional variables that influence narrative discourse, such as motivation, distractibility or decision-making of individual participants.

Fetal alcohol spectrum disorders (FASD) represent a wide range of neurodevelopmental differences associated with prenatal alcohol exposure and are highly prevalent. The current study represents the initial stages in adapting the Families Moving Forward (FMF) Program, an evidence-based behavioral consultation intervention for caregivers of children with FASD, to a website for teachers. Aims were to understand teachers' needs and preferences for an FASD-informed intervention website and to assess the goodness of fit of the FMF Program to teachers and the school setting. Twenty-three teachers with experience teaching students with FASD were interviewed. Interviews were conducted via Zoom and lasted about 53 min on average. Data were transcribed verbatim and analyzed using qualitative content analysis in Dedoose. Three overarching themes represented teachers' needs for an FASD-informed resource: teachers need evidence-based FASD information and strategies, teachers have very little extra time, and the needs of special and general education teachers vary. Teachers were positive about the concepts of the FMF Program and felt they would have good fit. Teachers need an evidence-based FASD-informed intervention that is easy to use, concise, and responsive to varying needs and levels of experience. Results will inform the adaptation process of the FMF Program.

Background: Fetal alcohol spectrum disorder (FASD) is a common form of developmental disability but may be poorly understood by professionals working with people with FASD. The aim of the research is to understand the FASD knowledge, attitudes, awareness, and practices among people employed by the education sector in Aotearoa New Zealand and identify gaps in knowledge. Methods: We conducted an online survey of New Zealand Education professionals. The survey focused on the following areas: Awareness of FASD; Knowledge and beliefs about FASD; Impact of FASD on professional practice; and Training needs. Results: Of the 419 participants, most had some knowledge of FASD and its effects on learning; however, there are still gaps that need to be addressed so educators can provide support to individuals living with FASD. Conclusion: There is a need to improve workforce capacity and develop guidelines that address the needs of front-of-line staff working with children with FASD in education settings.

Drug and alcohol neonate simulators were used to highlight the effects of substance misuse on prenatal development within lifespan development modules to 61 Psychology undergraduates and 12 sixth-form Health and Social Care students. A mixed method approach was used considering both knowledge development and perceptions of experiential hands-on learning. Student knowledge of the effects of drugs and alcohol on prenatal development was assessed before and after an interactive session on teratogenesis utilising neonate simulators demonstrating these effects. With this experiential learning approach, the statistical analysis combining both groups showed increased knowledge after the interactive session, and the students perceived this enhanced understanding to be a direct result of hands-on interaction with the neonate simulators. The researchers encourage the use of neonate simulators as good practice that can be effectively incorporated into the psychology and other health-related teaching contexts to facilitate knowledge on teratogenesis.

Background: Infants, children, and youth in foster care have frequently experienced prenatal substance exposure (PSE), neglect, and maltreatment as well as disruptions in their relationships with families. They also have great capacity for overcoming early adversities. In this synthesis of two previously conducted scoping reviews, we aimed to identify and describe literature that identifies a range of interventions that support the health and development of this population. Methods: This review integrates and extends two previously conducted scoping reviews, one focusing on infants and one focusing on children and youth, to synthesize themes across these developmental stages. The Joanna Briggs Institute scoping review methodology was employed for the current and previous reviews. A three-step search strategy identified published studies in the English language from January 2006 to February 2020. Results: One-hundred and fifty-three sources were included in this review. Four themes were identified: (1) early screening, diagnosis, and intervention; (2) providing theoretically grounded care; (3) supporting parents and foster care providers; and (4) intersectoral collaboration. Conclusion: Infants, children, and youth with PSE are overrepresented in foster care. Child welfare system planning should take a multi-sectoral approach to addressing the cumulative needs of this population and their care providers over developmental ages and stages. Although research remains limited, early screening, diagnosis, and developmentally and fetal alcohol spectrum disorder-informed intersectoral interventions are critical for optimizing outcomes.

Fetal alcohol spectrum disorder (FASD) is characterized by impulsivity and deficits in executive functioning. Given this, individuals with FASD might particularly benefit from interventions that teach them to manage their own behavior in a more adaptive manner. Using a reversal (ABAB) design, the current study investigated the effects of a function-based self-management intervention package on the academic engagement of a 12-year-old Hispanic female with FASD during her after-school routine. The intervention included implementing antecedent strategies, teaching the participant to self-monitor, and providing contingent reinforcement. Results revealed a functional relationship between the intervention package and the participant's academic engagement. This finding strengthens the small but growing evidence that individuals with FASD can benefit from function-based behavior analytic interventions. Implications for research, practice, and policy are discussed.

Background: The consequences for children born with birth defects and developmental disabilities encompassed by foetal alcohol spectrum disorder (FASD) are profound, affecting all areas of social, behavioural and cognitive functioning. Given the strong evidence for a core deficit in executive functioning, underpinned by impaired self-regulation skills, there has been a growing focus on the development of interventions that enhance or support the development of executive functions (EFs). Objectives: The primary objective of this review is to synthesise the evidence for structured psychological interventions that explicitly aim to improve EF in children. The review also sought to ascertain if the effectiveness of interventions were influenced by characteristics of the intervention, participants or type of EF targeted by the intervention. Search Methods: Sixteen databases, 18 grey literature search locations and 9 trial registries were systematically searched to locate eligible studies (up to December 2020). These searches were supplemented with reference harvesting, forward citation searching, hand searches of topic-relevant journals and contact with experts. Selection Criteria: Studies were included in the review if they reported on an impact evaluation of a psychological intervention aiming to improve EF in children 3-16 years who either had confirmed prenatal alcohol exposure or a formal diagnosis falling under the umbrella term of FASDs. Eligible study designs included randomised controlled trials (RCTs) and quasi-experimental designs with either no treatment, wait list control or an alternative treatment as a comparison condition. Single-group pre-post designs were also included. Data Collection and Analysis: Standard methodological procedures expected by the Campbell Collaboration were used at all stages of this review. Standardised mean differences (SMDs) were used to estimate intervention effects, which were combined with random effects meta-analysis (data permitting). Risk of bias was assessed using the Cochrane Risk of Bias Tool (RoB2) and Cochrane Risk of Bias in Non-Randomised Studies-Interventions tool (ROBINS-I). Main Results: The systematic search identified 3820 unique records. After title/abstract and full-text screening, 11 eligible studies (reported in 21 eligible documents) were deemed eligible, with a combined 253 participants. Of the 11 studies, 6 were RCTs, 1 was a quasi-experiment and 4 were single-group pre-post intervention designs. All studies were rated as having an overall high or serious risk of bias, with some variation across domains for RCTs. For RCT and quasi-experimental studies, the overall effect of EF interventions on direct and indirect measures of EF generally favoured the experimental condition, but was not statistically significant. There was no difference between intervention and comparison groups on direct measures of auditory attention (k = 3; SMD = 0.06, 95% confidence interval [CI] = -1.06, 1.18), visual attention (k = 2; SMD = 0.90, 95% CI = -1.41, 3.21), cognitive flexibility (k = 2; SMD = 0.23, 95% CI = -0.40, 0.86), attentional inhibition (k = 2; SMD = 0.04, 95% CI = -0.58, 0.65), response inhibition (k = 3; SMD = 0.47, 95% CI = -0.04, 0.99), or verbal working memory (k = 1; d = 0.6827; 95% CI = -0.0196, 1.385). Significant heterogeneity was found across studies on measures of auditory attention and visual attention, but not for measures of cognitive flexibility, attentional inhibition or response inhibition. Available data prohibited further exploration of heterogeneity. There was no statistical difference between intervention and comparison groups on indirect measures of global executive functioning (k = 2; SMD = 0.21, 95% CI = -0.40, 0.82), behavioural regulation (k = 2; SMD = 0.18, 95% CI = -0.43, 0.79), or emotional control (k = 3; SMD = 0.01, 95% CI = -0.33, 0.36). Effect sizes were positive and not significant for meta-cognition (k = 1; SMD = 0.23, 95% CI = -0.72, 1.19), shifting (k = 2; SMD = 0.04, 95% CI = -0.35, 0.43), initiation (k = 1; SMD = 0.04, 95% CI = -0.40, 0.49), monitoring (k = 1; SMD = 0.25, 95% CI = -0.20, 0.70) and organisation of materials (k = 1; SMD = 0.25, 95% CI = -0.19, 0.70). Effect sizes were negative and not statistically different for effortful control (k = 1; SMD = -0.53, 95% CI = -1.50, 0.45), inhibition (k = 2; SMD = -0.08, 95% CI = -0.47, 0.31), working memory (k = 1; SMD = 0.00, 95% CI = -0.45, 0.44), and planning and organisation (k = 1; SMD = -0.10, 95% CI = -0.55, 0.34). No statistically significant heterogeneity was found for any of the syntheses of indirect measures of EF. Based on pre-post single-group designs, there was evidence for small to medium sized improvements in EF based on direct measures (cognitive flexibility, verbal working memory and visual working memory) and indirect measures (behavioural regulation, shifting, inhibition and meta-cognition). However, these results must be interpreted with caution due to high risk of bias. Authors' Conclusions: This review found limited and uncertain evidence for the effectiveness of interventions for improving executive functioning in children with FASD across 8 direct and 13 indirect measures of EF. The findings are limited by the small number of high-quality studies that could be synthesised by meta-analysis and the very small sample sizes for the included studies.

People with disabilities have not been adequately represented in strengths-based research. This study is the first to examine strengths and positive influences of young children with fetal alcohol spectrum disorder (FASD). Thirty adoptive and relative caregivers of children with FASD reported their children's strengths and positive influences and completed measures on family functioning. Using a conversion mixed design, we described themes in strengths and influences, degree of caregiver positivity and relationships with child and family functioning. Caregivers reported wide-ranging strengths and positive influences. Frequency of adaptive strengths correlated with measures of family functioning, but thematic strengths and positive influences did not. Strengths and positive influences are distinct from measures of functioning and are not well captured in deficit-focused research.

Three of the most prevalent developmental disorders (DDs) are autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD) and fetal alcohol spectrum disorder (FASD). As part of a study screening for DDs in Greater Manchester, UK, a unique opportunity was taken to explore parents' experiences of receiving reports about their child's previously unrecognised DD. Six parents out of a possible 16 took part in interviews, which were analysed thematically. Findings drawn from parental responses revealed a number of barriers to accessing support for their child's additional needs, including perceived resistance from schools, particularly for quiet, well-behaved girls, and difficulty in accessing assessment or referrals. There needs to be greater awareness of additional needs in children without externalising behaviours, the presence of gender-specific differences in the presentation of DDs, and FASD as a commonly occurring DD. Ultimately, better support for children with DDs would reduce the burden of unmet needs for the children and their families, and for wider services.

Introduction Limited research has been conducted on suicidality among individuals with FASD. The purpose of this scoping review was to understand (1) how suicidality has been measured; (2) what proportion of individuals experience suicidality across the lifespan; and (3) what contextual factors are associated with suicidality. Method We conducted a scoping review of the literature on FASD and suicidality. Twenty-eight articles and gray literature sources were included. Results We identified an elevated risk of suicidal ideation, attempts, and death among individuals with FASD. Most studies were Canadian, published within the last 10 years, and focused on adolescents and adults in clinical settings. Only six studies were specifically designed to examine suicidality in FASD. Conclusion This review provides a foundational understanding of suicidality in FASD with important implications for research, policy, and practice. Rates of suicidality across the lifespan are high, underscoring the need for evidence-based approaches to screening, prevention, and treatment.

Purpose: To date, research on effects of prenatal alcohol exposure (PAE) has focused on a broad range of cognitive impairments, but relatively few studies have examined effects of PAE on development of reading skills. Although PAE has been linked to poorer reading comprehension, it remains unclear whether this impairment is attributable to deficits in phonological processing, word reading, oral language skills, and/or executive functioning. Methods: A comprehensive reading battery was administered to 10 adolescents with fetal alcohol syndrome (FAS); 16 with partial FAS; 30 nonsyndromal heavily exposed; 49 controls. Results: PAE was related to poorer reading comprehension but not to singleword reading or phonological processing, suggesting that the mechanics of reading are intact in adolescents with fetal alcohol spectrum disorders at this age. PAE-related impairment in reading comprehension was mediated, in part, by deficits in mastery of oral language skills, including vocabulary, language structure, and verbal fluency. Conclusions: These results are consistent with research showing that reading comprehension in adolescence relies increasingly on linguistic comprehension abilities, especially once word reading becomes automatic and text complexity increases. Our findings suggest that reading-impaired adolescents with PAE will benefit from intervention programs targeting vocabulary knowledge, language structure, verbal fluency, and reading comprehension skills.

Background: People with fetal alcohol spectrum disorder (FASD) and women who drink alcohol while pregnant can experience stigma, possibly exacerbated by stereotyped media portrayals. Method: To understand experiences of FASD stakeholders and reactions to news coverage, we conducted twelve focus groups across three categories: (1) people with FASD; (2) caregivers; and (3) professionals. Themes were identified using "framework analysis." Results: We identified stereotypes about: (1) FASD (e.g., negative life trajectories); (2) alcohol and pregnancy (e.g., bad mothers); and (3) non-biological caregivers. Participants identified potential effects of FASD stereotypes (e.g., self-fulfilling prophecies) and alcohol and pregnancy stereotypes (e.g., exacerbating difficult decisions about disclosing a child's adoptive status). Conclusions: Our results align with research about difficult experiences of FASD stakeholders. However, while Canadian news analyses found people with FASD portrayed as criminals, our participants identified mostly non-crime stereotypes. Participants also sometimes shifted the burden of motherhood stereotypes from low-income to higher-income women.

Introduction: Caregivers of autistic children and caregivers of children with fetal alcohol spectrum disorder (FASD) experience considerable stress. However, what is unique or similar across these groups remains understudied. This study explored how female caregivers of children with FASD who registered to participate in a caregiver focused mental health intervention differed from female caregivers of autistic children participating in a similar intervention. Methods: Prior to the intervention, caregivers of children with FASD (n = 21), and caregivers of autistic children (n = 22) were asked to complete an online baseline questionnaire. This questionnaire collected information pertaining to caregiver and child demographics, as well as clinical characteristics related to wellbeing, values, and what caregivers identified as rewarding and challenging about raising their child. Results: identified similarities across caregiver groups in terms of wellbeing, values, and the challenges and rewards they identified with raising their children. Conclusions: Given the similarities in these two caregiver groups, and the shortage of research on families of people with FASD relative to families of autistic people, interventions for family caregivers in the autism community may also be applicable for FASD families, for whom fewer resources are available.

The focus of this research is educators' relational experiences with learners presumed to have Fetal Alcohol Spectrum Disorder (FASD) in a South African school community. Although relational interaction (usually seen as trusting and caring) is an integral aspect of the learning environment, relational functioning within this context is seriously challenged when educators are working with FASD learners. A qualitative approach was used and 14 educators were selected as participants from a rural school community in the Western Cape Province. Data were collected via semi-structured individual interviews and two focus groups. Thematic analysis of the data revealed that the relational quality of educators' experiences is determined by their practical knowledge of the limited intellectual abilities, and impaired social functioning within the learning environment of learners with FASD; the negative impact of these experiences on educators' personal resources and job satisfaction; and, educators' relational experiences with learners identified with FASD entail a unique blend of challenges and competencies. Recommendations include specialised training for all South African educators to deal with the particular educational requirements of learners with FASD, and the requisite relational competencies, so as to actualise these learners' full potential.

Fetal alcohol spectrum disorder (FASD) is a diagnostic term used to describe an array of structural, neurocognitive, and behavioral effects that result from prenatal alcohol exposure. While ongoing efforts have been made to increase the capacity of communities to provide early FASD diagnosis, there continues to be on-going challenges, particularly for remote and rural communities. Telehealth is the use of technology to connect communities at a distance and has been effectively used in medicine for several decades. This literature review describes the use of telehealth in FASD and other developmental disabilities and makes recommendations for how telehealth can be used to facilitate the assessment and diagnosis of FASD in rural and remote communities.

Self-management has been found to be favorable for improving a wide variety of skills as well as decreasing problematic behaviors in individuals with a range of disabilities. We used a single case withdrawal design to investigate the use of a self-management intervention on problem behaviors of a nine-year-old Native American child with fetal alcohol spectrum disorder (FASD) during routines within the home setting. Specifically, we examined the effect of self-monitoring paired with contingent reinforcement on independent task completion of home routines. Introduction of the intervention resulted in an increase in the number of independently completed chores and homework tasks; withdrawal of the intervention resulted in a return to baseline levels of performance. These findings extend the examination of self-management interventions within home-based routines to children with FASD. Limitations and implications for research and practice are discussed.

The prevalence of Fetal Alcohol Spectrum Disorder (FASD) may be underestimated as it can be difficult to diagnose in early childhood possibly reflecting unique developmental trajectories relative to other Neurodevelopmental Disabilities (NDDs). Using data collected via the Early Development Instrument (EDI) between 2010 and 2015, we examined the prevalence of kindergarten children with FASD and their concurrent developmental outcomes. We found that the prevalence of FASD ranged from 0.01 to 0.31%. A greater percentage of children with FASD had teacher-reported home problems that interfered with their classroom functioning. Overall children with FASD had higher mean scores on the developmental domains compared to children with NDDs. Results of the current study can inform strategies and policies for early identification and intervention.

Youth who are high risk (YHR) face numerous adversities, and those with Fetal Alcohol Spectrum Disorder (FASD) may experience even more complex challenges due to the compounding impact of brain dysfunction. However, very little research has been conducted to understand or characterize this vulnerable group, or explore potential strategies for supporting their specific needs. In the current study, we sought to characterize some of the adverse experiences of YHR with and without FASD (N = 90) who were attending an innovative school that supports students who have struggled in other educational settings. We also examined services offered at this school and explored whether service access and several social and educational factors differ between youth with and without FASD. Findings indicate that YHR with FASD have more complex needs and a different pattern of service use than YHR without FASD. These findings are discussed in the context of how we might better support YHR and foster successful outcomes.

Teachers who adapt a multisensory approach to teaching learners who have been affected by fetal alcohol syndrome disorder (FASD) will encourage them to be self-supporting, and to excel in the classroom through participating in a myriad of stimulating activities. Researching the learners' unique characteristics will provide teachers with the tools for planning, thereby maximizing the learners' strengths through the introduction of visual, auditory, kinesthetic, and simulation strategies. There is no one learning style that suits all learners, and regardless of any learning difficulty experienced by FASD learners due to brain damage, if teachers capitalize on their unique strengths and talents, then they can create a student-centered learning environment wherein less disruptive behaviour is displayed, and more participation is encouraged.

Background: Early diagnosis of Fetal Alcohol Spectrum Disorder (FASD) is known to improve outcomes in children. It is less clear if diagnosis in adulthood also conveys benefits. This study investigated long-term outcomes for individuals diagnosed with FASD after 18 years of age. Method: Twenty adults aged 18-45 years at FASD diagnosis were interviewed. Pre-diagnosis information was compared to follow-up information gathered between 1 and 11 years later. Results: Individuals reported high rates of mental health disorders (55%) and unemployment (85%). Pre-diagnosis, 10% received disability income and 15% were eligible for intellectual disability (ID) services. At follow-up, 90% received disability income and 85% were eligible for ID services. All (100%) enacted at least one assessment recommendation and 75% enacted two. Most (75%) reported having a diagnosis was beneficial, providing better adaptation and self-understanding. Conclusion: An FASD diagnosis in adulthood can benefit individuals through more access to supports/services and greater personal understanding and adaptation.

Prenatal exposure to alcohol causes a pattern of brain-based deficits and is associated with behavioral challenges (Wozniak et al., 2019). Understanding the neurocognitive behaviors common among individuals with fetal alcohol spectrum disorders (FASD) can increase teachers' effectiveness (Tremblay et al., 2017). Environmental changes, such as modifying the classroom, providing high levels of structure, and increasing adult supervision, have been shown to improve the behavior of individuals with FASD (Bohjanen et al., 2009). There is also emerging evidence that explicit instruction in metacognitive strategies is effective with this population (Makela et al., 2019. Students with FASD can benefit from being explicitly taught to stop and think before acting and to use rehearsal, memory aids, and positive self-talk.

Schools across the province of Alberta are increasingly diverse in terms of student backgrounds, circumstances, and needs (Alberta Education, 2017). In order to respond to the needs of a diverse student population, many schools are providing supports targeted to children and youth identified as being at risk for poor outcomes. The Wellness, Resiliency, and Partnerships (WRaP) project, initiated in 2009, was born out of recognition for the need to provide individualized, strength-based supports to students with Fetal Alcohol Spectrum Disorder (FASD). For eight years, WRaP success coaches aimed to provide innovative, collaborative, strength-based services and supports to promote the success of students with FASD in Alberta schools. The project initially targeted junior and senior high school students with FASD. Over the project's most recent two years, the project expanded to serve elementary schools, as well as students with complex needs in addition to those that arise due to FASD. The aims of the project were to maximize school engagement, increase academic success, and enhance social, emotional, and physical well-being. In addition, coaches worked to enhance school and family capacity to support students with complex needs, and to build partnerships for youth to access supports at home, at school, and in their communities. Overall, the WRaP project demonstrated significant growth and positive outcomes in terms of building school capacity to support students with complex needs including FASD. We will draw on data from four years of annual interviews and focus groups conducted with WRaP success coaches and school personnel to describe the key processes, successes, and challenges involved in building school capacity through the WRaP project in Alberta schools.

Background: Prenatal alcohol exposure (PAE) is associated with growth deficits and neurodevelopmental impairment including foetal alcohol spectrum disorder (FASD). Difficulties with oral and written communication skills are common among children with PAE; however, less is known about how communication skills of adolescents who have PAE compare with those who do not. Adolescence is a critical time for development, supporting the transition into adulthood, but it is considered a high-risk period for those with FASD. Aims: We conducted a systematic review to synthesize evidence regarding oral and written communication skills of adolescents with PAE or FASD and how they compare with those with no PAE. Methods & Procedures: A comprehensive search strategy used seven databases--Cochrane Library, Cinahl, Embase, Medline, PsycInfo, Eric and Web of Science. Included studies reported on at least one outcome related to oral and written communication for a PAE (or FASD) group as well as a no/low PAE group, both with age ranges of 10-24 years. Quality assessment was undertaken. Main Contribution: Communication skills most often assessed in the seven studies included in this review were semantic knowledge, semantic processing, and verbal learning and memory. These communication skills, in addition to reading and spelling, were commonly weaker among adolescents with PAE compared with those with no/low PAE. However, the findings were inconsistent across studies, and studies differed in their methodologies. Conclusions & Implications: Our results emphasize that for adolescents with PAE, communication skills in both oral and written modalities should be comprehensively understood in assessment and when planning interventions. A key limitation of the existing literature is that comparison groups often include some participants with a low level of PAE, and that PAE definitions used to allocate participants to groups differ across studies.

Adolescents with Fetal Alcohol Spectrum Disorder (FASD) experience a range of cognitive, behavioral, and physical difficulties, including difficulties with self-regulation. We investigated self-regulation strategy use in adolescents with FASD who completed a self-regulation intervention program. The intervention was an adapted version of the Alert Program®, and it was delivered in hospital settings in two Canadian cities. We explored the types of strategies chosen by adolescents in the intervention, reported strategy use outside of the intervention, and feedback from adolescent participants about the program. We used both descriptive statistics and qualitative data to examine self-regulation strategy use in adolescents with FASD. Adolescents with FASD were found to use both sensory and non-sensory strategies to help them regulate at the beginning of each intervention session. Participants reported increasingly using the information they learned from the intervention program outside of the intervention, and the majority of participants reported using the information to help them at school. Overall, 96% of participants reported that they enjoyed the program, and 91% of participants reported that the things they learned in the program are helpful in their daily lives. Three themes emerged from a qualitative analysis of data gathered on the adolescents' experiences in the program: increasing capacity, sharing knowledge, and connecting meaningfully. These themes highlight important components of the intervention program. Implications for the use of a self-regulation intervention for adolescents with FASD are discussed. We specifically note the importance of differentiating between sensory and non-sensory regulation strategies, and the need for more research to increase our understanding of the use and impact of self-regulation strategies in adolescents with FASD.

Introduction: There is significant symptom overlap between fetal alcohol spectrum disorder (FASD), which results from prenatal alcohol exposure (PAE), and autism spectrum disorder (ASD). There is also limited research regarding the comorbidity of these disorders. Method: Thirty-nine individuals with ASD and PAE (ASD+PAE) aged 3 to 30 years were matched for age, sex, and IQ to 78 individuals with PAE-only and compared on demographics, comorbid conditions, and 9 domains of neurodevelopmental function. Results: The ASD+PAE group were significantly more likely to have deficits in motor and daily living skills. They also had a greater number of impaired neurodevelopmental domains overall. They were diagnosed with ADHD more often and reported more sensory sensitivities, self-regulation difficulties, and social skills deficits. Conclusions: Overall, the ASD+PAE group had a more complex and severe presentation of symptoms. The relationship between ASD, FASD, and PAE as well as the value of providing an ASD diagnosis in the context of PAE are discussed.

This article begins with an explanation of questions of neoliberalism in academia in an era of audit culture; the markers of successful academic projects (such as publication outputs) are challenged. Barriers to and dissemination of Community-Based Participatory Arts and Research (CBPAR) are discussed, such as the discrepancy between the lived experience of community members and potential peer reviewers. Following this discussion, a participatory project is outlined in which the authors seek to capture the untapped creativity of people with FASD, such as capacity for fluid improvisation. Deficits of FASD are reconfigured in an artistic space to capture creativity and lived experience.

Sleep problems are common among children with neurodevelopmental disorders (NDDs). We review sleep disturbance in three major NDDs: autism spectrum disorder, Down syndrome, and fetal alcohol spectrum disorder (FASD). We review associations with functional impairment, discuss how patterns of sleep disturbance inform understanding of etiology, and theorize about mechanisms of impairment. Sleep disturbance is a transdiagnostic feature of NDDs. Caregivers report high rates of sleep problems, including difficulty falling or staying asleep. Polysomnography data reveal differences in sleep architecture and increased rates of sleep disorders. Sleep disturbance is associated with functional impairment and stress among families. Further research is needed to elucidate mechanisms of impairment and develop more effective interventions. Despite significant sleep disturbance in FASD, limited research is available.

There is a pressing need for enhancing the learning environment for students affected by Fetal Alcohol Spectrum Disorders (FASDs). To develop relevant professional learning opportunities for teachers, a logical initial step is to explore the extent to which pre-service teachers accurately understand the unique neuropsychological functioning associated with FASDs and can apply their knowledge of how learning and development influence functions in the affected child. This research builds upon a theoretical framework operationalizing understanding as a composite of factual knowledge of the strengths and weaknesses of students with FASD and conceptions of how this underlying impairment impacts daily functions and the consequent potential for intervention by a classroom teacher (Job et al., 2013). The analysis of questionnaire data from 77 pre-service teachers revealed a limited knowledge of FASD and its associated deficits and a lack of ability for applying knowledge to classroom practice. The article concludes with a discussion of the implications for teacher education. In pre-service teacher education, knowledge about the causes and impairments associated with FASD can be taught, yet these are not useful in the absence conceptions that facilitate purposeful targeting of root issues for the individual in practice. Finally, we discuss the need for enhanced individualizing of programs for students with disabilities within an inclusive learning environment.

Individuals with intellectual and developmental disabilities (IDD) are at greater risk of health-related issues due to obesity and lack of physical activity. This study examined using virtual reality (VR) exergaming to increase the physical activity of high school students with IDD. Four students participated in this multiple probe across participants design. Data were collected on each student's total amount of time engaged in exercise and heart rate. Results indicate that all students increased the duration and intensity of their physical activity when using the VR exercise gaming (exergaming) intervention. The VR exergaming intervention increased the duration and intensity of the students' exercise sessions. Results are discussed in terms of applying VR and other emerging technologies to support the exercise health needs of the individual in the study.

Studies in north-western Australia Aboriginal communities identified executive functioning and behavioural regulation as significant issues for children. Exposure to alcohol prenatally and adverse childhood experiences are known risk factors for impaired self-regulation and executive function, these risk factors being present in remote communities. In response, a partnership was initiated to trial a teacher-delivered self-regulation intervention based on the Alert Program®. While student outcomes were assessed, this paper describes the implementation and impact of the intervention on teachers through the five dimensions of the RE-AIM framework (Reach, Efficacy, Adoption, Implementation, Maintenance). Trained classroom teachers (n = 29) delivered eight Alert Program® lessons to students over 8- weeks. Impact and implementation outcomes were assessed through teacher training and student lesson attendance data, and pre-training and post-intervention teacher questionnaires. Data were analysed using paired-samples t-tests and descriptive statistics. Eighty-one to 100% of prescribed lessons were implemented and teacher understanding of self-regulation and the Alert Program® improved significantly following the intervention (n = 14, p = 0.001). Most teachers (88%) reported changing their teaching and behaviour management practices because of the intervention and agreed there were benefits in teaching the Alert Program® to students in a region with high reported rates of foetal alcohol spectrum disorder and self-regulation impairment.

Background: Neurobehavioural screening measures specific to foetal alcohol spectrum disorders (FASD) are warranted to inform treatment and care. This study determined basic psychometric properties of the Fetal Alcohol Spectrum Consultation, Education, and Training Services (FASCETS) Neurobehavioural Screening Tool (NBST) to measure neurobehavioural deficits and understand the potential for adjunctive use with the FASD 4-Digit Diagnostic Code. Method: Caregivers of 86 children, adolescents, and young adults voluntarily completed surveys as part of a medical evaluation for FASD. Exploratory factor analyses were conducted to evaluate internal reliability and to describe the relationship between variables. Results: The NBST demonstrated adequate factor structure and internal consistency reliability. Two of the NBST subscales (Executive Function 1 and Learning) were significantly correlated with clinical rankings for central nervous system structural/functional abnormalities of the FASD 4-Digit Diagnostic Code. Conclusions: Results provide preliminary evidence that the NBST has adequate psychometric properties and may be a useful adjunctive screening tool for the medical diagnosis of FASD.

Metacognitive training is an emerging cognitive intervention for children with fetal alcohol spectrum disorder (FASD) that teaches children to think about their thinking and use strategies to improve learning and regulation. We investigated how children with FASD acquired metacognitive strategies during a computerized intervention delivered in a school setting. The number, type, and process of strategy acquisition were recorded for seven children with FASD during the intervention. As an indication of strategy learning, we recorded prompted and spontaneous strategy use over time. Children with FASD were found to use a total of 26 different metacognitive strategies, with eight strategies used spontaneously by all participants. Participants demonstrated a significant decrease in the number of different prompted strategies and a significant increase in the number of spontaneous strategies used over the course of the intervention. Implications for the use of a metacognitive approach for students with FASD are discussed, emphasizing the value of a strength-based approach.

Fetal Alcohol Spectrum Disorder (FASD) is the term to describe the range of adverse effects that can occur when a fetus is exposed to alcohol. At present in New Zealand there are no definitive statistics on the extent of FASD as a prevalence study has not been undertaken. However, as reported in the New Zealand Fetal Alcohol Spectrum Disorder Working Party Report (2016), at least one in two pregnancies are exposed to alcohol, with 10 per cent of these being exposed to high-risk levels. The life-long difficulties that people with FASD experience are becoming clearer as more is learnt about FASD and its effects. This paper describes the recent experience of two Year 11 teens attending different schools in New Zealand. The aim is to highlight the diversity of experience each had, due to the differing approach their school took towards them and their diagnosis of FASD.

The purpose of this article is to provide educators with information to support the increasing number of Fetal Alcohol Spectrum Disorder (FASD) affected students in mainstream classrooms. Educating FASD-affected children requires a thorough understanding of identifiable and non-identifiable characteristics, common behavioural and social traits, and effective teaching strategies. This knowledge will help educators and families to support the diverse needs of affected children and promote success both inside and outside of the classroom.

Prenatal alcohol exposure (PAE) is associated with profound and lifelong disability. The umbrella term fetal alcohol spectrum disorder (FASD) describes a spectrum of impairments resulting from the deleterious effects of PAE (Chudley et al., 2005). While the core aspects of the condition remain unchanged, the Australian guidelines comprise two diagnostic categories for FASD: (1) FASD with three sentinel facial features; or (2) FASD with less than three sentinel facial features. Understanding how to support children with a diagnosis of FASD is particularly important given the condition has been linked to a range of poor outcomes, including increased contact with the justice system, substance misuse (Burd, Fast, Conry, & Williams, 2010), antisocial and delinquent behaviour, learning disabilities, externalizing, and aggressive behaviour, as well as a range of other adaptive functioning and mental health problems (Bower & Elliot, 2016; Kodituwakku, 2009; Rasmussen, Andrew, Zwaigenbaum, & Tough, 2008). There is growing evidence that a core deficit underpinning many of these adverse outcomes is impairment in executive functions (EFs; Khoury, Milligan, & Girard, 2015; Kodituwakku, 2009). EFs are higher-order mental processes which allow individuals to deploy attention strategically, hold and manipulate goal-relevant information and consciously enforce goal-directed behaviour (Baggetta & Alexander, 2016; Diamond, 2013). Given the compromised outcomes associated with EF deficits, and the frequency of EF impairment in children with FASD, this rigorous synthesis of the effectiveness of available interventions offers great value to practitioners, individuals with FASD and their families.

Purpose: Data from standardized caregiver questionnaires indicate that children with fetal alcohol spectrum disorders (FASDs) frequently exhibit atypical auditory behaviors, including reduced responsivity to spoken stimuli. Another body of evidence suggests that prenatal alcohol exposure may result in auditory dysfunction involving loss of audibility (i.e., hearing loss) and/or impaired processing of clearly audible, "suprathreshold" sounds necessary for sound-in-noise listening. Yet, the nexus between atypical auditory behavior and underlying auditory dysfunction in children with FASDs remains largely unexplored. Method: To investigate atypical auditory behaviors in FASDs and explore their potential physiological bases, we examined clinical data from 325 children diagnosed with FASDs at the University of Washington using the FASD 4-Digit Diagnostic Code. Atypical behaviors reported on the "auditory filtering" domain of the Short Sensory Profile were assessed to document their prevalence across FASD diagnoses and explore their relationship to reported hearing loss and/or central nervous system measures of cognition, attention, and language function that may indicate suprathreshold processing deficits. Results: Atypical auditory behavior was reported among 80% of children with FASDs, a prevalence that did not vary by FASD diagnostic severity or hearing status but was positively correlated with attention-deficit/hyperactivity disorder. In contrast, hearing loss was documented in the clinical records of 40% of children with fetal alcohol syndrome (FAS; a diagnosis on the fetal alcohol spectrum characterized by central nervous system dysfunction, facial dysmorphia, and growth deficiency), 16-fold more prevalent than for those with less severe FASDs (2.4%). Reported hearing loss was significantly associated with physical features characteristic of FAS. Conclusion: Children with FAS but not other FASDs may be at a particular risk for hearing loss. However, listening difficulties in the absence of hearing loss--presumably related to suprathreshold processing deficits--are prevalent across the entire fetal alcohol spectrum. The nature and impact of both listening difficulties and hearing loss in FASDs warrant further investigation.

Self-regulation and executive functioning impairments are common in children with fetal alcohol spectrum disorder. Given the high rates of fetal alcohol spectrum disorder identified amongst children living in the remote Fitzroy Valley region of Western Australia, the Alert Program® was identified as a culturally safe intervention for use in local primary schools. Researchers collaborated with Aboriginal Elders, community members, and staff from a Fitzroy Valley primary school to trial the Alert Program®. Teachers were trained to deliver eight Alert Program® lessons to children in class. Self-regulation and executive functioning were measured using teacher and parent/caregiver questionnaires three times. Data were analyzed using repeated-measures ANOVA. Teacher-led delivery of the Alert Program® was feasible in a region with high fetal alcohol spectrum disorder rates. As measured by teacher and parent/caregiver ratings, this curriculum may improve the self-regulation and executive functioning of children for some outcomes and provide sustained effects for some children. This community partnered pilot research, evaluated a school-based program to reduce the behavioral impact of fetal alcohol spectrum disorder, and informed design of a larger trial across eight Aboriginal community schools.

How are mental health practitioners using Snoezelen rooms with children with fetal alcohol spectrum disorder (FASD) within a community mental health setting? Using purposive sampling, we collected information from seven practitioners on how they currently use Snoezelen rooms to support children with FASD and what evidence they believe is needed to assess Snoezelen's treatment efficacy. Using grounded theory methodology, results indicated that priority research areas include the efficacy of Snoezelen for increasing self-regulation skills, positive parent-child interactions, and parent education. To support evidence-driven use of Snoezelen rooms for mental health treatment, we recommend that future research be focused in these areas.

Fetal alcohol spectrum disorder (FASD) is a significant cause of cognitive and developmental disability among children in Canada, with accompanying lifelong risks to independent living. Previous studies have called for improved home-school collaboration to support children with FASD, but barriers remain for parents seeking collaborative involvement. Using a narrative approach, this article presents one parent's experiences advocating for children with FASD within a school system in central Canada. Emerging narrative themes were schools' lack of knowledge and awareness of FASD, the difficulty of choosing a school or program, and the importance of listening to parents and families. Within the context of previous findings, this parent's narrative confirms and makes urgent key areas of need for improved support of children with FASD. These include improved training for teachers and administrators, flexible accommodations including specialized environments when needed, and above all an active commitment to trusting collaborations and encouragement of parental involvement.

Fetal alcohol spectrum disorder (FASD) is one of the most prevalent causes of developmental disability, impacting up to 2-5% of children in the United States. Yet, evidence-based treatments for individuals with FASD are notably limited, and individuals with this diagnosis have been very underrepresented in the empirical behavior analytic literature. The current study investigated the effects of an intervention package consisting of self-monitoring and contingent reinforcement on the behavior of an 11-year-old Hispanic male with FASD. The intervention had therapeutic effects on the participant's independent task completion and arguing behavior. These results suggest the promise of behavior analytic interventions for individuals with FASD, and document the positive effects of this self-management intervention in particular. Implications for behavior analytic research and practice among individuals with FASD are discussed.

Fetal alcohol spectrum disorders (FASD) are a group of disorders directly caused by prenatal alcohol exposure. This spectrum of disorders cause neurodevelopmental, neurobehavioral, and mental health effects. The consequences of prenatal alcohol exposure are permanent, leaving children and adults with behavioral and learning difficulties throughout their lifetimes. This article provides an overview of medical diagnosis and assessment of FASD; neurological manifestations; neurocognitive and neurodevelopmental effects; assessment and special education; and interventions. Evidence-based intervention and treatment can help a child with FASD become more successful at school and with learning tasks, as well as give them the tools to be successful as an adult. School psychologists play an important role in helping determine and provide teachers with the necessary tools for intervention. Although there is no cure for FASDs, available treatment options can improve the outcome for affected individuals.

This exploratory study addresses the call for an increased presence of key stakeholders' perspectives in educational research involving students with Fetal Alcohol Spectrum Disorders (FASDs) (Duquette, Stodel, Fullarton, & Hagglund, 2006a). Specifically, greater understandings are necessary to support the educational success of students with FASDs. The analysis of 11 focus groups and 3 interviews with teachers, administrators, caregivers, and allied professionals (total n = 60) revealed three themes: fostering relationships, reframing practices, and accessing supports. These findings have important implications for the use of a qualitaitve approach in generating evidenced-based educational practices for stakeholders reflective of enhanced communication and collaboration that better meet the needs of students with FASDs.

Health disparities in fetal alcohol spectrum disorders (FASD) are of high importance to American Indian/Alaska Native (AI/AN) communities. We conducted focus groups and interviews with 21 AI/AN women and key informants in Southern California to modify a brief, Web-based program for screening and prevention of prenatal alcohol use. This process resulted in several important program modifications and was essential for fostering partnerships between researchers and the community, engaging community members in research, and identifying community priorities.

The postsecondary experiences of adults diagnosed with Fetal Alcohol Spectrum Disorder (FASD) were examined in this qualitative research. Tinto's Student Integration Model (SIM) (1975, 1997) provided the theoretical framework that guided the study. Tinto posits that the interplay of background characteristics, academic integration, and social integration affect persistence in postsecondary education. The participants included four adults with FASD (3 males and 1 female) and their parents. In-depth interviews were conducted with the adults with FASD and their parents responded to open-ended questions in an online survey. Only one of the adults completed a postsecondary program. It was found that the background characteristic factor, and specifically having FASD, affected academic and social integration. Suggestions for revisions to the SIM are proposed, recommendations for postsecondary course instructors and academic counselors are made, and factors to consider when selecting a postsecondary program for an individual with FASD are described.

Evidence-based Practice Guidelines for Fetal Alcohol Spectrum Disorder (FASD) and Literacy and Learning are derived from an inductive analysis of qualitative data collected in field research. FASD is the umbrella term for a spectrum of neurocognitive and physical disabilities caused by prenatal exposure to alcohol. Data from a sample of N=150 was collected using sharing circles with Aboriginal elders and community members; conversational interviews with parents and their children with FASD; and interviews and focus groups with professionals who support children with FASD and their families. Special protocols were followed in collaboratively planning and participating in research involving Aboriginal communities. Aboriginal research methodologies utilized are situated among emerging, multi-disciplinary, qualitative research methodologies suitable for understanding the complexity of natural phenomena such as FASD. The goal of dissemination is to further translation of research findings regarding evidence-based guidelines for FASD to the clinical or practice levels, across disciplines and sectors, as well as across the life cycle, in order to prevent adverse life outcomes.

Fetal alcohol spectrum disorder (FASD) is a lifelong condition that significantly affects the individual's learning, development, behavior, family, and quality of life. Diagnosing children with this condition and providing effective supports is challenging for professionals because little intervention research has been performed with the population. This is frustrating for caregivers who often take an active role in their child's life to ensure that needs are met. This article summarizes quantitative and qualitative studies that have targeted learning and behavioral interventions that aim to support children with FASD and their families. Research suggests that practices accommodating children's neurocognitive and neurobehavioral deficits are likely to produce positive outcomes. Interventions that include the family are also promising in their effectiveness. Extra attention needs to focus on early intervention for infants and toddlers and interventions that can promote the self-determination of adults with FASD. Additional directions for future research are provided along with policy and practice implications.