A study, which was the first to examine a range of cognitive factors and social behavior in children with FASD and ADHD, found that those with FASD have significantly weaker social cognition and facial emotion-processing abilities.
According to a story published on the Science Daily website:
Behaviorally, FASD and ADHD can look quite similar, particularly with respect to problems with very limited attention, physical restlessness, and extreme impulsivity,” explained Rachel Greenbaum, a clinical psychologist with the Children’s Mental Health Team at Surrey Place Centre in Toronto, who conducted the study as part of her doctoral dissertation.
“However, social deficits in children with neurodevelopmental disorders may have different underlying mechanisms,” noted Piyadasa W. Kodituwakku, associate professor of pediatrics and neurosciences at the University of New Mexico School of Medicine.
For example, children with ADHD experience social problems because of poor self-regulation rather than deficient knowledge of appropriate social behavior. In other words, a child with ADHD may accurately recite social rules, but fail to apply them.
In contrast, social difficulties in a child with autism (note: although autism is used here, the study was FASD, so this would be similar I suspect) may result from a fundamental deficit in social sense, referred to as mind-blindness.
This study looked specifically at social-cognition and emotion-processing abilities, said Joanne Rovet, a professor at the University of Toronto and senior scientist in neurosciences and mental health at the Hospital for Sick Children, and supervisor of the fetal alcohol research program.
“Social cognition refers to the ability to consider and differentiate between the beliefs, thoughts, feelings, and intentions of oneself and others,” said Rovet, who is also the study’s corresponding author. This involves understanding the meaning of social information and knowing how to interact appropriately. These abilities are important for communicating and relating successfully with others.
Emotion processing refers to understanding and processing information related to feelings. This includes the ability to recognize and differentiate between varied emotions in others and in oneself. These skills are also important for relating and communicating socially with other people.
In terms of social cognition and emotional processing, the core deficit in FASD appears to be in understanding and interpreting another’s mental states and emotions.
For example, a child with ADHD may be able to predict how another child would feel in a certain situation, but he or she may do something to hurt that child’s feelings despite this ability. On the other hand, a child with FASD may do something to hurt someone else’s feelings because of an inability to appreciate that person’s reactions.
This difference has implications for the development of social-skills training programs. That is, a training program designed for a child with ADHD may include procedures targeting how to translate what the child already knows into actions, while a program designed for a child with FASD may address both building specific cognitive skills and practicing appropriate actions.
One finding with potential for immediate action was that children with FASD have difficulty interpreting social information, including emotions in faces, said Rovet. “These difficulties predict their behavior problems and are linked to their social development,” she emphasized. “It is imperative that these children receive assistance in social and emotional processing domains, specifically targeting interventions to deal with their unique deficits.”
Alcoholism: Clinical & Experimental Research. “Children With Fetal Alcohol Spectrum Disorders (FASD) Have More Severe Behavioral Problems Than Children With Attention Deficit Hyperactivity Disorder (ADHD), Study Finds.” ScienceDaily. (July 31, 2017).
So how do we help someone who has difficulties with social awareness, complex expression of feelings, understanding directions, social cues and fast-paced conversations?
FASD Waterloo Region suggests:
- Role-play: Role-playing and role-modeling are effective techniques to help your child understand how to act in social situations.
- Help your child learn to recognize body language and social expressions: Look at pictures of people in books and magazines and teach what the people might be thinking or feeling.
- Involve your child in group activities: Sports teams, clubs, and groups are a good way to expose your child to organized social settings, build social skills, and meet children with common interests.
- Develop a support network: Join (or form) a support group for families with children affected by FASD. Encourage the friendships your child makes at these meetings.
The FASD Toolkit has samples of social stories:
Social Stories were originally develop by Carol Gray to help provide children with Autism an easy way understood correct social responses to situations and develop the individual’s social skills. However, research suggests that children with FASD exhibit similar difficulties to children with ASD in regards to executive function, perception of social cues, reading of body language, impulsivity and likelihood to exercise poor judgement when interacting socially (Bishop, Gahagan & Lord, 2007).
Therefore, Social Stories would likely work for children with FASD as well to help them navigate the social climate.
Social Stories are an individualized short stories that are used to model an appropriate social interaction, behavior or skill by describing a relevant social context to the one the child is struggling with.
The story breaks down the challenging social situation by providing the student with other people’s perspectives and an appropriate response to the situation. The goal of the story is to improve the child’s understanding of the social situation which may lead to a change in behavior and decision making in future events similar to the story.
Social skills training groups are another way to help. If there are not any FASD specific social skills training courses in your area, check out an e-learning video training series on-line at FASD Outreach.
FASD Outreach has produced modules highlighting a framework for working with learners with FASD (in elementary and secondary school) to help them acquire the social skills needed to live and succeed in their day-to-day school life.
Come back tomorrow for Day 61 of our journey!