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Most standard parenting or clinical techniques are based on standard learning theories which do not make allowances for brain dysfunction. Two of the prominent learning theories are behaviourism and cognition.
With behaviourist “stimulus-response” learning theory, learning is conditioned by what occurs after the behaviour. Rewards for good behaviour encourage more good behaviour. This approach assumes the individual can learn rules, understand underlying principles, remember concepts and be able to generalize to other situations or behaviours. However, many individuals with FASD have difficulty with both memory and generalizing from one situation to another.
Cognitive learning theory relies on the person’s internal mental processes. New information enters a sensory register where it is transferred to short-term memory if it is deemed important or interesting. New information is compared to existing cognitive structures that can be combined or altered to accommodate the new information. Useful information is then transferred to long-term memory and storage for use. Insight, information processing, short- and long-term memory and perception are required for cognitive learning practices. These areas are often compromised when a person has FASD.
Common symptoms of FASD include a slow processing rate, difficulty making links or forming associations, difficulty storing and retrieving information, associated difficulty generalizing, and difficulty with abstraction and prediction.
In order for a person to change their behaviours, the brain must process language quickly, form associations, store and retrieve information, generalize and predict. For many people with FASD this will be an impossible task.
Such standard teaching techniques as lecturing, time out, star charts, or consequences are all based on various learning theories that do not fit with FASD. The application of these types of learning theories contributes to a general impression that “nothing works”. The real problem is that these learning tools all require the same cognitive abilities that are often not available to those with FASD and are variations of the same theme.
Many widely used treatment programs also use a cognitive-behavioural approach and similarly will not be appropriate without significant adaptations.
Effective techniques emerge from understanding the neurobehavioural characteristics of each person. If the person learns visually, use visual techniques and build on strengths. If the person learns visually and hands-on, use these techniques in working with the person. Teaching methods that show a skill in a step-by-step process and allow for practice – one step at a time – until confidence is gained in the entire process is appropriate. Remembering that practice and many repetitions of any new learning will be necessary.
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