The effects from prenatal alcohol exposure have been found to cause a range of congenital physical and cognitive abnormalities (Chasnoff, Wells, Telford, Schmidt, & Messer, 2010; Kable & Coles, 2004a). The neurological impairments associated with the effects from prenatal alcohol exposure often cause learning problems, most notably in mathematics (Kable & Coles, 2004a; Howell et al., 2006). Studies have indicated that when provided instructional interventions in mathematics, children affected by prenatal alcohol exposure made gains in learning. However, the studies did not provide specifics as to how children with FAS construct the understanding of a skill or concept (Kable, Coles, & Taddeo, 2007; Coles, Kable, & Taddeo, 2009). This study contributes to the literature by examining how children affected by prenatal alcohol exposure learn the concept of equivalence through their use of gestures in contrast to their learning outcomes. Previous studies have shown that children’s use of gestures while learning mathematics assist with the integration of verbal and visual stimuli, support concept formation, and facilitate flexible encoding of problems (Goldin-Meadow, Cook, & Mitchell, 2009; McNeil & Alibali, 2004). The results from this study indicated that children in the Alcohol Exposed group showed little to no learning after the intervention as compared to a control group matched by age and IQ. The study showed that children affected by prenatal alcohol exposure used fewer conceptual gestures while learning equivalence as compared to a control group. According to the gesture analysis, the children in the Alcohol Exposed group mentally represented the concept of equivalence as a series of isolated steps or procedures. The procedural representation was not transitioned into a flexible conceptual format and applied to solve different problem types accurately (McNeil & Alibali, 2004). Future studies need to investigate whether teaching children affected by prenatal alcohol exposure to gesture during mathematics instruction would be effective to increase concept formation, accurate encoding, and learning mathematics / Inclusive Education / D. Ed. (Inclusive Education)

Thesis (M Social Work)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Fetal alcohol spectrum disorders (FASD) is caused by maternal drinking during pregnancy. Pre-natal drinking has a range of deleterious effects including physical, mental and behavioural consequences for the affected child. Although FASD is completely preventable, it is irreversible with consequences that last into adulthood. The range of effects of FASD forms a spectrum with fully developed FAS on the one end and no effects on the other end of the spectrum. The Western Cape has one of the highest recorded rates of FAS in the world. This seriously affects almost all systems in society and strains the already overburdened educational-, health-, social- and judicial systems. For this reason preventing FASD is of the utmost importance and requires a comprehensive approach on multiple levels. This study explores and describes FASD prevention services in the Bonnievale, Robertson, Ashton and Montagu-areas – a wine-producing area in the Western Cape. Available FASD prevention services on all levels of prevention, the focus-areas of the different prevention activities, collaboration and co-ordination between the role-players and obstacles in delivering prevention services, was examined. By adopting an ecological approach, FASD prevention services could be investigated on multiple levels. This study used a combination of quantitative and qualitative research. An exploratory design and a purposive sampling method were used. Participants were interviewed individually and with the help of a semi-structured questionnaire. The findings of the empirical investigation show that, although prevention efforts are applied on the universal, selective and indicated levels of prevention, a lack of formal prevention efforts that are actively pursued - especially on the level of indicated prevention - exists. This is aggravated by the absence of formal co-ordination of services and structured systems of referrals. NGO‟s and government departments are, as a result, not clear about their respective roles and responsibilities and women with the highest risk for having a child with FAS, therefore, fall through the cracks of the system. This happens partly because social workers are often perceived as the only agents for social change in the community. According to the ecological approach all levels (micro, meso and macro) of organizations in the social environment should work together for change by repeating prevention messages on the different levels and thereby reinforcing it. In the study area, however, most FAS prevention services were on the micro-level with few on the meso-level and virtually none on macro-level. Participants identified a lack of co-ordination, unplanned families, a lack of resources, a lack of training and training material and low levels of education as obstacles in service delivery. Recommendations resulting from the study indicate that FAS prevention will benefit from structured, formal programs on all levels of prevention. This will require non-government organizations and government departments to co-ordinate services and to develop a formal system of referral amongst the role-players. Training of personnel in clinics, NGO‟s, government departments and volunteers, as well as the development of training material targeted at people on different levels of education, should receive attention. It is, in conclusion, recommended that community organizations and structures such as churches, places of business, farmer‟s associations and liquor outlets are actively involved in the prevention of FASD. / AFRIKAANSE OPSOMMING: Fetale Alkohol Spektrum Afwykings (FASA) word veroorsaak deur alkoholgebruik tydens swangerskap. Alkoholgebruik tydens swangerskap het „n reeks skadelike effekte, insluitend fisiese, psigiese en gedragsafwykings in die geaffekteerde kind. Alhoewel FASA heeltemal voorkombaar is, is dit onomkeerbaar en duur die gevolge daarvan voort in volwassenheid. Die reeks effekte van FASA vorm „n spektrum met volledig ontwikkelde FAS aan die een kant en geen effekte nie aan die ander kant van die spektrum. Die Wes-Kaap het een van die hoogste aangetekende voorkomssyfers van FAS in die wêreld. Dit affekteer feitlik alle sisteme in die samelewing en plaas nog meer druk op die reeds oorlaaide opvoedkundige-, gesondheids-, maatskaplike- en regssisteme. Om hierdie rede is die voorkoming van FASA van uiterste belang en word „n omvattende benadering op veelvuldige vlakke vereis. Hierdie studie ondersoek en beskryf FASA voorkomingsdienste in die Bonnievale-, Robertson-, Ashton- en Montagu-area – „n wynproduserende streek in die Wes-Kaap. Die beskikbaarheid van FASA voorkomingsdienste op alle vlakke van voorkoming, die fokus-areas van die verskillende voorkomingsaktiwiteite, samewerking en koördinering van dienste tussen die rolspelers, sowel as struikelblokke in voorkomingsdienste, is ondersoek. Deur die ekologiese benadering aan te neem, kon FASA voorkomingsdienste op veelvuldige vlakke ondersoek word. Die studie kombineer kwantitatiewe en kwalitatiewe navorsing. Die ontwerp van die studie is verkennend en daar is „n doelbewuste steekproef gedoen. Indivuduele onderhoude met deelnemers is met behulp van semi-gestruktureeerde vraelyste gevoer. Die bevindinge van die empiriese ondersoek toon dat, alhoewel voorkomingspogings aangewend word op die universele, selektiewe en indikatiewe voorkomingsvlakke, daar 'n gebrek bestaan aan formele voorkomingspogings wat aktief nagestreef word, veral op die indikatiewe vlak. Dit word vererger deur die afwesigheid van formele koördinering van dienste en gestruktureerde verwysingsisteme. Nie-regeringsorganisasies en staatsdepartemente het gevolglik nie duidelikheid oor hul onderskeie rolle en verantwoordelikhede nie. Die gevolg hiervan is dat vroue met die hoogste risiko om geboorte te skenk aan kinders met FAS, deur die krake in die sisteem val. Dit geskied deels omdat maatskaplike werkers dikwels gesien word as die enigste agente vir maatskaplike verandering in die gemeenskap. Volgens die ekologiese benadering behoort alle vlakke (mikro, meso en makro) van organisasie in die sosiale omgewing saam te werk om verandering teweeg te bring deurdat voorkomingsboodskappe op die verskillende vlakke te herhaal en sodoende te versterk word. In die studie-area is die meeste voorkomingsdienste egter op mikro-vlak gelewer met min op meso-vlak en feilik geen op makro-vlak nie. Deelnemers aan die studie het „n gebrek aan koördinasie van dienste, onbeplande gesinne, „n gebrek aan hulpbronne, „n gebrek aan opleiding en opleidingsmateriaal en lae vlakke van geletterdheid geïdentifiseer as struikelblokke in dienslewering. Aanbevelings wat uit die studie voortvloei, dui aan dat FASA voorkomingsdienste sal baat vind by gestruktureerde, formele programme op alle vlakke van voorkoming. Dit sal vereis dat nie-regeringsorganisasies en staatdepartemente hul dienste koördineer en „n formele verwysingstelsel tussen die verskillende rolspelers ontwikkel. Opleiding van personeel in klinieke, NRO‟s, staatsdepartemente en vrywilligers, sowel as die ontwikkeling van opleidingsmateriaal wat persone op verskillende vlakke van opvoeding teiken, behoort aandag te geniet. Dit word laastens ook aanbeveel dat gemeenskapsorganisasies en strukture byvoorbeeld kerke, besighede, boere-verenigings en verkoopspunte vir alkohol, aktief betrek word by die voorkoming van FASA.

The effects from prenatal alcohol exposure have been found to cause a range of congenital physical and cognitive abnormalities (Chasnoff, Wells, Telford, Schmidt, & Messer, 2010; Kable & Coles, 2004a). The neurological impairments associated with the effects from prenatal alcohol exposure often cause learning problems, most notably in mathematics (Kable & Coles, 2004a; Howell et al., 2006). Studies have indicated that when provided instructional interventions in mathematics, children affected by prenatal alcohol exposure made gains in learning. However, the studies did not provide specifics as to how children with FAS construct the understanding of a skill or concept (Kable, Coles, & Taddeo, 2007; Coles, Kable, & Taddeo, 2009). This study contributes to the literature by examining how children affected by prenatal alcohol exposure learn the concept of equivalence through their use of gestures in contrast to their learning outcomes. Previous studies have shown that children’s use of gestures while learning mathematics assist with the integration of verbal and visual stimuli, support concept formation, and facilitate flexible encoding of problems (Goldin-Meadow, Cook, & Mitchell, 2009; McNeil & Alibali, 2004). The results from this study indicated that children in the Alcohol Exposed group showed little to no learning after the intervention as compared to a control group matched by age and IQ. The study showed that children affected by prenatal alcohol exposure used fewer conceptual gestures while learning equivalence as compared to a control group. According to the gesture analysis, the children in the Alcohol Exposed group mentally represented the concept of equivalence as a series of isolated steps or procedures. The procedural representation was not transitioned into a flexible conceptual format and applied to solve different problem types accurately (McNeil & Alibali, 2004). Future studies need to investigate whether teaching children affected by prenatal alcohol exposure to gesture during mathematics instruction would be effective to increase concept formation, accurate encoding, and learning mathematics / Inclusive Education / D. Ed. (Inclusive Education)

Indiana University-Purdue University Indianapolis (IUPUI) / Despite warnings about the dangers of drinking during pregnancy, little progress has been made in reducing alcohol drinking among women of childbearing age. Even after the recognition of pregnancy, 15% of women continue to drink, 3% of which admit to binge drinking. Because we cannot stop women from drinking during pregnancy, and many children with fetal alcohol spectrum disorders (FASD) are adopted, there is a significant need to develop postnatal interventions that can improve the long-term outcome of children adversely affected by prenatal alcohol exposure. This thesis aims to evaluate one promising new treatment in the rehabilitation or rescue of specific learning deficits long after the damage has occurred. The treatment evaluated herein (40µg D-NAP + 40µg D-SAL) has long been used in the prevention of the detrimental effects of long-term and binge-like alcohol exposures in rodent models of fetal alcohol syndrome and FASD. Until recently this peptide treatment had only been shown to be effective in preventing some of the consequences of alcohol exposure when administered concurrently with the prenatal alcohol exposure. A recent report by Incerti and colleagues (2010c), however, reported that these peptides could completely reverse a profound spatial learning deficit induced by one episode of a heavy binge-like alcohol exposure (5.9g.kg in a single intraperitoneal injection) on gestational day 8 (G8) in C57BL/6 mice. In that report, the peptide treatment was administered starting in late adolescence, beginning three days prior to and throughout water maze training, and the profound deficits in their alcohol-placebo group were completely eliminated in the alcohol-peptide group. There are currently no FDA-approved treatments for FASD. An effective treatment for the cognitive and behavioral dysfunctions suffered by the 1% of people born today could potentially improve the lives of millions of children and adults. The first aim of this thesis was to determine whether the peptide treatment could reverse the significant spatial learning deficits we have demonstrated in adult C57BL/6 mice given high-dose binge-like alcohol exposure (2.5 g/kg in each of two intraperitoneal injections separated by two hours) on postnatal day (P)7. When administered three days prior to and throughout water maze testing (P67-76), the peptide treatment had no effect on spatial learning. The second aim sought to determine whether the same peptide treatment could reverse water maze spatial learning deficits in G8 binge-like exposure models, as reported by Incerti et al. (2010c). For this analysis, the first study used a different binge-like alcohol exposure model that is more commonly used than that employed by the Incerti et al. (2010c) study, namely administration of 2.8g/kg in each of two intraperitoneal injections separated by four hours (Sulik et al., 1981). This model has been shown to produce high peak blood alcohol concentrations and neuroanatomical aberrations in the hippocampal formation and septal regions (Parnell et al., 2009), which have been implicated in learning and memory. Surprisingly, this G8 binge-like alcohol exposure failed to produce a spatial learning deficit, undermining the usefulness of this model in evaluating the peptide effects. In direct contrast to the outcomes of Incerti et al. (2010c), the G8 Webster alcohol exposure was also unable to produce any deficits in acquisition of spatial learning in the Morris water maze. Surprisingly, neither of the heavy binge-like alcohol exposures on G8 were able to produce spatial learning deficits in the Morris water maze. The binge-like alcohol exposure on P7 did yield the expected spatial learning deficit, but the peptide treatment was unsuccessful in recovering water maze learning. These findings fail to support oral administration of 40µg D-NAP and 40 µg D-SAL as a potential therapy for postnatal alcohol-induced spatial learning deficits in adult mice.

Text in Afrikaans with a summary in Afrikaans and English / The motivation for this study was to use animal-assisted therapy to the advantage of the child with Fetal Alcohol Syndrome. The purpose of this study was to describe the use of therapeutic horse riding in Gestalt therapy and its influence on the awareness levels of the child with Fetal Alcohol Syndrome that present with Attention deficit/Hyperactivity disorder. For the purpose of this study a quantitative research approach with a descriptive nature was used. Semi-structured interviews were used to compile information about a single child in a therapeutic milieu. This information was combined with information gathered from the literature to compile guidelines for the counsellor. In this study horse riding was effectively combined with Gestalt play therapy to enhance the awareness levels of the child with Fetal Alcohol Syndrome. / Die motivering van hierdie ondersoek was om diergefasiliteerde terapie tot voordeel van die kind met Fetale Alkohol Sindroom te benut. Die doel van die studie was om die benutting van terapeutiese perdry in Gestaltspelterapie en die invloed daarvan op die bewustheidsvlakke van die kind met Fetale Alkohol Sindroom wat met Aandagafleibaarheid/hiperaktiwiteitsindroom presenteer te beskryf. Vir die doel van hierdie studie is kwalitatiewe navorsing met 'n beskrywende aard benut. Semi-gestruktureerde onderhoude is gebruik om inligting in te samel rakende 'n enkele kind in 'n terapeutiese milieu. Hierdie inligting is gekombineer met die inligting uit die literatuur ten einde riglyne vir die berader op te stel. In hierdie studie is perdry effektief by Gestaltspelterapie geintegreer om die kind met Fetale Alkohol Sindroom se bewustheidsvlakke te verhoog. / Practical Theology / M.Diac. (Play Therapy)

Text in Afrikaans with a summary in Afrikaans and English / The motivation for this study was to use animal-assisted therapy to the advantage of the child with Fetal Alcohol Syndrome. The purpose of this study was to describe the use of therapeutic horse riding in Gestalt therapy and its influence on the awareness levels of the child with Fetal Alcohol Syndrome that present with Attention deficit/Hyperactivity disorder. For the purpose of this study a quantitative research approach with a descriptive nature was used. Semi-structured interviews were used to compile information about a single child in a therapeutic milieu. This information was combined with information gathered from the literature to compile guidelines for the counsellor. In this study horse riding was effectively combined with Gestalt play therapy to enhance the awareness levels of the child with Fetal Alcohol Syndrome. / Die motivering van hierdie ondersoek was om diergefasiliteerde terapie tot voordeel van die kind met Fetale Alkohol Sindroom te benut. Die doel van die studie was om die benutting van terapeutiese perdry in Gestaltspelterapie en die invloed daarvan op die bewustheidsvlakke van die kind met Fetale Alkohol Sindroom wat met Aandagafleibaarheid/hiperaktiwiteitsindroom presenteer te beskryf. Vir die doel van hierdie studie is kwalitatiewe navorsing met 'n beskrywende aard benut. Semi-gestruktureerde onderhoude is gebruik om inligting in te samel rakende 'n enkele kind in 'n terapeutiese milieu. Hierdie inligting is gekombineer met die inligting uit die literatuur ten einde riglyne vir die berader op te stel. In hierdie studie is perdry effektief by Gestaltspelterapie geintegreer om die kind met Fetale Alkohol Sindroom se bewustheidsvlakke te verhoog. / Philosophy, Practical and Systematic Theology / M.Diac. (Play Therapy)