© FASCETS, Inc.

PPC TeleconferenceFebruary 24, 2015

Fetal Alcohol / neurobehavioral conditions: FA/NBTrying 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 logs1. One thing you’ve observed

2. One example of seeing things differently

4. Feelings

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Session 2

1. Feelings and emotions: They’re normal

2. Now what? Trying differently rather than harder

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EMOTIONS

Where do those strong feelings about behaviors come from?

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Values and values clashesPrimary characteristic

Values,

expectations

Interpretation /

Feelings

Intervention Secondary symptom

Accommodation: Build on strengths

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Values and values clashesPrimary characteristic

Values,

expectations

Interpretation /

Feelings

Intervention Secondary symptom

Accommodation: Build on strengths

Dysmaturity Act your age

Being a baby,

Lazy, not trying

Frustrated

Punish Anxiety, anger

Think younger Adjust expectations

Confabulation

Honesty

Lying, manipulative,

“At me”

Fear, angry sad

Punish, ground Anger, denial

Recognize brain dysfunction, alter communication

Memory problems

Remember

“Should” know!!

Angry frustrated Remove privileges

Anger, frustration

Accept need to reteach, based on learning strengths

Slow processing pace

Value speed – think fast

Not trying, withholding ,

on purpose

Angry, frustrated

Speed up, yell, embarrass

Shut down, fear, avoidance, withdrawal

SLOW DOWN!

Use fewer words

Difficulty generalizing, gets the piece, not the picture

Know and apply concepts in different settings

Breaking the rules,

Should understand concepts in all settings

Angry, frustrated

Consequence Confusion, anxiety, frustration

anger

Show rather than tell, reteach in different settings

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Poor fit

FA/NB Characteristic

Visual learner………........

Processes slower……….

Needs external support..

Difficulty organizing…….

Concrete…………….........

Strategy / expectation

Verbal instruction

Fast paced

Work independently

Organize, prioritize

Abstract

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Good fit: Accommodations

FA/NB Characteristic

Visual learner………........

Processes slower……….

Needs external support..

Difficulty organizing…….

Concrete…………….........

Strategy

Provide visual cues

Allow adequate time

Provide supports

Provide structure

Teach experientially, build on strengths

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Fit and behaviors

• Poor fit = challenging secondary behaviors

• Good fit = prevent or reduce challenging behaviors

• Build on strengths: Round peg, round hole

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Application: Functional Neurobehavioral Assessment

A systematic approach to developing person-specific accommodations in all

settings and managing the complexity of FA/NB

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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

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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

3

Primary symptoms FA/NB

4

Devel. Age

(estimate)

5

Secondary

behaviors

5

Strengths

6

Accommodations

Listen, learn Process fast

© 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 Process fast

Slow processing pace

© 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 Process fast

Slow processing pace

3

© 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 Process fast

Slow processing pace

3 Frustration

© 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 Process fast

Slow processing pace

3 Frustration Visual learner

© 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 Process fast

Slow processing pace

3 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

4

Devel. Age

(estimate)

5

Secondary

behaviors

5

Strengths

6

Accommodations

Listen, learn Process fast

Slow processing pace

3 Frustration Visual learner

Provide visual cues, use fewer words

Be age-appropriate

Develop “on time”

Dysmaturity 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

4

Devel. Age

(estimate)

5

Secondary

behaviors

5

Strengths

6

Accommodations

Listen, learn Process fast

Slow processing pace

3 Frustration Visual learner

Provide visual cues, use fewer words

Be age-appropriate

Develop “on time”

Dysmaturity 3 Isolation

Depression

Willing, relational

Adjust expectations,

“Stretch toddler”

Sit and learn, paper and pencil

Ability to abstract

Concrete, difficulty with abstraction

2 Anger, frustration,

avoidance

Learns by doing

Hands-on

Kinesthetic

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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

4

Devel. Age

(estimate)

5

Secondary

behaviors

5

Strengths

6

Accommodations

Cognitive behavioral techniques

Abstract, analyze

Concrete, literal

14 May not finish assignments

Artistic, experiential

Art, drama, music, relationship, role modeling

Communicate Process language

Slow processing pace

12 Anger, frustration

Determinedcreative

Art, drama, music, poetry

Apply new knowledge

Store, retrieve and generalize

Memory problems, difficulty generalizing

16 Defensive Relational Teach in different settings, use mentor

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Brain = behaviors

Brain changes = behavioral changes

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General starter strategies

Stop fighting

Ask: What if?

Think younger

Give time

Recognize strengths

Breathe

Be kind to yourself

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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

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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

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Diane V. Malbin, M.S.W.

FASCETS

PO Box 69242Portland, OR  97239

dmalbin@fascets.org

www.fascets.org