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PPC Teleconference February 24, 2015 Fetal Alcohol / neurobehavioral conditions: FA/NB Trying Differently Rather than Harder Understanding and application of a brain-based approach Diane V. Malbin, MSW © FASCETS, Inc. Session 1: Thoughts, observations? 1. One important or new point? 2. One thing you learned about your child? 3. Observation logs 1. One thing you’ve observed 2. One example of seeing things differently 4. Feelings © FASCETS, Inc. Session 2 1. Feelings and emotions: They’re normal 2. Now what? Trying differently rather than harder © FASCETS, Inc. EMOTIONS Where do those strong feelings about behaviors come from? © FASCETS, Inc. Values and values clashes Primary characteristic Values, expectations Interpretation / Feelings Intervention Secondary symptom Accommodation: Build on strengths © FASCETS, Inc. Values and values clashes Primary characteristic Dysmaturity Values, expectations Interpretation / Feelings Act your age Being a baby, Lazy, not trying Frustrated Honesty Confabulation Memory problems Slow processing pace Difficulty generalizing, gets the piece, not the picture Remember Lying, manipulative, “At me” Fear, angry sad “Should” know!! Angry frustrated Value speed – think fast Not trying, withholding , on purpose Angry, frustrated Know and apply concepts in different settings Breaking the rules, Should understand concepts in all settings Angry, frustrated Intervention Punish Punish, ground Remove privileges Speed up, yell, embarrass Consequence Secondary symptom Anxiety, anger Accommodation: Build on strengths Think younger Adjust expectations Anger, denial Recognize brain dysfunction, alter communication Anger, frustration Accept need to reteach, based on learning strengths Shut down, fear, avoidance, withdrawal SLOW DOWN! Use fewer words Confusion, anxiety, frustration anger Show rather than tell, reteach in different settings © FASCETS, Inc. Poor fit FA/NB Characteristic Strategy / expectation Visual learner………........ Processes slower………. Needs external support.. Difficulty organizing……. Concrete……………......... Verbal instruction Fast paced Work independently Organize, prioritize Abstract © FASCETS, Inc. Good fit: Accommodations FA/NB Characteristic Strategy Visual learner………........ Processes slower………. Needs external support.. Difficulty organizing……. Concrete……………......... Provide visual cues Allow adequate time Provide supports Provide structure Teach experientially, build on strengths © FASCETS, Inc. Fit and behaviors • Poor fit = challenging secondary behaviors • Good fit = prevent or reduce challenging behaviors • Build on strengths: Round peg, round hole © FASCETS, Inc. Application: Functional Neurobehavioral Assessment A systematic approach to developing person-specific accommodations in all settings and managing the complexity of FA/NB © FASCETS, Inc. Application: Functional Neurobehavioral Assessment Setting:____________________ Age: ___ Developmental age: ___ 1 Task or Expectation 2 Brain has to 3 Primary symptoms FA/NB 4 Devel. Age (estimate) 5 Secondary behaviors 5 Strengths 6 Accommodations © FASCETS, Inc. Application: Functional Neurobehavioral Assessment Setting: ___School___________ Age: _6_ Developmental age: _3_ 1 Task or Expectation 2 Brain has to 3 Primary symptoms FA/NB 4 Devel. Age (estimate) 5 Secondary behaviors 5 Strengths 6 Accommodations Listen, learn © FASCETS, Inc. Application: Functional Neurobehavioral Assessment Setting: ___School___________ Age: _6_ Developmental age: _3_ 1 Task or Expectation 2 Brain has to Listen, learn Process fast 3 Primary symptoms FA/NB 4 Devel. Age (estimate) 5 Secondary behaviors 5 Strengths 6 Accommodations © FASCETS, Inc. Application: Functional Neurobehavioral Assessment Setting: ___School___________ Age: _6_ Developmental age: _3_ 1 Task or Expectation 2 Brain has to 3 Primary symptoms FA/NB Listen, learn Process fast Slow processing pace 4 Devel. Age (estimate) 5 Secondary behaviors 5 Strengths 6 Accommodations © FASCETS, Inc. Application: Functional Neurobehavioral Assessment Setting: ___School___________ Age: _6_ Developmental age: _3_ 1 Task or Expectation 2 Brain has to 3 Primary symptoms FA/NB 4 Devel. Age (estimate) Listen, learn Process fast Slow processing pace 3 5 Secondary behaviors 5 Strengths 6 Accommodations © FASCETS, Inc. Application: Functional Neurobehavioral Assessment Setting: ___School___________ Age: _6_ Developmental age: _3_ 1 Task or Expectation 2 Brain has to 3 Primary symptoms FA/NB 4 Devel. Age (estimate) 5 Secondary behaviors Listen, learn Process fast Slow processing pace 3 Frustration 5 Strengths 6 Accommodations © FASCETS, Inc. Application: Functional Neurobehavioral Assessment Setting: ___School___________ Age: _6_ Developmental age: _3_ 1 Task or Expectation 2 Brain has to 3 Primary symptoms FA/NB 4 Devel. Age (estimate) 5 Secondary behaviors 5 Strengths Listen, learn Process fast Slow processing pace 3 Frustration Visual learner 6 Accommodations © FASCETS, Inc. Application: Functional Neurobehavioral Assessment Setting: ___School___________ Age: _6_ Developmental age: _3_ 1 Task or Expectation 2 Brain has to 3 Primary symptoms FA/NB Listen, learn Process fast Slow processing pace 4 Devel. Age (estimate) 3 5 Secondary behaviors 5 Strengths 6 Accommodations Frustration Visual learner Provide visual cues, use fewer words © FASCETS, Inc. Application: Functional Neurobehavioral Assessment Setting: ___School___________ Age: _6_ Developmental age: _3_ 1 Task or Expectation 2 Brain has to 3 Primary symptoms FA/NB Listen, learn Process fast Slow processing pace Be ageappropriate Develop “on time” Dysmaturity 4 Devel. Age (estimate) 5 Secondary behaviors 5 Strengths 6 Accommodations 3 Frustration Visual learner Provide visual cues, use fewer words 3 Isolation depression Willing, relational Adjust expectations: “stretch toddler” © FASCETS, Inc. Application: Functional Neurobehavioral Assessment Setting: ___School___________ Age: _6_ Developmental age: _3_ 1 Task or Expectation 2 Brain has to 3 Primary symptoms FA/NB Listen, learn Process fast Slow processing pace Be ageappropriate Develop “on time” Sit and learn, paper and pencil Ability to abstract 4 Devel. Age (estimate) 5 Secondary behaviors 5 Strengths 6 Accommodations 3 Frustration Visual learner Provide visual cues, use fewer words Dysmaturity 3 Isolation Depression Willing, relational Adjust expectations, “Stretch toddler” Concrete, difficulty with abstraction 2 Anger, frustration, avoidance Learns by doing Hands-on Kinesthetic © FASCETS, Inc. Application: Functional Neurobehavioral Assessment Setting: __Mental Health__ Age: _32_ Developmental age: _15_ 1 Task or Expectation 2 Brain has to 3 Primary symptoms FA/NB Cognitive behavioral techniques Abstract, analyze Concrete, literal Communicate Process language Apply new knowledge Store, retrieve and generalize 4 Devel. Age (estimate) 5 Secondary behaviors 5 Strengths 6 Accommodations 14 May not finish assignments Artistic, experiential Art, drama, music, relationship, role modeling Slow processing pace 12 Anger, frustration Determined creative Art, drama, music, poetry Memory problems, difficulty generalizing 16 Defensive Relational Teach in different settings, use mentor © FASCETS, Inc. Brain = behaviors Brain changes = behavioral changes © FASCETS, Inc. General starter strategies Stop fighting Ask: What if? Think younger Give time Recognize strengths Breathe Be kind to yourself © FASCETS, Inc. Advocacy: Success 1. Trust yourself 2. Accept that you have to teach others 3. Don’t settle for “good enough.” Is it? 4. Never, never, never, never give up Churchill © FASCETS, Inc. Review 1. FA/NB is a brain-based physical disability 2. Reframe behaviors: Neurobehavioral Screen -- primary, secondary and tertiary symptoms 3. Application: Observation. Fit and accommodations Functional neurobehavioral assessment © FASCETS, Inc. Diane V. Malbin, M.S.W. FASCETS PO Box 69242 Portland, OR 97239 [email protected] www.fascets.org © FASCETS, Inc.
