FASD and Socio-Cognitive Habilitation in the Community: The MILE Program

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Prenatal alcohol exposure has been demonstrated to be associated with a range of negative outcomes, now described as the fetal alcohol spectrum disorders (FASD) of which fetal alcohol syndrome (FAS) is only the most severe and easily diagnosed. Despite the life-long cognitive, functional, and behavioral disabilities associated with these disorders, there have been no empirically validated methods for educational and behavioral intervention available for use in community and educational settings. To increase the availability of such services, the current application proposes to translate the results of a clinical trial of a method for socio-cognitive habitationto community settings. Two components of this protocol were found to be efficacious in the initial trials and will be evaluated independently for effectiveness in the broader community setting. These are: Caregiver Education/Training and the MILE (Math Interactive Learning Experience) Program. To evaluate a distance learning model for caregiver education and training, we will collaborate with Virtual Reality Aides, Inc and their educational-oriented website, www.do2learn.com. Two Caregiver Modules, 1) Understanding FASD and Advocating for Your Child, and 2) Behavioral Regulation, as well as all supporting outcome measures will be made available in a distance-learning format and this method of intervention compared with standard care and a Workshop model in 60 families requesting information about their children's functional problems. To evaluate the effectiveness of the MILE tutoring program, 60 families with children 3 to 9 years will participate in one of three randomly-assigned conditions, a community- translation of the MILE program and two contrast groups, Center-based, and parent education. Community partners including tutoring services, after school programs and recreation programs have been recruited to adapt the MILE program and supporting materials and curriculm to their settings. For the purposes of outcome evaluation and participation in the Collaborative Database, all children will be diagnoses with FAS or pFAS in the FAS Center Clinic and tested by study staff. A Community Advisory Board will provide support to the investigators in translating methods to the community sites and in designing and implementing a Train-the Trainer program to be carried out in Year 4 in order to make the results of this research widely available and easily accessible.