The UK has one of the highest Foetal Alcohol Syndrome birth rates in the world, writes Margaret Mulholland, yet it is still difficult to detect before school age. But this doesn’t mean that there is nothing teachers can do to help.

Must try harder. Doesn’t follow directions. Loses interest. Needs constant support.

According to parents, these phrases are common feedback to learners with Foetal Alcohol Syndrome (FAS).
A recent report in The Lancet stresses that that these gaps are not set in stone, and it says that there is growing evidence about what can help – early intervention.

It’s a tough one to write about. We have a Hogarthian image bias to thinking this only affects children from extreme circumstances, a world of drug addiction and poverty. Such stigma is perhaps why FAS is more commonly acknowledged with young people who are adopted. But this is not always the case.

Adoption UK claims Britain has the “unenviable record of having one of the highest FAS birth rates in the world”. FAS can be difficult to detect and is often not identified until things start to go wrong at school.

When a disability isn’t visible, it’s easy to ignore, and can lead to the pupil being blamed for the neurological challenges they face. As one pupil put it “If I was blind, you wouldn’t write that I should ‘try harder’ to see.”

Each child presents a unique learning profile causing parents to describe the brains of these young people as being ‘wired differently’.

Barry Carpenter, of Oxford Brookes University and Carolyn Blackburn, of Birmingham City University, argue the prevalence of FAS and its concurrent challenges requires teachers to develop a new pedagogy that recognises this neurodiversity and complexity.

So what can we do as teachers?

Once we know the diagnosis, look further into the child’s actual learning profile. There’s increased evidence that children with FAS can be taught the skills they lack naturally (Riley et al 2003; Kingdon et al 2016). Joanna Grace, who specialises in supporting young people with profound and complex disabilities, identified in her excellent blog that we need to “teach overtly the social awareness, where the brain does not have the ability to acquire these skills’.

Research by Malbin suggests building on positive personality traits; sensitivity, loyalty, humour, curiosity, all of which, if celebrated and linked to learning, can support access to the curriculum.

Teachers can make such a difference to learners with neurological difficulties, diagnosed or not.

Margaret Mulholland is director of development and research at Swiss Cottage School in Camden, London

* Popova, S, Lange S, Probst, C, Gmel, G, Rehm, J: “Estimation of national, regional, and global prevalence of alcohol use during pregnancy and foetal alcohol syndrome; a systematic review and meta analysis”, The Lancet, Volume 5, issue 3, PE290-E299, 1 March 2017,
* Walker, M, Al-Sahab, B, Islam, F, Tamim, H: “The epidemiology of alcohol utilization during pregnancy: an analysis of the Canadian Maternity Experiences Survey (MES)”, BMC Pregnancy and Childbirth, 2011, Volume 11, Number 1, Page 1,
* Blackburn,C: Educating Children and Young People with Fetal Alcohol Spectrum Disorders: constructing personalised pathways to learning, Routledge 2012
* FAS Handbook, University of South Dakota Council on Developmental Disabilities:
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