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Bradley hits the teen years
by: Muriel Van Loh

Alcohol abuses the unborn . . .
Parents force "underage” alcohol use; cause brain damage
Bradley hits the teen years

In Tragedy in Grade Four (see Journal articles) we met a boy we called Bradley, age 11.
This article continues the story of the school experience of Bradley .

Alcohol has made him what he is—a failure. He just can't ever be trusted to carry through on a project. He's not putting two and two together. He does what comes to mind or what someone suggests. He doesn't connect actions with consequences. It's no use talking to him. He can’t change. It's the alcohol.

But Bradley doesn’t drink.
His dad and his mom did that for him—or should we say "to him”?

In “Tragedy in Grade 4,” Bradley’s 4th grade teacher, the school psychologist and other staff were trying different techniques to help him. They were focused on psychological behavior modification. The tests they gave Bradley did not reveal his main problem—permanent neurological (not psychological) brain damage.         

Alcohol—the ultimate child abuse tool

Alcohol, reaching through his parents to him, from conception to birth—that’s what has happened to Bradley. Alcohol dissolved brain cells and alcohol twisted brain connections; it left him with no hope for a normal life. And the alcohol damage that has made his life so hard in his early years is growing more noticeable as he grows older. Bradley’s story continues now. Three years have passed and he is 14.

Suspended? Again?
A typical question from a desperate teacher

Teacher: I have a 14 year old student with FASD (Fetal Alcohol Spectrum Disorder)1 and Attention Deficit Disorder (ADD). Bradley has been suspended twice in the past 3 months for stealing from teachers. There seems to be a recent escalation in unacceptable behaviors.

Bradley is living with a cousin and her son.  The cousin tries but has an “in your face” demeanor that I’m pretty sure is not the way to deal with the recent problems.

I am this boy’s resource teacher. I have known him for 4 years. His cousin and I agree that he should not be in the regular classroom. School staff  DOES NOT GET IT!!  They don’t understand FASD.

Is there a procedure that works with these kids in these situations? I talk to him calmly and I have bribed him with pay-offs for good behavior. Recently I put a band-aid on his shoulder to remind him to think before acting. He is on medication for the ADD. 

What Teresa Kellerman, FAS researcher, says that fits Bradley's case:

This child is on track

Bradley is right on track—right where you would expect him to be at age 14 with FAS/FAE (Fetal Alcohol Syndrome/Fetal Alcohol Effects). “Some kids are into lifting cool things like cell phones and CD players or money from the teacher’s desk or from other students. Some are into inappropriate sexual behavior. Both are very common for this age and none are easy to deal with.” 

Suspension doesn’t work

Suspension is not a good way to deal with Bradley’s behavior nor will it help him. And a band-aid on the arm might work for a non-disabled student but is pretty useless for kids with FASD.

The challenge

You’ve got three challenges to face; the boy’s behavior, the home behavior and the school’s behavior. To change the boy’s behavior, the home and the school’s behavior has to change. He can’t change his permanent brain damage. His brain acts in inconsistent and unpredictable ways.  Some days he can do fine but other days he just blows it.

Bradley needs a small classroom and lots of supervision. Fetal alcohol kids almost always fail in a large classroom that is filled with sensory stimulation like bright bulletin boards and where there is not enough supervision to keep them out of trouble.

Try to understand the frustration of Bradley’s cousin  She will have better success if she is reasonable and calm.       

Kellerman: What to expect from children like Bradley

1.  Do not expect Bradley’s social abilities to improve with age

Teachers, professionals and family members will generally expect Bradley to act his age. He CAN’T.

The area of “Inter-personal Relationship Skills” is where FAS/E people are most impaired. Children with FAS appear to plateau in social abilities at about the 4 to 6 year old level.  Adolescents and adults stay at the level of a 6 year old and they do not improve with age.This is arrested social development, not simply delayed social development.3 Bradley is a 6 year old in a 14 year old’s body. He will always be a 6 year old, whatever his body’s age.

2. Expect Bradley to show inappropriate sexual behavior

Most FASD people show inappropriate sexual behavior. For many of them this means trouble with the law.

Bradley, like others damaged by alcohol, will have normal hormone surges (beginning well before puberty). His stunted social development means he reacts like a kindergartner. Since his frontal lobes are damaged, he lacks judgment and impulse control. He is vulnerable and naïve. He can easily be a victim, a perpetrator, or both.

Appropriate sexual behavior is not a matter of learning for Bradley. He can know what is right and wrong, understand consequences and what the law says about sexual assault. But he cannot control his impulses or connect consequences with his actions. He will make decisions that get him into trouble.

Whether the IQ is normal, or low as in Bradley’s case (68), children and adults with FASD have a history of the following sexual behaviors—starting with the most prevalent:

  1. sexual advances
  2. sexual touching
  3. promiscuity
  4. exposure
  5. compulsions
  6. voyeurism (peeping tom)
  7. masturbation in public
  8. incest
  9. obscene phone calls4

Those with an IQ under 70 tend to get into trouble for inappropriate sexual touching and for masturbating in public. They touch or rub themselves through their clothes without thinking, even though told not to.

3. Do not expect Bradley’s brain to process normally what he hears, what his senses try to tell him, or anything he has to remember. His brain does not transfer (carryover) information from one situation to another. Input and output do not equate. He is not non-compliant . . . He is non-competent.

FASD adolescents are often very verbal and give the appearance of being much more functional than they are. We judge people on just exactly this—language use. Bradley will have the appearance of capability without actual ability.

4. Expect problems with perseverative behavior such as drumming fingers, knocking, pacing or rocking. FASD people are unable to “let go”.

5. Don’t expect Bradley to understand time.

Even though he can tell you the time, Bradley does not know what time is or how it works. How can 60 minutes be one hour if 30 days is one month? 30 is smaller than 60 but a month is longer than a day . . .

FASD people do not keep appointments, follow through on instructions, show up for work on time, come back from lunch on time. They have no sense of time passing.

6. Don’t expect to hear truth from Bradley

Bradley has “flow-through memory”. Information may be learned, stored and retained for a while, disappear without warning and reappear just as suddenly, hours, days or weeks later.

The FASD person is not a liar; he can’t recall or make sense of past events in the logical, rational, sequential order we call truth. If others accuse or blame him, he defends himself—telling his story.

What to expect from children like Bradley

1. Start a “Communication Book” that school staff and Bradley’s cousin write in every day—put in one thing positive and share issues each needs to know about.

Since Bradley’s level for responsibility is that of a kindergartner, he does not have the ability to be responsible for notebooks, backpacks, homework, etc. His having what he needs when he needs it should be the responsibility of teachers and parents. We can praise him when he remembers, but we can’t expect him to remember.

Praise for his successes should be written in the book and read to him each day to encourage him. Heaven knows he makes enough mistakes that he is reminded of constantly.

2. This boy needs close supervision AT ALL TIMES, including on the bus, on school grounds, in the cafeteria, before, during and after classes. Someone responsible, not another student, needs to monitor him. He has mental disabilities that prevent him from controlling his behavior and his impulses. This is a statement of fact. He’s riding downhill on a bike with no brakes. He can’t STOP on his own. He needs 24/7 like a boy with MS needs a wheelchair.

3. The staff who work with children like Bradley need training in an FAS workshop.

4. FAS/E children need to be evaluated with the right tools. The best IQ test for FASD is Woodcock-Johnson. The other test, a MUST for FASD kids, is the Vineland Adaptive Behavior Scales.

5. About medications. He has a chemical imbalance in his brain that is permanent. He needs his Adderall like a child with diabetes needs insulin. If a child has classic ADHD, after a few years he may be able to cope without meds. If ADHD is from alcohol the child may need meds the rest of his life. Adderall dosage may increase as the child’s body grows. Most teens do well on Adderall and a medication like Paxil, Zoloft or Prozac—not for depression but to help with emotional outbursts and some with impulse control.

For everyone concerned about the Bradleys around us . . .www.comeover.to/FAS/

Bradley is fortunate to have a teacher who even asks about FASD. His alcohol damaged body will always malfunction in the same old ways. He may eventually be diagnosed with brain damage and get social service help but he will never be able to live independently. His best hope is getting into a facility run by Christians who honor God, know about FASD, and who will love him.

Unless he is cared for, he will be homeless and in trouble with the law. Most likely he will be drinking. He may have children of his own.

God has the final word
The Bible warns us that “Wine is a mocker.” Alcohol has played a large part in destroying civilizations. It has not lost any of its ability.

Endnotes

1 The term FASD Fetal Alcohol Spectrum Disorder was chosen to cover the whole range of alcohol damage a child may suffer before birth.

The term Fetal Alcohol Syndrome includes the word Syndrome, a medical term. Children diagnosed with Fetal Alcohol Syndrome come under the American Disabilities Act. Officially FAS children have to display certain facial characteristics as part of the diagnosis. These facial abnormalities come if the mother drinks between the 19th and 21st day of pregnancy. Most children who display the same brain damage as FAS chlildren do not have the face. Therefore their handicap goes undiagnosed and they are often blamed for what they cannot help.

Governments like the term FASD—if all alcohol damage were diagnosed and received disability compensation, they would be bankrupt.

2 Teresa Kellerman has given SDWCTU permission to use her writing and expertise on FAS. www.come-over.to

3 Dr. Edward Riley, San Diego & Dr. Ann Streissguth, U of WA , & Steinhausen et al, studies on FAS arrested social development

4 Streissguth, U of WA

 

   
 
Copyright 2005
Woman's Christian Temperance Union
of South Dakota