Jewelry, phones, undergarments, car? ... port and personal program plans. .... This is a really cheap way of sharing wit
TIPS
For Support Workers
PRACTISE BORROWING Learning should take place in different contexts and over long periods of time. Otherwise, individuals with FASD may learn their own methods, often referred to as coping mechanisms. In the case of sharing, coping mechanisms can look like borrowing without asking, lending out money or objects of worth, using items that should not be shared like medications and undergarments and unfortunately, stealing. We know that impulse control is a difficult symptom to work with for an individual living with FASD. As such, the best place to start is by developing a proper understanding of ownership and sharing. • As the support worker or parent, you can start by asking the child to hold on to something for you for safe keeping, such as a lucky pen or favorite hair tie. This will help the child begin to understand what borrowing looks like. • It is important to lend to a child or ask a child to keep something safe for you because all too often we teach them how to borrow or use something that is not theirs, but we rarely teach them how to lend properly. • Look for ways to borrow something from your child, like a lipstick or a DVD. This will model a valuable lesson about what is appropriate to lend out and what is not. A lipstick or lip chap should never be shared. A DVD is fine to share but only one at a time. • Challenge children and youth to understand consequences to lending and borrowing. For instance, ask to borrow a child’s bike for a day knowing they will need the bike that evening to visit friends. Go as far as to ask to borrow a child’s shoes when they are still on the child’s feet. These types of social boundaries are not explicit for a child, youth or adult living with FASD and must be practised for many years. • Have rules about lending money. Often we give our children or lend our children money, but we rarely borrow from our children. Experiencing limited finances due to lending is something that should be learned and practiced from a very young age. Individuals with FASD can be vulnerable to these types of situations whether it be from a need to fit in, naiveté, or pure generosity. Think about these questions when you are teaching borrowing: • What types of things are safe to lend out? Jewelry, phones, undergarments, car? • How often is it OK to lend or borrow something? • What is the difference in asking to borrow something and asking to use something? • Who is it safe to borrow from? • What should you do if something you borrow breaks, or if something someone has borrowed from you breaks?
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SAFES Having a safe in the home is not a typical parenting strategy that caregivers anticipate using. However, the reality of living with a child, youth or adult with FASD often means using proactive strategies to avoid dangerous and potentially expensive mistakes. Using a safe to store valuable and dangerous items provides a safety net for families and individuals living with FASD who are still learning about ownership. • If it is apparent a child, youth or adult struggles with understanding ownership, there is an obligation to eliminate some of the most tempting and dangerous items. These items include car keys, medications, money, credit cards and cell phones. • A simple safe can be picked up at a variety of locations for various prices. Many home furnishing and hardware stores will carry safes from anywhere between $15 and $300 depending on size and shape. • An alternative option that some families prefer are locks on bedroom doors. • Don’t store any money in the house. • Keep cheque books in locked desk drawers. • As professionals and parents, it is important not to punish behaviour that is intrinsic to an individual’s disability. Instead, eliminate the temptation and work towards an understanding of ownership. • Reasonable consequences will look different for each person as they depend entirely on how each individual’s brain works. If he or she struggles less with memory, then grounding may work. However, if he or she has poor memory functioning they will not remember why they are facing consequences 30 minutes into a grounding or time out. • It is OK to ask a child to pay back the cost of a lost or stolen article (within reason). If the individual is responsible for taking someone’s MP3 music player, they should be responsible for either compensating the person financially or with in-kind labour such as chores. • Be sure that whatever punishment is used does not focus on the act of stealing or impulsiveness – remember this can be an aspect of the individual’s disability. Instead, punishment should focus on the individual’s refusal to return the item or frustration with you or the person who told on them.
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PLAIN LANGUAGE Prenatal alcohol exposure changes the way the brain is able to process information. As a result, individuals living with FASD may require more time to understand the world around them. By using plain language, we make this process a bit easier for the individuals and help them experience success in communication and relationship building. Plain language is language that the reader or listener can easily understand, navigate and use. • Always start by using plain language first, and then adjust your communication style to meet the individual’s needs. • Each individual processes information in a way unique to his or her skill set. It is important to recognize that even though an individual might talk fast, have an incredible vocabulary, and seem as though they are processing information quickly, they may still struggle when receiving information. • Simplify: • Use shorter sentences. • Reduce unnecessary information. • Rather than providing lengthy instructions, provide a point form list of how to complete a task. • Be Direct: • Say what you want rather than what you don’t want. • Use the person’s name to direct their attention to you. • Be clear and make sure that the information you are providing is organized. If you are talking about the steps required to complete a task, list them in the order they should be done. • Using phrases that an individual is familiar with can help them remember how to complete tasks. It is even more useful when as many people as possible use the same phrases and words such as “clean up, tidy up, pick your stuff up.” • Become a language detective. Find out what words are being used at home and then encourage teachers and supervisors to use the same words when referring to the same things. • Share information about plain language with parents and other professionals. • Use plain language to explain legal and medical information. • Ask what word the the individual prefers to use, or what he or she used in the past (jacket vs. coat, sneaker vs. shoe, cash register vs. till, etc.).
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SENSORY PARK Be sure to remember that play can also have a purpose. Learning about each child’s individual sensitivities can help to develop support and personal program plans. • It is important to recognize what a child enjoys and what they shy away from. For example, if a child has no interest in playing on the swings and prefers to climb through small spaces, you may be able to see a pattern of sensory control. The child may feel safer and more comfortable in an environment that is more rooted and closed in, which could be key to understanding how best to put the child down to bed or help to calm them down when they are upset. • Try looking around in your community to see what types of activities are available for children and youth with disabilities. • If a child prefers a small closed in space to play, try setting up a little tent in the play room or living room. • If a child loves the swings, they may love other movements that have rhythm or repetitive motions. Try a rocking chair or nursing chair. • If a child enjoys the sound options on the playground, cater to that strength and play music whenever possible, ensuring that control to turn the volume up or down is not taken away from the child. • If a child is easily visually distracted by games, movement, shine and puzzles, explore these strengths. They may be artistic, mechanically inclined, or great at “find it” puzzle books.
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SENSORY SOOTHING It is typical, starting at a very young age, for children to start expressing what they prefer in foods, dress, music, etc. One very important factor to consider is why these likes and dislikes form; could they be mimicking a parent or sibling? Or maybe they are displaying how they interpret things through their senses. Every person utilizes their senses in the quest to find favourite foods, most comfortable blanket and perfect volume level. A great majority of children living with FASD tend to find they have oversensitivity and/or undersensitivity to things like textures, tastes, sights, sounds, smells, movements and even their sense of where they are in the world. How and where to use sensory soothing techniques: • At bedtime, use something warm, soft, smooth or scented. • At dinner time, place a heated blanket over the chair, make sure the child is balanced with both feet touching the ground or ensure that foods are all the same temperature so that the child’s senses have less work to do. • In the car, use a seat cover made of soft flannel or use sunshades to soothe tired eyes. • When sleeping, play soft music or use floor nightlights rather than on a table top. • At work, school or home, cut tags out of clothing, choose fabrics that are soft or wash uniforms and clothes in unscented detergent. What might you already have in your home that can work for this? • A hot water bottle • A heated blanket (substitute with blanket fresh out of the dryer) • Warm bath • Fan (quiet buzzing sound) • Sleeping music (waves, wind, etc.) • Flannel sheets • Weighted blanket, vest or jacket • Body pillow (used as bed bumpers to create a tighter space) • Bed tents (purchased or made to create a tent-like feel of a child bed) • Plates with food separators • Sunglasses
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HANGING CHAIR An individual living with FASD may be a sensory seeker, meaning they are looking for sensations. A hanging chair can create a sensory soothing atmosphere. Some alternative options that create a similar sensation include swing sets, hammocks, rocking chairs, exercise balls and more. • By providing a chair that hugs the individual and provides a sense of floating in the air or swinging side to side, you can create a sensory soothing sensation • This chair can be used to calm a child, encourage quiet play and to relax the body. • Hanging chairs can be used inside the house if properly attached to a stud or ceiling beam. Outside, the chair can hang off a tree or a play set meant for swings. • Don’t forget to pair this tool with something the child finds soothing, like a hand held game, music or book. • If an individual hesitates to try the chair, do not push the subject. Leave the chair up to see if he or she explores it on his or her own. • A hanging chair is not just for children. Older kids and adults may like a comfortable place to chat on the phone, play on the computer, watch TV and hang out on their own. • Swings designed for sensory processing will have added benefits, so never turn one down if available. The hanging chair is a less expensive way to enjoy some of the sensory swing benefits.
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BEDTIME Sleep issues can be a problem for any person. Individuals with FASD can experience problems not only falling asleep but staying asleep. In some cases, the problem is caused by a lack of melatonin, a chemical in the brain that helps a person fall and stay asleep. • Always consult a doctor before introducing a sleep aid, even if it is all natural. • Some of the most effective strategies for bedtime involve things like weighted blankets, covered beds, and nylon cylinders that an individual can slip into. • A sleeping bag, tightly tucked sheets or blankets help to keep the individual wrapped up tight. • Heavy blankets, make the individual feel more weighted and secure. • Background noise. • Scented candles. • Teaching a child to sleep when it is absolutely quiet is unrealistic for them later in life. Maintain the normal house sounds during bedtime. In fact, you can increase the presence of household sounds by bringing a fan into the room or turning music on very low. • An occupational therapist may be helpful if you need to seek a professional opinion. • Keep night lights down low to keep sensory stimulation at a minimum. • Try to give a child who has trouble sleeping their own room. If not possible, put up a sheet or a screen around the bed to reduce sights and sounds.
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VISUAL & AUDITORY TIMERS In the case of proper time management, it is important to understand that a child, youth or adult living with a cognitive disability may not understand or feel time pass the same way peers might. By using a timer, children are able to see in a tangible sense how much time has gone and how much is left. Timers have many different purposes in many different settings. Timers can be used in the home to help a child, youth, or adult manage the time they spend on the computer. • Be flexible with how the individual chooses to use personal time. The lesson is time management, not proper use of time. • When thinking about time management, remember transitioning can be one of the most common triggers for children living with a cognitive disability. Imagine if our traffic lights had no yellow, only green and red. We would have no warning about when to stop. • Timers allow for several warnings, especially for younger children who still have no concept of time. Coloured timers can be used to visually indicate when time is running out. • A timer that clicks, hums and beeps may also be beneficial. • It is most important that children, youth and especially adults feel they have some control over how much time they have and how they are going to manage it. Whenever possible, the individuals should plan their own time and set their own timers. • Try allowing a teen to use a cell phone with a timer. Use the timer as a tool to get home on time. Ask the youth to set the timer for 11:00 p.m., when the timer goes off the youth is reminded to go to the bus stop and catch the bus so that he or she can be home for midnight. Other options for timers • The timer on the stove or microwave • An inexpensive egg timer • A playlist of the same five or 10 songs • Children’s television programming often has cues to when a show is starting and when a show is coming close to the end • A stop watch • Hang the clock off a white board and write in each day’s important times • Wristwatch
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WEATHER INDICATOR Knowing how to dress for the weather is a skill we usually acquire through lessons from our parent(s) and our senses. Lessons from a parent(s) can be difficult to remember and senses can sometimes be unreliable for children and youth living with FASD. To accommodate these problems, try creating a weather indicator. At its most basic function, the weather indicator provides the individual with a guide of what to wear. • In the family home, a thermometer can be used outside the window and a large thermometer with clothing examples can be provided on the wall. Each day the individual can see the temperature and what to wear. • As a client gets older, the weather indicator can be smaller and can be used in conjunction with the weather displayed on the TV or internet. Some cell phones provide weather updates throughout the day. • If you wish to customize the weather indicator, take pictures of the individual’s clothes (or better yet, the individual in their clothes). Don’t forget to teach layering, because over-dressing can be as dangerous as under-dressing to an individual who cannot rely on their senses to tell when they are too cold or too hot. • Simple thermometers can be found at dollar stores and hardware stores and are usually inexpensive. • This tool can be used at school for understanding seasons and temperature. • If an individual seems bored by the simplicity of the weather indicator, turn it into a game: provide Velcro backings and have the individual choose the right clothes for each temperature. • Instead of buying a weather indicator “thermometer” make one at home out of cardboard and red paper. • Put labels on the front of drawers for hot weather and cold weather. • Keep clothes for the appropriate season in the closet so they are all viewable at a glance. Keep out-of-season clothing away so it can not become a source of confusion. • Use the weather indicator for all children in the home. The sooner they understand the right clothes to wear, the sooner they can dress themselves. • Make sure the weather indicator is fun instead of a chore, otherwise it might not be a tool they will use.
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TACTILE LIFE SKILLS By incorporating options that also teach life skills into regular play time, the child will be able to develop some of the fine motor skills required to enjoy and prepare for life experiences typical for his or her age group.
• Provide toys that help a child experience and develop these fine motor skills early in life. Less frustration will occur when these fine motor skills begin to look like a chore. • Starting early can increase a child’s self-esteem and willingness to explore different options. If the task has been considered a toy or game for several years, it can help with potential feelings of isolation when they are unable to complete a task their peers have already mastered. • Once a child seems fluent in the practice, don’t put the toy away. Allow the child to become bored of the toy and then put it into storage. Keep the toy and pull it out as a reminder for the brain and muscle memory when they seem to be falling behind. • Make these toys at home on a budget. Glue a baby shoe down, use some old Velcro, and maybe cut the zipper out of an old pair of pants. • Toy swap with other parents. This is a really cheap way of sharing with your community and also getting toys for free! • Don’t let your child become too frustrated with the toy. Otherwise they will ignore it, or even worse, destroy it. • These toys can be found at a variety of educational supply stores.
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FASD NETWORK OF SASKATCHEWAN 510 Cynthia St Saskatoon, SK 1-866-673-3276 www.saskfasdnetwork.ca
