Presenting at the EU FASD Conference

Next week I will be presenting at the EU FASD Conference in Berlin.

Over the past year I have been looking at the link between sleep, cognition, emotion and behaviour in children with FASD. Our theory is that the less a child sleeps, the more impact it has on their daily function - it sounds like common sense - and we have 'known' this for centuries, but this has not been scientifically measured yet. In fact, scientists cannot yet explain why we sleep. It has something to do with memory consolidation, it has something to do with homeostasis, it has something to do with our neurocognitive development - but what exactly is the thing we do not know.

So over the past year I have been asking parents questions about their children's sleep patterns. Do they sleep well? do they wake up at night? do they snore, are they restless, do they dream, are there nightmares? Then I ask them about:

- Their children's behaviour. Are they aggressive? timid? introverted?

- Their children's anxiety. Are they afraid of things? can they be alone? do they get scared when they take a test at school?

- Their children's executive functioning. Can they plan and organise things? Can they get lists of instructions? What is their memory like?

- Their children's attachment. How do they make friends? How do they relate to the adults around them? what are they like when they are by themselves?

I then take all of this information and put it into a statistical model, which tells me which of the questions most relates to children's sleep habits.

So far, I have focused on children on the FASD and Autism Spectrum, and typically developing children. Here are some preliminary results:

- Children with FASD have the highest number of sleep problems, followed by Autistic children, then Typically Developing children.

- Sleep problems in children with FASD are most related to Executive Functioning (in particular the Executive Functioning component of Inhibition).

- Separation Anxiety is the second most contributory factor to poor sleep in children with FASD.

- The results were the same for Autistic children, but less intensely related to separation and inhibition

I will be presenting these results at the EU FASD Conference. Hopefully this work on FASD and sleep can inform us of how sleep has an impact on children with a neurodevelopmental condition - but most of all, how problems related to FASD can be overcome through things like sleep interventions.

Thank you and Sorry!

Thank you to everyone who has taken part in the study so far. I have been inundated with questionnaires all year and I apologise for the amount of time it is taking to get back to you all individually!

But I am getting through everyone and am going to be sending reports to every person who has filled in my questionnaire. Thank you for your patience.

A day in the life of a child with executive functioning issues

Executive functions are part of the brains 'engine' that help us understand, organise and process information. They have an affect on essentially everything we do.

Executive Functions include the following:

- Organising, prioritising, starting tasks

- Focusing on things, and being able to move from one task to another

- Regulating ourselves, staying on task, staying alert

- Managing our emotions

- Using our short term memory to hold bits of information, then recall that information

- Controlling our impulses

To understand how these things can have an impact on everyday life, meet Sam. Sam is seven years old and has problems with his executive functioning. Here is an outline of his day:

8.30am

Sam leaves for school on his scooter, accompanied by his mum and younger sister. Argh! fifteen minutes down the road, at the school gates, he realises he has forgotten his game for show and tell. He had spent all evening the night before painting, cutting, designing, gluing together all the pieces of the game. It was made from a shoebox, a tiny football stadium with football players made out of straws; you blow through the straw, and the little ball moves around the little pitch! All his friends were going to love that game, it might even make him popular. And now he had forgotten it at home. They were never allowed to bring in their own games. This opportunity would probably never come again. His friends would never get to see the awesome game. Aaaaaaarrrrghhh!!!! I have to go home and get it! I need it!! I NEED IT NOW!! In his eagerness, Sam runs towards the road before being stopped by mum. A crowd has gathered.

Organising, Managing Emotions, Controlling Impulses.

11am

Sam's teacher asks him for the answer to one of the questions she has just read out. It had taken Sam a full hour to calm down from the morning and had not been paying attention to the teacher since he had sat down in class. There is a book open in front of him, there are words written down on the board, and an adult hired by the school to sit with him. The adults job is to mainly point at things and be frustrated because of other adults at the school. Sam cannot answer the question. It makes him sad.

Working Memory, Managing Emotions.

1pm

It is lunch time. Sam is sitting with the other kids in his class and they are talking about the new equipment in the playground and last weeks X factor. Sam joins the conversation, talking about football and naming every player he likes and their club history. He does not notice that the other kids have stopped talking. In their politeness, they let him speak.

Focusing, regulation, impulses.

3pm

Sam has been engrossed in his collage of 'Why I love Britain' as part of the citizenship for seven year olds curriculum. There is a picture of Jose Mourinho, a computer, and a christmas tree as these are Sam's favourite things about Britain. Because the Christmas tree is there, it only makes sense to now print and cut out all of the things he wants for Christmas - an iPad, lights for his shoes, the game where you splat your face with cream, and a Lego set so far. He is cutting out a picture of an Avengers Hero kit when his teacher tells him that he needs to keep in theme with the task - things about Britain. But he hasn't finished! After the Avengers Hero Kit, there were several other things. He needs to complete the list, one simply cannot have an incomplete list.

Shifting from one task to another.

5pm

It's tea time. Sam is having a cheese croissant and a glass of milk, his favourite. He finishes up and mum tells him to put everything away. He picks up his plate and glass, and goes to put them in the kitchen sink - but on the way he realises he has forgotten the knife and fork. He puts down the plate and glass on the coffee table and goes to get the knife and fork. He picks up the knife and fork, but under the table there is a small football straw from his game.. ahhhh my lovely game! Leaving the knife and fork on the floor, he hurries upstairs to be reunited with the game.

Staying on task, Focusing.