Children with fetal alcohol spectrum disorders (FASDs) resulting from prenatal alcohol exposure often have behavior problems. Their teachers and caregivers report that they have frequent “melt downs” when faced with frustration and are impulsive and thoughtless when presented with problems to solve. These problems are common in children who have not developed self-regulation abilities and can make it difficult to master the skills needed for everyday coping, academics and interacting with other children.
At the Center for Maternal Substance Abuse and Child Development (MSACD), we recently completed a clinical trial on the effectiveness of a treatment program designed to improve self-regulation in alcohol-affected children from 4 to 10 years old. The program, called GoFAR, has three parts. First, we use a computer game to teach children how to use the FAR technique to improve self-control and problem solving. FAR is named for three elements:
- F (Focus and Plan)
- A (Act)
- R (Reflect)
Children are easily engaged by computer games and may have less resistance to learning in this environment. By teaching young children to use these elements when they go about their daily activities, it is possible to reduce impulsive and thoughtless behavior as well as frustration. The second part of the program involved teaching parents how to use FAR at home when they were working with their children. The third and last part is practical application of the FAR techniques with real-life problems. The whole program took 10 weeks with families working with us for an hour each week and then doing “homework” outside the clinic.
To see if the program was effective, parents filled out our “Disruptive Behavior Record Form” that measures the number of Melt Downs each day as well as rates the child for “Displays low Frustration Tolerance”, “Acts Aggressively”, “Responds Impulsively”, “Destructive Behavior” and “Sustained Attention”. The form was completed before the GoFAR program began, after 5 sessions and at the end of the 10 sessions.
Parents reported that children who learned this method were less likely to show disruptive behaviors. The results of this study suggested that teaching children with FASD the FAR technique and having them apply it, either in the computer game or in the therapeutic situation led to significant improvement in behavior.
For further information regarding this article please contact Dr. Claire D. Coles at the Center for Maternal Substance Abuse and Child Development, Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, 12 Executive Park Drive NE, Atlanta, Georgia, 30329. You can also phone us at 404-712-9814 or visit our website at Center for Maternal Substance Abuse and Child Development
The Center for Maternal Substance Abuse and Child Development is funded by the Georgia Department of Behavioral Health and Developmental Disabilities
Reference
Coles, CD, Kable, JA, Taddeo, E, & Strickland, DC (2015, in review) GoFAR: A Metacognitive Strategy for Reducing Disruptive Behavior in Children with Fetal Alcohol Spectrum Disorders, Submitted to: Alcoholism: Clinical and Experimental Research.