PDF Summary:Trying Differently Rather Than Harder, by Diane Malbin

In Trying Differently Rather Than Harder, Diane Malbin examines the neurological basis of Fetal Alcohol Spectrum Disorders (FASD). She explains how prenatal alcohol exposure affects brain development, leading to challenges with memory, processing speed, abstract thinking, and emotional maturity.

Rather than attempting to modify behaviors perceived as "willful," Malbin advocates for creating supportive environments tailored to FASD-related neurodevelopmental needs. She provides practical accommodations—such as adapting sensory input, utilizing strengths and interests, and providing step-by-step guidance—to help individuals with FASD reach their full potential.

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Focusing on Altering Actions Instead of Addressing Neurological Causes

Malbin criticizes the traditional focus on modifying behaviors without addressing the root cause: the underlying brain-based issues. She argues that attempting to modify behaviors without acknowledging and accommodating for the brain-based variations is like "treating the symptom, not the disease." This approach, according to Malbin, typically leads to a frustrating cycle of punishment and reward that fails to address the individual's true needs and potentially exacerbates challenging behaviors. By solely focusing on modifying outward behavior, valuable opportunities for genuine understanding and supportive actions are overlooked.

Context

• A more effective approach involves a holistic understanding of the individual, considering emotional, social, and environmental factors alongside neurological ones. This can lead to more personalized and effective support strategies.
• Failing to address the root causes of behavior can negatively impact an individual's self-esteem, as they may feel misunderstood or incapable of meeting expectations despite their efforts.
• Traditional behavioral modification often relies on systems of rewards and punishments to encourage desired behaviors. This method assumes that behaviors are choices rather than symptoms of underlying neurological differences.
• Gaining a deeper understanding of the individual's experiences and challenges can foster empathy, leading to more compassionate and effective support.

Recognizing Physical Impairments From FASD Shifts Focus From Behaviors to Supportive Environments

Malbin strongly advocates for recognizing FASD as a physical disability, emphasizing that brain-based differences should be treated with the same understanding and accommodations as any other physical disability. This shift in perspective requires a departure from viewing challenging behaviors as deliberate or intentional choices and instead understanding them as the result of a neurological disorder.

Symptoms or Coping, Not Willful Actions

Malbin urges a reframing of behaviors in individuals with FASD, shifting from interpreting them as deliberate actions to recognizing them as:

• Symptoms: Just as limping is a sign of a sprained ankle, challenging behaviors in individuals with FASD can be viewed as manifestations of their brain-based disability. These actions are often not intentional but rather a direct result of their difficulty processing information, regulating emotions, or understanding social cues.

• Coping Mechanisms: Without appropriate support and understanding, individuals with FASD may develop maladaptive behaviors to cope with overwhelming sensory input, navigate a world that feels confusing and unpredictable, or mask their difficulties. These behaviors, while challenging, are often attempts to manage their surroundings and communicate their needs in the best way they know how.

Context

• Early identification and intervention can help tailor support strategies to the individual's needs, potentially reducing the development of secondary issues such as mental health problems or trouble with the law.
• The brain regions affected by FASD can include those involved in controlling emotions. This can result in heightened emotional responses or difficulty managing stress and frustration.
• Creating environments that accommodate sensory and cognitive needs can help reduce the reliance on maladaptive coping mechanisms. This includes structured routines, clear communication, and sensory-friendly spaces.
• People with FASD may struggle with interpreting social cues and understanding social norms, which can result in misunderstandings and social isolation. Coping behaviors might include mimicking others or avoiding social interactions altogether.

Supporting Neurological Differences Prevents Behavioral Issues

Malbin emphasizes that proactive environmental adaptations, tailored to the specific needs of individuals who have FASD, can prevent or significantly reduce challenging behaviors. By providing a supportive and understanding environment, we create conditions where those with FASD can thrive. Instead of investing time and energy in reacting to and imposing consequences for difficult behaviors, Malbin encourages a proactive approach focused on anticipating and accommodating for difficulties, leveraging strengths, and fostering a sense of competence and belonging. This approach shifts the dynamic from a reactive cycle of being frustrated to a proactive cycle of support and growth.

Context

• Anticipating potential challenges and preparing strategies in advance can help mitigate issues before they arise, reducing stress for both the individual and those around them.
• Effective environmental adaptations often require collaboration among educators, healthcare providers, and caregivers to ensure comprehensive support tailored to the individual’s needs.
• Focusing on strengths involves identifying and nurturing the unique abilities and interests of individuals with FASD, which can enhance self-esteem and motivation.
• In educational settings, leveraging strengths might involve adapting teaching methods to suit visual or hands-on learners. In the workplace, it could mean assigning tasks that align with an individual's unique skills, such as creativity or problem-solving.
• Proactive strategies not only address immediate behavioral issues but also contribute to long-term development by building skills and resilience, reducing the likelihood of future challenges.

FASD-Related Developmental Differences, Not Chronological Age, Should Guide Expectations and Interventions

This subsection highlights the importance of understanding and accommodating for the developmental discrepancies often seen in those with FASD. Malbin stresses that chronological age should not be the sole factor in determining expectations and interventions but rather that the developmental stage, particularly in the realms of social and emotional maturity, should play a central role.

FASD Individuals Display Younger Developmental Behaviors Requiring Adaptations

Malbin explains that individuals with FASD typically exhibit social and emotional maturity significantly below their chronological age. They may engage in behaviors, have interests, and struggle with concepts typical of children significantly below their age. This disparity between their physical appearance and their developmental capabilities can lead to significant misunderstandings and misinterpretations of their actions. It is essential to remember that judging an individual with FASD solely on how old they are can lead to unrealistic expectations and create a significant mismatch between their capabilities and the demands placed upon them.

Practical Tips

• Create a journal to track and reflect on your own childhood interests and struggles. Write down memories of the games you played, the challenges you faced, and how you felt about different concepts when you were younger. This personal reflection can help you empathize with children who may be experiencing similar things and provide a basis for connecting with them on their level.
• Develop empathy by engaging in role-playing exercises where you and a friend act out scenarios that highlight the disparity between appearance and ability. Take turns playing the roles of individuals who are often misjudged, such as a physically small person in a physically demanding job. After each role-play, discuss the feelings and challenges associated with the misjudgments. This can help you better understand and relate to the experiences of others.

Focusing on Developmentally Appropriate Behaviors Lessens Frustration and Fosters Growth

Malbin advocates for a shift in perspective from focusing on "age-appropriate" behaviors to expectations and interventions that align with an individual's development. She emphasizes that recognizing and accommodating for developmental differences is essential for:

• Reducing Frustration: When expectations align with an individual's stage of development, it significantly reduces the likelihood of frustration and meltdowns. By meeting the individual where they are in their development, we create an environment conducive to learning and growth, rather than one fraught with constant struggles and corrections.

• Fostering Growth: Supporting people with FASD at their developmental level fosters a sense of competence and encourages them to progress at their own pace. By providing a safe and understanding environment, we empower those with FASD to develop skills and strategies that enable them to navigate their world more effectively.

Context

• Aligning expectations with developmental abilities can improve self-esteem by allowing individuals to experience success and mastery, rather than constant failure when held to inappropriate standards.
• These are techniques or tools that help individuals manage their daily activities more effectively. Recognizing developmental differences allows for the creation of adaptive strategies that are specifically suited to an individual's needs.
• When expectations are based solely on chronological age rather than developmental ability, individuals may experience undue stress and pressure, leading to frustration and emotional outbursts.
• Emphasizing developmental levels aligns with the principles of neurodiversity, which advocate for recognizing and respecting neurological differences. This perspective promotes inclusion and acceptance in educational and social settings.
• Empowerment comes from providing opportunities for success, celebrating small achievements, and encouraging self-advocacy, which can build confidence and independence.

Practical Strategies to Create Supportive Environments and Accommodations

This section translates the conceptual knowledge of FASD into practical strategies for parents, educators, and caregivers. Malbin provides concrete examples of environmental adaptations and supportive techniques based on an individual's specific needs and capabilities.

Adapt Environments to Reduce Sensory Overload and Provide Stability

Malbin emphasizes the importance of creating environments that minimize sensory overload and provide a sense of predictability and stability for individuals with fetal alcohol spectrum disorder. This involves being mindful of sensory sensitivities and incorporating strategies that promote calmness and focus.

Reduce Distractions, Noise, and Stimuli For Individuals With FASD

Malbin suggests:

• Minimizing visual clutter: Creating organized and visually calming spaces by reducing unnecessary decorations, using clear containers for storage, and providing designated areas for specific activities. Imagine how a cluttered, chaotic space contrasts with a well-organized environment with designated areas for work and play for someone who struggles with filtering visual information.

• Controlling auditory input: Reducing background noise by turning off the television or radio when not in use, using headphones during focused work, providing quiet spaces for breaks, and speaking in calm, clear tones. This is especially important for individuals who have FASD, as they may be hypersensitive to sound and easily overwhelmed by multiple auditory stimuli.

• Being mindful of tactile sensitivities: Using soft fabrics, providing opportunities for deep pressure through weighted blankets or compression vests, and allowing for personal space. Recognizing that seemingly minor tactile stimuli like a scratchy tag on clothing can be extremely distressing for someone with sensory sensitivities can significantly improve their comfort and capacity to manage.

Context

• Incorporating principles of environmental design, such as using neutral colors and natural lighting, can enhance the calming effect of a space and support sensory processing.
• By using clear containers, individuals with FASD can independently locate and access items, fostering a sense of autonomy and reducing reliance on others for assistance.
• Designated areas can help minimize distractions and enhance focus by providing a consistent and familiar setting for each activity. This can lead to better engagement and improved outcomes in tasks such as learning or therapy.
• Practical strategies include using noise-canceling headphones, installing soundproofing materials, and creating quiet zones within homes or classrooms to help manage auditory input effectively.
• It’s important to ensure that the volume is kept at a safe level to prevent hearing damage, and breaks should be taken to avoid auditory fatigue.
• The effectiveness of quiet spaces can vary based on individual preferences and needs. Some may benefit from complete silence, while others might find soft, calming music helpful. Personalizing these spaces can maximize their effectiveness.
• Complex or rapid speech can increase cognitive load, making it harder for individuals with FASD to follow conversations. Clear and calm speech reduces this load, aiding comprehension and retention.
• Comfort with tactile sensations can influence emotional regulation. When individuals are not distracted or distressed by uncomfortable textures, they may find it easier to manage their emotions and behaviors.
• The application of deep pressure can trigger the release of neurotransmitters like serotonin and dopamine, which are associated with mood regulation and relaxation. This can help mitigate stress and anxiety symptoms.
• Being in close proximity to others can increase stress and anxiety for those with sensory processing challenges. Personal space can help mitigate these feelings by providing a buffer from overwhelming stimuli.

Maintain Consistency to Support Memory and Orientation

Malbin stresses the importance of:

• Establishing predictable routines and schedules: This provides a sense of security and helps those with FASD anticipate what to expect, reducing anxiety and promoting cooperation. Visual schedules, timers, and checklists can be valuable tools for enhancing comprehension and independence.

• Maintaining consistency in the physical setting: Keeping furniture arrangements constant, clearly labeling belongings, and providing predictable locations for everything. This helps individuals affected by FASD who heavily rely on visual cues for orientation and can reduce anxiety associated with unpredictable changes.

• Using consistent language and communication styles: Employing clear, concise language, avoiding idioms and sarcasm, and pairing verbal instructions with demonstrations or visual signals. This helps connect language comprehension and expression, ensuring information is received and processed effectively.

Context

• Timers can help individuals with FASD understand the concept of time and manage transitions between activities. This can be particularly helpful in reducing anxiety related to changes or waiting periods.
• Using consistent language helps build a sense of trust and security. When individuals know what to expect in communication, it reduces uncertainty and anxiety, fostering a more supportive environment.

Leverage Capabilities to Optimize Person-Environment Fit

Malbin underscores the importance of identifying and leveraging the unique strengths and talents of each person with FASD to establish compatibility between the individual and their surroundings. By emphasizing their strengths, individuals are more likely to experience success, build confidence, and cultivate a positive self-image.

Cultivate Interests and Abilities In Creative, Hands-On, or Experiential Areas

Malbin encourages exploring and nurturing strengths in areas such as:

• Music and Art: Encouraging participation in music classes, providing art supplies, and celebrating creative expression through displays of artwork and performances. These activities provide outlets for self-expression, develop precise hand movements, and tap into often-strong abilities to process visual and sound information.

• Hands-on Activities: Engaging individuals in hands-on activities like building, cooking, gardening, or woodworking. These experiences provide opportunities for learning through tangible experiences, developing problem-solving skills, and mastering a sense of accomplishment through completing projects.

• Movement and Physical Activities: Participating in sports, dance, or other movement-based activities. This can help regulate sensory input, build coordination, and provide opportunities for social interaction and teamwork.

Context

• Both music and art have been shown to reduce stress and anxiety, promoting overall mental well-being and relaxation.
• Seeing others' creative work can inspire and motivate individuals to pursue their own artistic endeavors, fostering a cycle of creativity and innovation.
• Mastering precise hand movements in creative activities can boost self-esteem and confidence. Successfully creating art or music can provide a sense of achievement and personal satisfaction.
• Strong visual and auditory processing skills can lead to career opportunities in fields such as graphic design, music production, architecture, and sound engineering, where these abilities are highly valued.
• Activities like woodworking and cooking can significantly improve fine motor skills, which are crucial for tasks requiring precision and coordination.
• Some individuals learn best through physical activities rather than listening to a lecture or watching demonstrations. Hands-on experiences cater to kinesthetic learners by allowing them to engage physically with the material.
• Engaging multiple senses during hands-on activities can improve memory retention, as the physical act of doing can reinforce learning more effectively than passive observation.
• Completing projects can provide a sense of purpose and direction, contributing to overall well-being and life satisfaction.
• Being part of a team or group can foster a sense of community and belonging, providing social support and enhancing interpersonal relationships.
• Incorporating regular physical activities into a daily routine can provide structure, which is beneficial for individuals who thrive on predictability and consistency. This can help reduce stress and improve time management skills.
• Both sports and dance require practice and dedication, teaching discipline and the value of perseverance in achieving goals.
• These activities can provide chances for individuals to take on leadership roles, enhancing confidence and decision-making abilities.

Utilize Preferred Learning Modalities and Cues For Retention and Generalization

Malbin suggests incorporating:

• Visual aids: Utilizing pictures, diagrams, videos, and other visual tools to boost understanding and memory. Remember that individuals who have FASD typically possess strong visual memories and benefit from seeing information presented in a concrete, visual format.

• Hands-on learning experiences: Providing opportunities to gain knowledge through hands-on exploration, experiments, and real-life ways to use concepts. This helps those with FASD bridge the gap between abstract concepts and concrete experiences, promoting deeper understanding and retention.

• Repetition and Practice: Recognizing that mastering new skills and concepts may require additional repetition and practice than for typically developing peers. Perseverance and ongoing reinforcement are key to building confidence and fostering a sense of accomplishment.

Context

• People with FASD may experience challenges with executive functioning, which includes skills like planning, organizing, and remembering details. Visual aids can help by providing clear, structured information that is easier to process.
• Educators can design lessons that incorporate physical activities or real-world applications to cater to diverse learning needs, making education more inclusive and effective for students with FASD.
• FASD is a range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects may include physical, behavioral, and learning difficulties, with lifelong implications.
• Applying learned concepts in real-life situations helps solidify understanding by allowing individuals to see the practical relevance and impact of what they have learned, making the information more meaningful and memorable.

Give Clear Support, Not Assumptions

Malbin advises against making assumptions about an individual's understanding or abilities. Instead, she encourages a proactive approach that involves providing clear, step-by-step guidance, using specific wording, and regularly confirming understanding.

Break Down Tasks Into Step-By-step Guidance

Malbin recommends:

• Chunking information: Dividing complex tasks into smaller, manageable steps, providing clear instructions for each step. This reduces overwhelm and promotes a sense of mastery as the individual progresses through the task.

• Utilizing graphic checklists or organizers: Providing visual representations of steps involved in a process to improve memory and organization. This can be as straightforward as a written list, pictures, or a flow chart.

• Offering frequent check-ins and opportunities for clarification: Regularly verifying comprehension throughout a task or activity, prompting queries, and providing extra help when necessary. This proactive approach helps avoid feeling frustrated and ensures that the individual stays on track.

Context

• This technique is used in fields like computer programming, where complex code is broken down into functions or modules, and in project management, where large projects are divided into smaller tasks.
• Visual elements can make tasks more engaging, increasing motivation to complete them. This is particularly beneficial for individuals who might find traditional methods less stimulating.
• Frequent check-ins create a feedback loop that helps both the instructor and the learner identify areas of strength and those needing improvement, facilitating continuous improvement.

Use Repetition, Visual Aids, and Scaffolding For Memory and Processing Challenges

Malbin suggests:

• Repetition: Recognizing that repetition is crucial for individuals with Fetal Alcohol Spectrum Disorders, presenting information in multiple formats and through various activities.

• Visual aids: Incorporating visual aids whenever possible to reinforce verbal information and create memorable associations. Pictures paired with words, timelines, diagrams, and graphic organizers can all be valuable tools.

• Scaffolding: Providing temporary support and direction that gradually fades as the individual becomes more independent. This involves breaking down tasks into smaller steps, modeling the desired behavior, providing prompts and cues, and offering encouragement and positive reinforcement along the way.

By understanding and addressing the unique neurological basis of FASD, embracing a strengths-based approach, and implementing these practical strategies, Malbin believes we can create environments where individuals with FASD can thrive and maximize their potential. Keep in mind, the focus isn't changing the individual to suit society but rather adapting society to accommodate and celebrate their differences.

Context

• Repetition helps reinforce learning by providing multiple opportunities for the brain to encode information. This is particularly important for those with FASD, as they may need more time and varied methods to fully grasp and remember new concepts.
• Diagrams and charts can simplify complex information, breaking it down into more digestible parts that are easier to understand and remember.
• They can bridge language barriers and support understanding in diverse cultural contexts by providing universal visual cues.
• Besides cognitive assistance, scaffolding can also involve emotional support, helping individuals build confidence and motivation as they tackle new challenges.
• Breaking tasks into smaller steps helps manage cognitive load, making it easier for individuals to process information without becoming overwhelmed.
• Practically, this approach might involve creating personalized learning plans, using interest-based activities, and setting achievable goals that highlight and utilize the individual's strengths.
• Both caregivers and educators play a crucial role in implementing these strategies consistently across different environments, providing a stable and supportive learning atmosphere.
• Community programs might focus on awareness campaigns and support networks that educate the public about FASD and promote acceptance and understanding.