Identifying and treating social communication deficits in school-age children with Fetal Alcohol Spectrum Disorders

Abstract

Children with fetal alcohol spectrum disorders (FASD) have functional deficits that compromise their ability to use language in socially appropriate ways. An interpretive framework conceptualizing social communicative competence is presented. The framework provides experienced clinicians and educators with new ways of thinking about and treating the social communication problems of school-age children with FASD. Fetal Alcohol Syndrome (FAS) is a birth defect characterized by growth deficiency, a cluster of minor facial anomalies and central nervous system damage in the presence of confirmed prenatal alcohol exposure (Astley and Clarren, 2000; Jones, Smith, Ulleland and Streissguth, 1970). A large body of descriptive and experimental research underscores the broad range of harmful effects teratogenic alcohol exposure exerts on growth and development (Astley and Clarren, 2000; Mattson and Riley, 1998; Thomas, Kelly, Mattson, and Riley, 1998). The term fetal alcohol spectrum disorders (FASD) describes the range of effects that can occur in an individual whose mother drank alcohol during pregnancy (O'Malley and Hagerman, 1998). Much of the clinical research over the last decade for children with FASD has focused on refining identification criteria (Astley, 2004; Astley and Clarren, 1996; Clarren, Carmichael Olson, Clarren and Astley, 2000) and/or increasing access to related services (Streissguth, 1997). Children with FASD present complex clinical profiles. They often show problems learning from experience, following directions and understanding logical consequences (Carmichael Olson, Morse and Huffine, 1998). They are frequently unfocused and impulsive, have recurring difficulties adapting to routine school activities, and interacting with peers (Coles, Platzman, Raskind-Hood, Brown, Falek and Smith, 1997; Kleinfeld, and Wescott, 1993; Mattson and Riley, 1998 Streissguth, 1997). The social and behavioral problems often associated with FASD become more pronounced during the school years and coincide with problems in adaptive behavior and secondary disabilities (Streissguth, 1977). It is, therefore, not particularly surprising to find that many school-age children with histories of significant prenatal alcohol exposure have also been diagnosed as having a learning disability and/or an attention deficit hyperactivity disorder (Oesterheld and O'Malley, 1999). Of particular interest for speech-language pathologists is the impressive number of alcohol-exposed youngsters who exhibit social problems, as revealed during verbal interactions with peers (Coggins, Olswang, Carmichael Olson and Timler, 2003; Spohr, and Steinhausen, 1993; Olswang, Coggins and Timler, 2001; Thomas, Kelly, Mattson, and Riley, 1998; Timler, Olswang and Coggins, 2005). Interestingly, the majority of these youngsters do not typically have debilitating conduct disorders of serious social-emotional problems if they experience supportive environments and appropriate expectations. Moreover, even though they exhibit processing limitations and learning difficulties, their intellectual abilities are often found to be broadly within the normal range (Kerns, Don, Mateer and Streissguth, 1997). What sets these children apart from their school-age peers is their difficulty using language in more sophisticated social contexts. They lack the pivotal communicative abilities to enter peer groups, resolve conflicts, negotiate compromises, and maintain friendships. While interdisciplinary assessment teams are becoming increasingly effective in diagnosing the spectrum of disabilities associated with FASD (Clarren, Carmichael Olson, Clarren and Astley, 2000), few professionals have the necessary information for treating children with social communication problems The purpose of this paper is to present an interpretive framework for understanding communicative deficits in school-age children with FASD. To this end, we build an argument that the complex array of deficits in this clinical population creates special problems in social aspects of language use. Based on this argument, we present a model for conceptualizing social communication competence. We believe this framework offers practitioners a rational basis for selecting functional objectives and designing effective interventions for children who have do not use language to communicate appropriately. © 2007 by Nova Science Publishers, Inc. All rights reserved.

Original languageEnglish
Title of host publicationADHD and Fetal Alcohol Spectrum Disorders (FASD)
PublisherNova Science Publishers, Inc.
Pages179-196
Number of pages18
ISBN (Print)9781594545733
StatePublished - 2011
Externally publishedYes

Fingerprint

Fetal Alcohol Spectrum Disorders
Communication
Social Problems
Alcohols
Learning
Social Skills
Peer Group
Conduct Disorder
Learning Disorders
Psychological Adaptation
Attention Deficit Disorder with Hyperactivity
Biomedical Research
Central Nervous System
Pregnancy
Thinking
Conflict (Psychology)

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Coggins, T. E., Timler, G. R., & Olswang, L. B. (2011). Identifying and treating social communication deficits in school-age children with Fetal Alcohol Spectrum Disorders. In ADHD and Fetal Alcohol Spectrum Disorders (FASD). (pp. 179-196). Nova Science Publishers, Inc..

Identifying and treating social communication deficits in school-age children with Fetal Alcohol Spectrum Disorders. / Coggins, Truman E.; Timler, Geralyn R.; Olswang, Lesley B.

ADHD and Fetal Alcohol Spectrum Disorders (FASD). Nova Science Publishers, Inc., 2011. p. 179-196.

Research output: Chapter in Book/Report/Conference proceedingChapter

Coggins, TE, Timler, GR & Olswang, LB 2011, Identifying and treating social communication deficits in school-age children with Fetal Alcohol Spectrum Disorders. in ADHD and Fetal Alcohol Spectrum Disorders (FASD). Nova Science Publishers, Inc., pp. 179-196.
Coggins TE, Timler GR, Olswang LB. Identifying and treating social communication deficits in school-age children with Fetal Alcohol Spectrum Disorders. In ADHD and Fetal Alcohol Spectrum Disorders (FASD). Nova Science Publishers, Inc.2011. p. 179-196.

Coggins, Truman E.; Timler, Geralyn R.; Olswang, Lesley B. / Identifying and treating social communication deficits in school-age children with Fetal Alcohol Spectrum Disorders.

ADHD and Fetal Alcohol Spectrum Disorders (FASD). Nova Science Publishers, Inc., 2011. p. 179-196.

Research output: Chapter in Book/Report/Conference proceedingChapter

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N2 - Children with fetal alcohol spectrum disorders (FASD) have functional deficits that compromise their ability to use language in socially appropriate ways. An interpretive framework conceptualizing social communicative competence is presented. The framework provides experienced clinicians and educators with new ways of thinking about and treating the social communication problems of school-age children with FASD. Fetal Alcohol Syndrome (FAS) is a birth defect characterized by growth deficiency, a cluster of minor facial anomalies and central nervous system damage in the presence of confirmed prenatal alcohol exposure (Astley and Clarren, 2000; Jones, Smith, Ulleland and Streissguth, 1970). A large body of descriptive and experimental research underscores the broad range of harmful effects teratogenic alcohol exposure exerts on growth and development (Astley and Clarren, 2000; Mattson and Riley, 1998; Thomas, Kelly, Mattson, and Riley, 1998). The term fetal alcohol spectrum disorders (FASD) describes the range of effects that can occur in an individual whose mother drank alcohol during pregnancy (O'Malley and Hagerman, 1998). Much of the clinical research over the last decade for children with FASD has focused on refining identification criteria (Astley, 2004; Astley and Clarren, 1996; Clarren, Carmichael Olson, Clarren and Astley, 2000) and/or increasing access to related services (Streissguth, 1997). Children with FASD present complex clinical profiles. They often show problems learning from experience, following directions and understanding logical consequences (Carmichael Olson, Morse and Huffine, 1998). They are frequently unfocused and impulsive, have recurring difficulties adapting to routine school activities, and interacting with peers (Coles, Platzman, Raskind-Hood, Brown, Falek and Smith, 1997; Kleinfeld, and Wescott, 1993; Mattson and Riley, 1998 Streissguth, 1997). The social and behavioral problems often associated with FASD become more pronounced during the school years and coincide with problems in adaptive behavior and secondary disabilities (Streissguth, 1977). It is, therefore, not particularly surprising to find that many school-age children with histories of significant prenatal alcohol exposure have also been diagnosed as having a learning disability and/or an attention deficit hyperactivity disorder (Oesterheld and O'Malley, 1999). Of particular interest for speech-language pathologists is the impressive number of alcohol-exposed youngsters who exhibit social problems, as revealed during verbal interactions with peers (Coggins, Olswang, Carmichael Olson and Timler, 2003; Spohr, and Steinhausen, 1993; Olswang, Coggins and Timler, 2001; Thomas, Kelly, Mattson, and Riley, 1998; Timler, Olswang and Coggins, 2005). Interestingly, the majority of these youngsters do not typically have debilitating conduct disorders of serious social-emotional problems if they experience supportive environments and appropriate expectations. Moreover, even though they exhibit processing limitations and learning difficulties, their intellectual abilities are often found to be broadly within the normal range (Kerns, Don, Mateer and Streissguth, 1997). What sets these children apart from their school-age peers is their difficulty using language in more sophisticated social contexts. They lack the pivotal communicative abilities to enter peer groups, resolve conflicts, negotiate compromises, and maintain friendships. While interdisciplinary assessment teams are becoming increasingly effective in diagnosing the spectrum of disabilities associated with FASD (Clarren, Carmichael Olson, Clarren and Astley, 2000), few professionals have the necessary information for treating children with social communication problems The purpose of this paper is to present an interpretive framework for understanding communicative deficits in school-age children with FASD. To this end, we build an argument that the complex array of deficits in this clinical population creates special problems in social aspects of language use. Based on this argument, we present a model for conceptualizing social communication competence. We believe this framework offers practitioners a rational basis for selecting functional objectives and designing effective interventions for children who have do not use language to communicate appropriately. © 2007 by Nova Science Publishers, Inc. All rights reserved.

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