 We're very fortunate this evening to have a speaker, Tracy Mastrangelo. She's the program coordinator for wellness, resiliency, and partnerships, and she is going to be running our workshop this evening. Before I pass the mic over to her, I just wanted to acknowledge that I am moderating tonight from Treaty 6 territory, the traditional meeting grounds, gathering place, and traveling route to the Cree, Sotel, Blackfoot, Métis, Denay, and Dakota Sioux. We acknowledge all the many First Nations, Métis, and Inuit, whose footsteps have marked these lines for centuries. And without further ado, I will introduce and hand the mic over to Tracy. Welcome, Tracy. Thank you, Celeste, and hello, everyone. It's nice to be able to join you this evening. I'm really looking forward to it, and I love that we have a nice-sized group because I think that that will provide some opportunity for us to have some really rich conversation. So without further ado, I'm going to jump right into it, and we'll start with a bit of an agenda. We have an overview of how I hope to take the evening through. I'm very comfortable with questions throughout. So if something comes up and you've got a question, please don't hesitate to either turn on your talk button and ask me, or even if you're more comfortable putting in chat, you're welcome to do that as well. So through the evening tonight, what we're going to start with is a quick introduction. I'll tell you a little bit about me and why I choose to speak about FASD tonight. We'll talk about FASD in Alberta. I'm going to give you a quick picture about what that actually looks like in Alberta and why it's important for us in Alberta schools. And then we're going to have a bit of a conversation around a shared understanding of what actually is FASD because I think that we talk to lots of acronyms, especially in the education world. And so we'll have a little conversation about what that actually looks like, what our diagnosis process looks like, and what that might look like in the classroom. And then from there, we'll actually talk to more about supporting student success and maybe have a bit of a conversation around what we are currently doing in some schools in Alberta. And it might be a good opportunity for those of you that are connected with school councils to be able to think about whether or not these kinds of supports are put in place in the schools that you're working with. And we'll briefly discuss the promising practices and some of the research that is guiding our work and what we're doing to move forward with the idea of FASD. So this is always kind of interesting to do a webinar where we can't see each other. So I've included a small picture of myself so you can picture the voice that is going along and is going to walk you through the evening. I'm looking forward to the evening. I'm a provincial coordinator for the Provincial Program Wellness Resiliency and Partnership, which is WRAP. And we specifically work with students with FASD in junior and senior high schools throughout the province. So I'm really, again, looking forward to working with each of you tonight. And welcome. Welcome to our webinar. So when we're talking about FASD, which is Beetle Alcohol Spectrum Disorder, it's become really relevant to us in our country since the 70s is when FASD started to be diagnosed throughout Canada. And so initially, we were diagnosing in Northern Canada. And in the last 10 years, we've seen a lot more communication and conversations around FASD. And what we know about FASD in our communities is that these are really the kids who are amongst the most vulnerable of the most vulnerable. So when we're looking at pyramids of support and we're looking at the targeted group that we're supporting with FASD students, we're really looking at that tip of the iceberg, the very top most complex students. We'll talk tonight about why they're the most complex. But really what we see, especially in junior and senior high schools, is that these are the students who are often really disengaged in school if they are attending. It's probably sporadic often. And they're making definitely difficult choices and often poor choices. They succumb to social pressure very easily. And they're probably not the kids involved in a lot of positive community-based activities. What we do know is that they can actually, people with an FASD and especially students with an FASD, although they have difficulty maintaining healthy relationships, are the students that also would most best benefit from healthy relationships with adults. So what is FASD? So FASD stands for Fetal Alcohol Spectrum Disorder. FASD happens only through alcohol exposure in utero. And so what that means is that a mother has to consume alcohol during her pregnancy in order for a child to be born with FASD. Now, one of the myths that's been out there that has come up on multiple occasions and at multiple times is that children can have FASD if a dad consumed alcohol and if the sperm was affected by alcohol. And what we know from research is that that's not actually true. It definitely can affect sperm and it might make it so that we're not getting the very best sperm when the sperm and eggs meet. However, it doesn't actually affect the development of the fetus throughout pregnancy. So the only way that we get FASD is through alcohol exposure in utero. This picture on the bottom of the slide is, I have to preface it first by saying it's not technical, it's not a technical picture, but the idea of it really is to just tell us and to bring our exposure to the idea that alcohol, we have FASD anywhere in the world where we have women who are able to get pregnant and we have alcohol. And so the purpose of the picture on this slide is really to just show us that not specifically what we're drinking in each country, although that's the way it kind of ends up looking in this slide, but rather just to show us and bring our attention to the fact that there's actually alcohol consumption in all parts of the world. So even in some of our eastern countries that we wouldn't connect to alcohol consumption, we still actually see really high rates of alcohol consumption. So as I said in the early 70s is when we started diagnosing FASD in Canada. And Canada therefore has become a real leader in diagnosing, in assessing, in supporting and preventing now FASD and is seen as a leader across the world. And so all other countries are always looking to Canada to kind of see what's the newest research and what's happening out there. I think the other important piece to talk about is that very few countries in our world, other than Canada and our neighbors to the South United States and now New Zealand, very few other countries actually do diagnose FASD. And so it becomes a bit of a worldwide problem, but Canada definitely is a leader in understanding FASD. So that's why it's important and why we're talking about it. Right here in Alberta, we know that about $927.5 million per year is spent on supporting people with FASD, which is a really astronomical number. So what's happened in Alberta is that the ministries of our government about 10 years ago got together and decided let's address FASD in our province. Janet, did you have a question? I see your microphone popping on and off. Okay, we're going to keep on keeping on. And if you've got something, feel free to put your hand up. It dings for me on this end and I'll know to pause. So in Alberta, the ministries across the province decided to address FASD, because what we know of this population is that these were the people who, people with an FASD, were the same individuals who were using multiple services. They were our highest frequent, our frequent flyers in many services. So whether it was education and they're getting supports and services in our, in the education world, or unfortunately high representation in justice and in our jail systems, as well as our courts, our children's services systems and our healthcare systems. And so what the idea was was to pull together and work together collaboratively across ministries to address FASD in the province in a collaborative way. We created a 10-year strategic plan. So we're just, 2018 will be our 10th year of the strategic plan. And the really the idea has been to work together collaboratively, both in communities and in government to address FASD. And from these quick statistics that I've put up on this slide, we can see why we might want to do that. So what we know, and Alberta's statistics are not that different than anywhere else in the world, it just happens that we've actually collected this kind of data in Alberta where other areas in the world have not. But what we know is that 50% of all Alberta pregnancies are unplanned. And we'll talk about the significance of that being unplanned as well as kind of when we find out we're pregnant as women and the impact that that has. 9% of Alberta women have reported drinking during their last pregnancy. And often what we're finding is that women are not learning that they're pregnant until they're about two months pregnant or eight weeks. And may have been consuming alcohol in that time frame. 41% of women in high income groups report drinking in the last pregnancy, which is a really interesting statistic when you consider that often what we have considered FASD to be unfortunately is a First Nation problem. And we associate it to particular cultures. The reality is that we do have statistically higher numbers of First Nation children diagnosed with FASD. But we also suspect that that's not because we have more First Nation women consuming alcohol during pregnancy. And actually the data and statistics would tell us here with 41% that that might not necessarily be true. But we do see higher numbers of children with First Nation families overrepresented in the child welfare system. And so that's where those kinds of data that kind of data comes from. Our most recent numbers which unfortunately are a couple of years old now was that we have 46,000 Albertans diagnosed with FASD. Diagnosed numbers statistically are 1 in 100. So it actually becomes the most common developmental disability worldwide. Other developmental disabilities that we might think are more common, things like Down syndrome for example, Down syndrome has a rate of 1 in 1,000. So we have much higher rates of FASD worldwide than we have of more commonly or considered common developmental disabilities like Down syndrome. So let's talk quickly about FASD diagnosis and how that actually happens. FASD diagnosis would follow the Canadian Diagnostic Guidelines. So the Canadian Diagnostic Guidelines, the most recent version of that came out about a year ago actually in 2016. It was about this time last year. And it was a document that was worked on quite rigorously by a number of doctors and leading professionals in the field. And so what it actually does then is it gives a larger guideline for multidisciplinary teams to determine how would one actually go about diagnosing a child or an adult because adults can be diagnosed as well. How would one go about diagnosing a child or an adult with FASD? And so one of the things that our guidelines tells us is that it needs to be diagnosed from a multidisciplinary team. And so what that means is that we have a number of professionals that work very closely together. They each do their own individual assessments. And then from there, they work together and meet together to determine whether or not the individual that they are working with actually is suffering from an FASD. So on our multidisciplinary teams, we have pediatrician or in an adult clinic, we would have a GP that is specialized in FASD. We have a psychologist, a speech and language pathologist, an occupational therapist, and a social worker. And so each of those individuals does their own assessments and definitely a pediatrician or the general practitioner doctor is looking for some medical kinds of connections. The psychologist is looking for brain impairments and speech and language pathologists, occupational therapists are looking for what would actually equal to brain impairments as well but in their chosen field. And then the social worker works together with the individual and the family to obtain prenatal alcohol exposure or conformation of prenatal alcohol exposure. So when we're diagnosing FASD, we actually diagnose with three considerations in mind. So in order to get an FASD diagnosis, we're looking for, go ahead, Janet. You've got a question? I'm just going to wait a moment while Janet is typing. While we're waiting, Tracy, I'm just asking, are all of these funded by your organization or do they come in as a multiple member of your multidisciplinary team voluntarily or how does that work? Wonderful question. Thank you for that. So a multidisciplinary team for FASD diagnosis are all paid. And so one of the initiatives that's happened through the cross ministry committees and through the government's initiative to address FASD in the 10-year strategic plan is fetal alcohol service networks. And so I believe right now we have 12 fetal alcohol service networks, and they're split up throughout the province. And those FASD networks each receive funding to fund multidisciplinary diagnostic teams. So in Edmonton, for example, that happens out of the Glen Rose Hospital. So it's actually a team that's within the Glen Rose Hospital. And then in a number of jurisdictions kind of from Red Deering North, there is a mobile diagnostic team. And so each FASD network is working together with that mobile team. And so the mobile team generally is the pediatrician and the psychologist, and then each FASD network is finding local speech and language pathologist and occupational therapists and social workers. Yes, it's all funded through cross ministry committee and through the FASD networks and the diagnostic clinics. Oh, that's wonderful. Thank you so much, Tracy. I appreciate it. And I think Janet has finished taking our question. Yes. Janet's question is, is exposure to drugs also included in the diagnosis? No, it's not, Janet. And the reason being is that alcohol as are many drugs including prescription medications are considered what we call teratogenics. And so what that means is that those substances can cross the barrier, the placenta barrier from mom into baby. What we actually know from research is that of all of the teratogens out there, so alcohol, cocaine, heroin, methamphetamines, any of those, as well as prescription medications, alcohol is by far the most damaging teratogen that we have. And so it's a little bit, it becomes a little bit of a mixed messaging because as a community, as a society, we are very accepting of alcohol. And I'm not saying that any of the drug exposures could not also cause brain impairment. Absolutely. And we believe that there's been some recent research around things like methamphetamine being one of the closest to alcohol, but still alcohol by far is the worst teratogen. So that's a great question, Janet. Thanks for bringing that up. So when we're considering as a multidisciplinary team how to go about diagnosis, we're really looking at three things. And so one is actually getting that conformation of prenatal alcohol exposure. Without conformation of prenatal alcohol exposure, FASD diagnostic teams won't go forward with a diagnosis. So that becomes a very big piece. And where the social workers role becomes so essential and important to getting that diagnosis. The next piece that we're looking at is facial dysmorphology. And so facial dysmorphology just speaks to changes in the face that we actually can directly link to alcohol consumption. And there's actually been a direct, they've actually narrowed, researchers are incredible. And they've narrowed it down to specific days of alcohol consumption. And so if alcohol is consumed only on this particular day, then we will see facial features. And so what we refer to as facial features for FASD is a flat siltrum. And the siltrum is that bumpy part on your top lip between your nose and your top lip. And so facial dysmorphology of FASD, we would not have that bumpy. It would be less pronounced and a little bit smoother. The other piece is measurement between from the corner to corner of the eyeball. And so these are measurements that pediatricians or the GP would be doing. It's really actually very rare. As I said, it comes down to one particular day that mother consumes alcohol during her pregnancy. And so if alcohol is not consumed on that particular day, we won't actually have facial dysmorphology. The other consideration that has to be present is brain impairment or an FASD diagnosis. Prior to probably about 10 years ago, maybe a little more than that, definitely 15 years ago, we had two different diagnoses that were very common that we would hear a lot about. We had an FAS diagnosis, fetal alcohol syndrome, and we had an FAA, fetal alcohol effects. And so the difference between FAS and FAA is that FAS, in order to get a diagnosis of FAS, we had to have the facial dysmorphology. And we tended to believe then that because the facial dysmorphology was absent in an FAA diagnosis that it wasn't as bad. But we actually still had brain impairment and significant brain impairment. So when we're looking actually at brain impairment, we're looking at brain injury in three or more of these areas. And we're looking actually at significant brain injury in three or more of these areas. Now, where this becomes a little bit confusing is that anything, only one of these areas can actually be broken down into many different areas. So something like executive functions, for example, can be broken down into 12 different areas. Everything from time management to working memory is part of executive function. So we're looking at brain injury in three or more areas. Intelligence, which is IQ, is actually not a very good indicator for FASD because it's only one area where we could actually see impairment. Aspect regulation, which is the very last on the list, is our newest area of brain injury that's been included in our 2016 guidelines. What aspect regulation is, is it's actually speaking to depressive disorders or anxiety mood disorders. And what we are learning, as we're just learning new stuff every day about FASD, is that 80% of youth with an FASD will also present with a mental health disorder, either a depressive disorder or an anxiety-related disorder. And so science is actually telling us that that might actually be hardwired into the brain and might be as a result to alcohol exposure in utero. And so now it's been included as one of the brain areas that is tested for in an FASD diagnosis. I'm going to just sit through that one. So I'm not a neuroscientist, but I think that it's really important for us to have a quick little conversation about the brain since we know that alcohol has so much impact on the brain on a developing child. So please bear with me as I butcher the brain and share this information with you. This particular slide is a cross-section of the brain. So if we were to cut the brain right down the middle of your face and open it up, this is what we would kind of see. That red cauliflower-looking piece is at the back of our head. And then that front part is kind of a wormy-looking part is kind of behind our forehead. So when we're talking about the brain, there's really three main parts to the brain. And again, as not a neuroscientist, I'm a social worker by trade, I'm going to just quickly tell you a little bit about my understanding of it. The first part to develop in the brain is the brain stem. And so that's that purply-looking piece at the bottom of the picture. And that goes all the way down and connects to your spinal cord. The brain stem has really the one main purpose. And that main purpose is survival of the individual. So personal survival. The brain stem controls everything from our heart rate to our body temperature to regulating things like our breathing, really basic, basic things that we don't think about are still imperative to our living. If we're not breathing, we're not living. So that's the most basic part. And it's actually the first part of the brain in utero to develop. And it starts out like a little tube. From there, the next part, it kind of grows up and grows out like a cauliflower. So the next part to develop is the limbic system. And that's that yellowy kind of part and there's a red part in there. The limbic system or another term that you can often hear is the midbrain. And so that would be the next piece in our development of our brain that developed in utero. That part of the brain, that main purpose is survival of our species. And so it controls things like emotions, fight or flight comes from that part of our brain. Those are kind of terms that we've heard about before. All of our emotional regulation, our attachment and our ability to feel love and all of those kinds of things comes from that part of our brain, as well as things like sex drive and the desire to want to have sex, which is what keeps our species alive and keeps our species going. It comes from that mid part of our brain. So the third and most complex part of our brain that developed is actually the neocortex or the cortical brain. I, because I'm not a scientist, I'll tell you that it's the thinking part of our brain. This is the most complex part of our brain. And it really is what separates us from lots of other species is that we have this part of our brain. This part of our brain really controls all of those executive functioning things. So like our working memory, things like math and logic cause and effect, really our understanding of how the world kind of works around us, all comes from that thinking part of our brain. So the way that those three kind of work together is that messages follow like the green highway there on the slide, follow up our brain stem, up into, I mean I've got a traffic cop in there now, but it's a hypothalamus is where that comes to. The hypothalamus's job is to determine, is this information that's important for us right now? Is this a threat to our survival? What are we seeing here? Where does this information happen, need to go? And then disperses the information to the part of the brain where it needs to be. We actually have over 100 billion cells that work together to actually grow and develop our brain. It's really quite magnificent and really quite interesting to think about how that all orchestrates beautifully and perfectly like clockwork in order for us to be born and having this conversation now today. What ends up happening is that as information comes up, if it's an information that's considered a threat, that traffic cop, so for example, if we see a bear, that traffic cop brings an alarm bell at the pituitary and releases cortisol and when cortisol is released in our brain, it actually allows us, makes it so that we can't actually access that top cortical thinking part of our brain and then we just react. We fight or fight kicks in. We either fight the bear or we run from the bear. So that's kind of the way messaging happens. What we know is that there are times in a child's life. We kind of talk about the formative years being from zero to six. And that's because those are the periods of time in a child's life when we're most likely, when it's most prime to make connections into that thinking part of our brain. And so we want to be able to make as many connections into all of the math part of the brain and the language part of the brain and the music part of the brain. It's why it's much easier to learn a second language as a child rather than as an adult. So I don't know if any of you have had the experience of trying to learn a second language as an adult, but it's a difficult experience if it's not a part of the brain that you've already accessed and made some connections amongst the cells in that part of the brain. So when we're talking about brain development in utero, I had mentioned before that we start kind of as a tube, which is our brainstem, and then it grows up and out like a cauliflower. That grow up and out like a cauliflower actually is two sets of cells in our brain. And so the first brain cells that we have are the glial cells. And the glial cells act as scaffolding, kind of like scaffolding. And so those glial cells build themselves up. I see your questions, Celeste, or your comments, and I'm going to come right back to it. Celeste says that explains why kids often pick up or learn languages so easily compared to adult. Yes, it absolutely does, Celeste. And what ends up happening is the more we make a connection or the more neural pathways is what they're called, that we make to a certain part of the brain, the stronger that pathway gets, and we're more likely to be able to use that pathway and we're more likely to use that pathway throughout life. So yeah, you're absolutely right. That's why it's easier. When the window of opportunity, there's not very many windows of opportunity that completely shut, so that's why we can still learn a language as an adult. It's just a lot harder. It's not prime time, so we've got to work a little harder. So when we're building the glial cells, that scaffolding builds itself up into the brain in order for our neurons, which are the next brain cells, they come up the scaffolding and go to the part of the brain where they need to be. So language neurons kind of are all housed together kind of at the top part of the brain there. Math neurons, for example, are up at the front in what's called our prefrontal cortex, which is kind of right behind our forehead. Right behind our forehead is where we store math. So those neurons will go to the area of the brain where they're meant to be. So there is math neurons that will go to the math part of the brain and language neurons that will go to the language part of the brain. So really quite a fascinating way to imagine here, if we can imagine how we've got traffic cops up there directing traffic and all kinds of incredible things. So let's look at what happens when we actually introduce alcohol in utero and what happens to the brain and this magical thing of orchestra of all of these cells going where they need to go when we introduce alcohol. So this picture here just is meant to show during the weeks of pregnancy if alcohol is consumed at any particular point in time what part of the embryo or fetus is most susceptible to being affected by that alcohol. So for example, in week five of a pregnancy we can see that the central nervous system which is our brain and our nervous system, our parasympathetic nervous system which allows us to deal with stress, our fight or flight kind of piece. That week five, that's definitely being affected. Red would tell us that it's actually more at danger of being affected. The heart is being affected at week five, the upper limbs are being affected, the eyes, the lower limbs and the ears. And so all of those, all of the cells that are being developed on an embryo in week five, all of those cells could be affected. Where this becomes important is because, I mean it's obviously important but what we're looking at also here is that our central nervous system which is brain development is actually developing from week two all the way through to the pregnancy. And so we definitely have times that are more susceptible for brain damage but it could be affecting an instance brain any time through pregnancy when mom consumes alcohol. Where this also becomes quite concerning is that those of us that are moms unless you have the experience of using in vitro to become pregnant, most of us don't actually have our pregnancy confirmed from a doctor until we're somewhere between four to eight weeks of being pregnant. And so that's where when we look at those earlier stats of the number of Alberta women that are saying that they consumed alcohol in their pregnancy that's where that comes into effect because I believe strongly that if mothers knew better they would do different. And so we just often don't know when we're pregnant but so much damage can happen. It's why also in a lot of the messaging like in these particular posters which you may see out and about they legally now have to be hung anywhere in Alberta where there is alcohol being sold. It's where these kind of posters become really important and the messaging of if you are pregnant or you think you could be pregnant or you're planning on getting pregnant, please don't consume alcohol. Okay, so let's look at what it actually means when we do consume alcohol to the developing brain. Okay, so I'm going to take us back a step here. When we talked about we have two sets of cells in the developing brain. We have the glial cells which are the scaffolding and then we have the neurons which are the worker cells. I told you I was going to butcher this brain stuff. I'm using all kinds of language that neurologists would never use. I'm sure of it. So if we consume alcohol when those first initial brain cells of the glial cells are developing and then that's kind of when the initial tube is developing and then it grows up and out like the cauliflower. So if we introduce alcohol when those glial cells or those scaffolding are being developed what essentially happens is that we change the scaffolding. So in some cases we might actually wipe out a whole piece of scaffolding. So now we don't have scaffolding for those worker cells, those neurons to be able to get up to the mass part of the brain where they need to be developing and they need to be going to do their job. And so the other thing that could happen is that we might actually just move a piece of the scaffolding. So it's still there. It's just we've kind of put it over two spots instead of where it's supposed to be. So it might still be there but it's not quite in the right spot. So that becomes a problem for the glial cells and for brain development and actually changes the basic foundation of our brain. The next piece that happens is our neurons or our worker cells come along. And if our neurons or worker cells are exposed to alcohol then there's two things that could happen in that case and in that scenario. Our neurons have two things. They come along with a job description and a map or it's 2017. Maybe they've got a GPS. When we expose those neurons to alcohol what happens is we either wipe out the map so they come along and they come up their glial cells but they don't know where they're supposed to go. So the mass cell, the mass neuron, ends up back here in the language area. We still have the mass neuron but if we're trying to access it and we're trying to find it later in life it might be kind of difficult because it's not up at the front with its mass buddies. So that's the first thing is that we can wipe out the map system or the GPS. The other piece that can happen is that we might not wipe out the map system we might just wipe out the job description. So that neuron or that worker cell might get to the area of the brain that they're supposed to be at and that they're intended to be at but once they get there they're not sure exactly what it is they're supposed to do. They're there with all their buddies but they don't know what their job is. So it becomes rather problematic when we're thinking about kids with an FASD who might struggle with being able to remember or retain information. It kind of looks like this. So if we imagine that our brains are like really complex filing systems where we've got a math file, a language file, maybe you've got a French file, a German file and an Italian file if you really have had a lot of exposure to language. All of those files in the average brain are very neatly organized in the part of the brain where they're meant to be and within those files all of the papers and information is neatly organized. With an FASD brain we still have all of the files. We just don't have the system. So they end up being in the brain. It just might be more difficult for us to find them. It's a bit problematic. Is that brain piece? Is that making sense okay to everybody? Just give me a thumbs up or maybe it's a thumbs down. Great. Thanks, Celeste. All right. So let's think about what does that actually mean for teachers? Because we have now a classroom of kids who might have the brain cells, might have the cells but they might not be in the same place, in the right place. So what we end up seeing in a classroom is teachers who today are working on these great math equations. What's 20 divided by 5? And we repeat it and repeat it and repeat it. Actually when we, essentially when we repeat it, what we're actually doing is connecting those neurons, those worker cells together so that a pathway is laid and we're able to access it later. So we can do that 20 divided by 5, 20 divided by 5, 20 divided by 5. Now we've got a great strong neuron today. Tomorrow little Johnny or little Sally comes into the class and the teacher says what's 20 divided by 5? What happened is that they have to dig through all of their files to be able to actually access and find where did I put that one? Where is that 20 divided by 5 that we worked on yesterday? For a teacher that becomes rather frustrating, I would imagine when we're in a class full of students and we need them to pick up this information so that we can move on to the next lesson and we can learn the next piece that we're meant to learn. One of the things that we know when we just go back to this brain really quickly is that the cells that have the farthest to travel are at the most risk to being damaged. And so those cells that are up here in that thinking part of our brain are likely the cells that are most complex but are most susceptible, are most damaged and most susceptible to being damaged. What that ends up meaning is that we actually have that limbic system or that midbrain being really well wired. That part of the brain of a child or an adult with FASD tends to be really well wired because it's not as far for those cells to have to travel and not as much risk for them to be exposed to alcohol because they just have a short way to travel. So what we end up seeing is we end up seeing kids and adults and people with FASD being hard wired to use that limbic system or that midbrain. So they tend to be more reactive. They tend to maybe even be more emotional. We would refer to them as going from zero to 60 really quickly. Really extreme emotions. So right now they're mad and in two minutes they're going to be happy again and then they're going to be sad. And they also end up having some inappropriate sexual behaviors because their sex drive, although it's wired in all of us, it's in the limbic system and so it's easily accessed for people with an FASD where they don't have that thinking part of the brain, that cause and effect part of the brain that tells them, okay, we have a sex drive but now is not the time or place. So we need that cortex and that's what we end up seeing with kids. So this is just another little look, a way of looking at FASD and what we actually see in our schools and in our communities. And when we look at it through a brain lens and we understand the cognitive part of our brain, it tends to make a little more sense to us why they might have disrupted school experiences, why they might have inappropriate sexual behaviors. We also, there's been some research that suggests that people, especially people that have been exposed to alcohol in utero are more susceptible to substance abuse problems. And so part of that's a bit of a double jeopardy thing where they are often in environments or come from environments where they might be already more easily influenced by alcohol or more willing to use and try alcohol or to use it as a coping mechanism. So they might come from environments that supports that or encourages that and then what ends up happening is that their brains are hardwired to be more susceptible to it. So we have higher addiction problems within this population as well. Lots of struggles with communication which we know come from specific parts of the brain. And then definitely problems with employment and living independently as we move on. So what are some things that we look at in supporting student success and in supporting success for people in our community? Deb Evanson and Jan Lutke have created what they call the eight magic keys for student success. And when I share this information with teachers, and this might be something that you want to have conversations with back in your school or in your communities about what are the interventions being used in your school to support success for students with FASD. These are interventions that specifically we know will work for kids with an FASD or students with an FASD, but we really know that they'll work for any student. So it's one of those pieces that could really be a targeted support for all students. We within the RAP project or the program that I coordinate have created a set of videos. And so this will be something that you would be able to take back and share with your school and share with your school council. It's on the RAP website which will be on the handout that you got, the last sheet. And these videos are intended to be really short. So they are all under three minutes. They're found on YouTube as well, I think. And they're just intended to be really short to kind of say, hey, let's think about how do we provide, why is it important to provide consistency or to be specific when it comes to working with a child or a student with FASD. So there's a quick tool that you might be able to use in your schools or in your community. The other piece, another piece that we've done, and this is directly out of relation to or out of connection to the 10-year strategic plan is we've created the Wellness Resiliency and Partnerships project. And so this is really looking at increasing success for students with FASD. Initially we were looking specifically at junior and senior high school students. And part of that is because we suspect that students with an FASD are very highly represented in the population of students that aren't completing high school. And so how can we actually support them to have success believing often that it's these kinds of disruptions that are getting in the way of them completing high school. So again, if you have a success coach or if you're working with a school, it might be an opportunity for you to go to your school and talk to them about whether or not there is a success coach. One of the really great things that we've been able to do with this particular success coach model, which is really a relationally based support in schools, is we've been able to build a shared understanding of FASD so that we can increase student success across the province. So again, it might be something, a conversation that you want to have with your school council or with your school admin team to find out if you do have a success coach in your school or particularly it might be, maybe not in your specific school, but maybe it connected to your school division. We've also been looking and working with some schools within the Edmonton region to expand the success coach model to being a relationally based support for vulnerable students. So recognizing that FASD is one within a population of vulnerable students. And so far we're seeing really great results with that as well. So RAP really has three main goals, academic success, student engagement and enhanced social, emotional and physical well-being, which is the same for our schools as well. However, typically our school's focus to social and emotional wellness is through academic success. So the same story if you can come to school, then you'll be successful in your classes and then you'll feel better about yourself and you'll make better friends. What the RAP program does and what our success coaches do is kind of flip this upside down and we approach academic success through the avenue of social and emotional well-being. So if we can address the social and emotional well-being of those students, then we can have them more engaged and want to come to school and through that we can actually build academic success. So it's the same sort of work, it's just a little bit of a flip. These are our guiding principles, which are really just the guiding principles of any RAP around support that we would see across the province because many of our schools and school divisions have that same piece. But again, this might be something, this particular slide might be something that you want to take back to your school or back to your school council if you do have success coaches and be having a conversation about are these principles, are we actually meeting these principles? One of the things that we've done in RAP is we've looked a lot at evidence-based principles and so we're looking at how do we implement research and current research into the work that we do. We talked a little bit about kind of what success coaches have done within the RAP project, really providing a mentor type position, although we do talk about mentoring as a formal mentor rather than a friend mentor or an informal mentor. So they're not volunteers, they are paid positions. And it really is looking at an interdisciplinary model in a school. So typically our success coaches come to us with a social work or child and youth care background and are a little more focused and connected to community and not strictly on the academic piece. As I said, evidence-based becomes an important piece. This is one piece of research that has been done, it's been done actually recently in the Edmonton area. And it's a promising practice and really great research that we've been able to use within RAP to increase the success for a lot of our students with FASD. So often because of the way that the brain develops, we see a lot of math struggles within the population of FASD. And this particular research, which is called the MILE program, which is Math Intervention Learning Experience, I believe, has just given us some different ways to support math in school. And we've seen incredible results when we've tested these really simple kind of ideas with students with an FASD or with a math problem. And so it might be things like just getting kids to use some rhymes or songs to try and memorize things. So it's giving them strategies to use their working memory. Another strategy that's been really, really kind of a simple one, but has been really a game changer for a lot of students with FASD is using a vertical number line instead of a horizontal number line. When we use a horizontal number line, we take it from being something that could be concrete into being rather abstract. But if it's horizontal, students are telling us, well, I don't know where to start on the line and I don't know if I'm going to left to right or right to left, whoever said that we're, you know, we're supposed to read from left to right. And so it doesn't quite make sense for kids with an FASD. When we take the number line and we actually make it vertical, we've actually seen huge improvements in the math abilities of kids with an FASD because it makes sense to them. It now becomes concrete that as you move up and you get higher, the number gets higher. So again, this might be something that as a school council, you want to have conversations around in your school. This is training that is being done through ERLC. I believe this spring that they are opening this training up to teachers and educational assistants to come and be trained in these strategies and in this particular program so that it can be implemented and spread across a number of schools rather than in just the particular schools that they are currently doing it in. There is some really great research for parents. And so again, again, for school councils, it might be another conversation to be able to bring back to your councils around what's the information and how are we sharing information for parents. And so the Tranco-Pendall-Sinol and Roddenberry just recently published an article. What they were looking at was students with an FASD that were experiencing behavior problems in school. The intervention that they used was to give parents of these particular students training in the neurocognition. So it was really the same sort of training that we had just gone through, the same brain understanding of FASD. And mindfulness for the parents. And so by just implementing those two interventions for parents, they actually seen these three researchers at drastic decline in the behaviors of the students in school. So it might be a good conversation as well to have in your school. Is this something that could be useful or this kind of research or this research supports that it is useful? Or is it something that students and parents in your community would benefit from? All of this kind of research is built on these two mindsets. So either a fixed mindset or a growth mindset. And so if we have a fixed mindset, we're really saying, I can't change anything. This is just the way it is. My kid is damaged. We're not going to make any changes. Or a growth mindset really saying, you know what? We can keep working hard and keep trying. New ways and different ways. And so there's really great research around mindset as well that if the adult working with the child has a fixed mindset, then likely we're not going to see growth and success in the child. If the adult on the reverse has a growth mindset regardless of what the child's mindset is, we actually will see improvements. And it comes down to also setting bars of expectation. This is a great sheet that I welcome you to share with your colleagues and your fellow parents and school councils. You can find this on professionalswithoutparachutes.com website under the resources tab. And so this really is speaking to mindset shift. The red blocks would indicate a fixed mindset. And the yellow is growth mindset. This was completed by some educators in a research project that we did with them. And this is specific to FASD. So it's a quick easy visual that can be shared in schools and in school councils to kind of shift our thinking and understanding and how do we approach FASD in our community. So this will be the online supports that you have. And so we do have a website for wrapschools.ca with lots of resources. And so it's something that also could be used or shared with your school councils and with parents. If parents are querying, my child might have an FASD or I think maybe my child has an FASD, but I don't know how to go through and get an assessment. We have a step-by-step printout actually on the WRAP website that you could share with them or even with teachers. If teachers are querying how to go through that process. We also have an app if you're on Apple phones, which if you go onto Apple phones and you search WRAP FASD, you'll be able to find that. Together with ERLC, we've created three videos about brain development and FASD in the brain. And so it's similar to what we've talked about tonight, but it might take you through a little bit more depth. The videos are quite short. I think the longest one is 14 minutes. And you're welcome to share those. Those are also found on the Professionals Without Parachutes website. So those are some great resources. You're welcome to share them. And if you're looking for more or haven't quite hit it for you, you are welcome to contact me. And I'd be happy to share more information with you. Oh, I'm just following the conversation here. Janet, you've used the Professionals Without Parachutes in the Brain Not Blame Sheet. Oh, good. Great. Great. I'm glad that you've used it. And it's been effective, Janet. I think that it's one of the documents that we were able to create in conjunction with some researchers from the University of Alberta. And it's one that we're really excited. We've shared it worldwide. And we have lots of copies of the Brain Not Blame across the world. So it's exciting. I'm glad that it is finding it effective as well. And thank you so much, Tracey. This has just been a fantastic webinar, the really valuable information. I think there's a lot of misconceptions and misunderstanding about there. Out there about FASD. And I know for me, you really clarified a lot and explained things in terms I would understand. So I really appreciate that. Great. Great. Thank you for the feedback, Celeste. Oh, you bet. No, this has been really, really helpful, really interesting. Great. Great. And I do encourage as well as you go away if you have questions that come up for you, or Janet, if you're back in your classroom and you're finding that you've got a student that you could use some information to shoot me an email and I'm happy to support and help out wherever I can. Well, maybe while Janet is typing back to you there, Tracey, I want to thank everyone so much, especially you for taking the time this evening to share this information with us. And thank you everyone for joining us this evening. If you do, again, have questions for Tracey, please make sure you're emailing her and she can be able to communicate with you that way. If you're looking to exit the room once you're done, you simply have to click on the X at the top right-hand corner of your screen. You'll get a pop-down window just asking you if you're sure you want to leave and that will take you out of the classroom. So thank you again, everyone, for joining us. This has been a wonderful evening. I appreciate everyone taking the time. And we'll see you, I'm sure, next week for our next webinar. Thank you so much, everyone. Thanks, Celeste. Thanks, everybody.