Vulnerable Kids and Teens: Why do Fetal Alcohol Syndrome (FASD) Children Fall Between the Cracks?*

Children born with Fetal Alcohol Syndrome (FASD) often go undiagnosed for years because of a persistent and hard to dispel stigma attached to the condition. That stigma is most often borne by mothers, passed along to their offspring, and, all too often, wreaks havoc on normal family life. It’s hidden away and whispered about in all too many households.

What’s it like to raise a child diagnosed with FASD?  Speaking at the opening of the recent Canadian FASD Conference held June 9 in Moncton, New Brunswick mother Nadia Mallet provided a pithy and revealing answer: “It’s like starting a blender without a top.” You can expect a mess and cleaning it up can and does become a mother’s full-time job.

Adoptive mother Alicia Munn of Fredericton, Chair of the N.B. FASD Parent Advisory Committee, went into more graphic detail in a recent exclusive interview and later at the conference. “There’s a lot of stigma, shame and humiliation associated with FASD,” she told me. “Brain damage adversely affects the child’s neurological development, all too often leading to lifelong dependence on social supports and, in some cases, a life marred by criminality.”

Advocating for, and supporting her 21-yer-old son Joseph Munn, was an exhausting thirteen-year struggle to get a clinical diagnosis that lasted from age 5 to 18 years of age. She guided, rescued and put him back on track multiple times, as he moved from school to school in Fredericton, five or six times.

Munn’s a nurse by profession and she also speaks with a ton of lived experience. Supporting and encouraging a FASD teen through the ups and downs is particularly stressful and unpredictable. “It’s like dealing with a half-wired house with a short circuit,” she says. “Things go off track and it requires periodic interventions to provide executive function support.”  Not every teen with FASD has a resilient “super mom” like Munn.

Alcohol and drinking are very much a part of our lives and so much so that we do not always recognize its adverse societal consequences. One of the most debilitating and lesser known is FASD affecting at least 4 per cent of all live births, or 250 children out of the province’s 6,200 births each year. That’s more than Autism Spectrum Disorder (ASD), cerebral palsy, and Down Syndrome combined.

Talking openly about FASD is far more common in Western Canada, particularly in Alberta, where the national organization is most deeply rooted. First diagnosed in 1974, FASD is gradually gaining acceptance as a recognized clinical condition eligible for social supports. Most of the medical research and health reform advocacy stems from the University of Alberta and the Institute for Health Economics.

The Canada FASD Research Network (CanFASD) was established in 2005 and since then has been acting as a catalyst for developing and expanding support programs for families affected by FASD right across Canada. The Executive Director, Audrey McFarlane, founder of the Lakeland Centre for FASD, is based in Cold Lake, Alberta, and has devoted over twenty years of her life to community outreach, prevention, and support program development.

Securing funding for FASD research and advocacy has been a challenge, McFarlane told me in a recent interview. Competition for governmental support in terms of funding is fierce and FASD currently receives a fraction of what is provided to Autism SD research and programs from province-to-province across Canada. “We don’t have any national plan or strategy to focus our resources,” she says. “Most of our efforts are local, offering pre-natal programs to alert mothers to the dangers of drinking and supporting changes in behaviour to reduce the incidence.”

Mothers are most susceptible during the first six weeks of their pregnancy and, as a result, a large proportion of those babies affected are born to women with unplanned pregnancies.  High incidence of FASD was first discovered and documented in Indigenous communities. “We know,” McFarlane says, “it’s related to high rates of alcoholism as a terrible legacy of colonialism affecting larger numbers of Indigenous children.”

Programs and systems of support are gradually emerging to improve life outcomes for impacted children. Without such interventions, FASD children and teens experience high rates of incarceration and suicide, and this is particularly true on Canada’s East Coast. What’s encouraging is that New Brunswick is ahead of Nova Scotia and other Atlantic provinces in tackling the unaddressed problem.

Talking openly about FASD is far more common in Western Canada, particularly in Alberta, where the national organization is most deeply rooted. First diagnosed in 1974, FASD is gradually gaining acceptance as a recognized clinical condition eligible for social supports. Most of the medical research and health reform advocacy stems from the University of Alberta and the Institute for Health Economics.

New Brunswick is definitely the lighthouse province in Atlantic Canada. A real pioneer and powerful advocate for FASD awareness was former Moncton MP, the late Claudette Bradshaw, who cleared the path for pediatrician Dr. Nicole LeBlanc, the leading medical researcher who established the clinical guidelines for diagnosis, putting FASD on the provincial medical and social services agenda. Action central for the provincial effort is the Centre Excellence NB, opened in 2012, managed by Vitalité Health Network and based in Dieppe, N.B.  Health Minister Dorothy Shephard chose the Moncton CanFASD Conference as a convenient event to announce some $800,000 in additional funding for the Centre for Excellence.

One of the most passionate advocates for FASD prevention and support is Mi’kmaw Elder Noel Milliea of Elsipogtog who opened the CanFASD Conference with a plea to “let our humanism shine though today.” He also provided some rather astute guidance to the predominantly white audience of some 200 parent activists, medical professionals and social workers. “Find the spirit in the child,” he said, “It’s about the children, not just increasing your toolbox. Let’s be careful we don’t stop at labelling them.”

Educators in New Brunswick are increasingly aware of the prevalence of FASD affecting children in the schools. Some 250 children affected by FASD enter the provincial school system each year. In the average school, with some 300 students, a dozen or so students are affected by the condition.  It’s visible to those on the front lines of education.

Some of these FASD affected students are diagnosed, but not many, particularly outside of the three major cities. Few, if any, supports are put in place and most are insufficient, so the burden falls back mostly on parents and families, where they are in a position to help their children. A huge FASD support service gap needs to be closed in the province and elsewhere in our region.

*Reprinted from The Telegraph-Journal, Brunswick News, June 17, 2022.

Why do Fetal Alcohol Syndrome Children still go undiagnosed?  Why is it such a challenge to secure support in our social service network? Given the prevalence of FASD among kids and teens why is it so hard to attract funding and research dollars?  Why are some provinces so much more advanced in providing FASD support compared to others?

Read Full Post »

Restorative Justice in Schools: Does it Work in Improving School Culture, Academic Tone, and Student Behaviour?

Restorative justice is very much in vogue in Canada’s K-12 schools.  Widespread adoption of restorative justice theory and practice, commonly reflected in “circle conversations,” is largely aimed at moderating punitive, and at times harsh, discipline in schools.  Defenders of the new student behaviour management approach, claim that it works to the benefit of ‘labelled students,’ drawn disproportionately from racialized and marginalized communities. Since the recent advent of Black Lives Matter and the 2015 Truth and Reconciliation Commission report, it has gained fresh currency in public schools everywhere.

Restorative justice flourished first in the criminal justice system as a preferred law reform venture for juvenile offenders and aimed at, in the words of leading expert Dalhousie law professor Jennifer Llewellyn, “repairing or addressing the harm cased to social relationships when wrongdoing happens.” It attempts, not always successfully, to bring together offenders, victims and affected community members to resolve conflict, normally after the judicial system or school disciple committee has rendered its decision.

The whole approach is not really new because it was actually pioneered fifty years ago by American criminologist and devout Mennonite Howard Zehr, a justice system reformer committed to humanizing what he saw as a punitive and harsh  justice system for both offenders and victims.

While popular in law reform circles as a way of promoting ”forgiveness,” it has struggled to gain acceptance, particularly among victims or crime and their families. It’s hard for victims, often suffering from life-altering trauma or witnessing blatant wrongdoing, to see let alone appreciate the harms being done by harsh sentences or punitive measures.  From the beginning, restorative justice resolutions have suffered because of the public perception that offenders or juvenile violators tend to “get off easy” and rarely face meaningful consequences.

Implementing restorative justice is definitely not the panacea envisioned by its ardent proponents. One professional review of School Restorative Justice, published in March 2019 by Mikhail Lyubansky in Psychology Today, identified the nine most common criticisms of the current practice. Restorative justice in schools, according to practitioners in the field, often suffers from a few or many of these shortcomings:

• Takes too long to implement in busy schools
• Can be emotionally draining
• Cuts into actual teaching time
• Lacks in accountability leaving too much to self-responsibility
• Little follow-through on agreed remedial actions
• Perceived as just a gentler way of controlling student behaviour
• Places unfair expectation on victims/survivors to talk with those who harmed them
• Victims/survivors unlikely to ever forgive perpetrators of sexual assault or overt racism
• Elements of compulsion creep into the process, causing victims and community members to harbour substantial resentment and demonstrate resistance.

Its mass application in elementary, middle school and high school classrooms is more about ‘humanizing kids’ through the latest mutation of what American education researcher Daniel Buck has termed “community-building prophylactics.”  It also remains essentially experimental because, until recently, no independent, evidence-based research has been conducted demonstrating its effectiveness.

Two reasonably sound RAND Corporation studies, conducted in Pittsburgh and Maine, have shown mixed results in implementing Restorative Justice in schools.  Twenty-two Pittsburgh public schools’ engaged in a restorative justice program were studied by RAND Corporation researchers over two school years, 2015-16 and 2016-17 in what was reportedly the most comprehensive study utilizing the first randomized trial — the gold standard in social science research.

Suspension rates were reduced somewhat in restorative justice schools, as 12.6 percent of students were suspended at least once, compared to 14.6 percent in regular schools. Fewer Black students received suspensions under to the program, though they were still much more likely to be suspended than white students. Most significantly, restorative justice all but eliminated expulsions and the placement of students in “alternative” schools.

While schools may have been a little safer, student academic results did suffer under restorative justice conditions. The effect was less pronounced in reading, but math scores for students in grades 3 through 8 did fall significantly. More concerning, it was black students, not white students, whose scores fell. A black student at the 50th percentile dropped to roughly the 44th percentile during the implementation of restorative justice.

The Maine study, published online in March 2019 by the Journal of Youth and Adolescence, found that adopting RJ in middle schools made little or no difference in school climate. While the study didn’t look at academic grades or suspension rates, it showed RJ had little impact on bullying and related school Indicators. It also revealed how hard it is for schools to implement restorative justice even after two years of teacher training, monthly consultations and visits by coaches. Students’ survey answers revealed that it didn’t really impact their behaviour,” teen resistance to “buying-in,” and reluctance to meet face-to-face with classmates seen as ‘enemies’ or threatening figures. It’s a voluntary process and not every kid wanted to talk.

Restorative Justice can also go awry when it drifts into the realm of professional mental health practice. Identifying and treating children and youth with serious mental health disorders should remain the domain of health experts. While most teachers have some background in psychology, social therapy is fraught with risks and best left to those who are trained and licensed psychologists.

Jumping into Restorative Justice is a classic case of “putting the cart before the horse” and jumping over the research.   Giving students personal advice and career guidance is perfectly fine, but restorative justice remains problematic.  We need to recognize that RJ’s effectiveness has not been proven and, if today’s classrooms come to mimic group therapy sessions, it may well cause unintended harms. It’s time to recognize the limitations of restorative justice insofar as they apply to its overuse in schools.

What’s the philosophical rationale for implementing Restorative Justice in schools?  What are some of the most common criticism?  How effective is it, judging from the latest evidence-based research? In adopting RJ in schools what might be the rewards – and the risks?  How might the potential downsides be addressed by schools?  

Read Full Post »

Child and Youth Advocacy: Is Establishing a Commission a Step in the Right Direction?

Child welfare reformers campaigned for years to secure independent Child and Youth Advocates in province-after-province across Canada. Since Canada ratified the United Nations Convention on the Rights of the Child (CRC) in 1991, self-standing government offices have proliferated in Canada’s English-speaking provinces to uphold and protect the “human rights of every child… regardless of race, ethnicity, religion, gender, abilities, birth order or other status.” Nova Scotia, as well as Quebec, were ‘weak sisters’ – outliers without self-standing offices.

Nova Scotia child welfare reformers who campaigned for a Child and Youth Advocate recently got something else – an ill-defined and bureaucratic sounding Child and Youth Commission. On March 28, 2022, Nova Scotia’s Minister of Community Services Karla MacFarlane announced that the province would be adopting a different, more restorative, less adversarial approach. Instead of appointing an independent provincial Advocate, that province would be establishing a Commission with a mandate guided by the UN Convention on the Rights of the Child and informed by restorative justice principles.

Ten years of periodic crises in children and youth care and protection and a series of reform initiatives had failed to register in Nova Scotia. Governments of all stripes – Progressive Conservative, NDP or Liberal – had, to date, shown a real aversion to giving voice to the voiceless, being proactive in identifying issues, or closing the gaps in services for at-risk children and youth.

When the needle finally moved, the Ministry of Community Services claimed that it was not a response to years of child welfare advocacy, but rather inspired by a recommendation buried deep within the November 2019 final report of the Restorative Inquiry on the Home for Colored Children.

One of the chief proponents of an independent Child and Youth Advocate, Alex Stratford was loathe to ‘look a gift horse in the mouth,’ but wondered if it passed the sniff test. “Social change” begins with advocacy, he pointed out, and it is adversarial by nature.  “There’s not been an incident in our history in which change has occurred where there hasn’t been some kind of adversarial approach to ensuring that government is accountable to the people that they serve.”

Two neighbouring Maritime provinces, New Brunswick and Prince Edward Island, have fully embraced Child and Youth Advocates as the means of monitoring child and youth abuse and ensuring high standards of child protection.  Since February 2022, newly-appointed NB CYA Kelly Lamrock has produced three investigative reports on mask mandates for school children, teem mental health services, and enshrining children’s rights in new child welfare legislation.  The latest Child and Youth Advocate legislation in PEI is hailed by experts as the most advanced because it incorporates dispute-resolution processes, including (where appropriate) restorative justice.

The Nova Scotia Ombudsman Office, founded in response to allegations of institutional abuse in the 1960s, focuses mostly on children in care and proved unequal to the task.  It has laboured on with a very limited mandate and an annual budget of only $1.8 million, a fraction of what is invested elsewhere.  Back in 2015, Nova Scotia spent only $400,000 of its $1.7-million budget investigating child and youth complaints, less than one-quarter of the amount expended in Newfoundland and Labrador.

The current Nova Scotia government wants no part of having to respond to ongoing and unpredictable investigations into gaps in child and youth at-risk services.  “The Commission,” Community Services spokesperson Christina Deveau advised me “will take feedback on an ongoing basis, and monitor system improvement, to illustrate its effectiveness and build trust in the system.”

It sounds well intended, but falls far short of establishing a Child and Youth Advocate, completely independent of the government and reporting to the Legislative Assembly.  So far it looks very much like a potential obstacle to a more robust approach with a full mandate to identify the cracks, investigate serious cases, and take the lead in advocating for changes in child welfare and youth-at-risk policy and services.

Why did the Nova Scotia government opt to create a Child and Youth Commission rather than appoint an independent provincial Advocate?  Is it a step forward or a potential obstacle shielding Community Services from regular, ongoing, independent public scrutiny?  Will the new agency be pro-active or reactive in its orientation?  If the modus operandi is inclusivity, trauma-informed practice, and restorative justice, will we ever succeed in rooting out the worst forms of physical/emotional abuse, cyberbullying, and sexual assault affecting children and teens?   

Read Full Post »