Webinar - Medicine Wheel Tools for FASD Screening

Last modified by Doug Maynard on 2013/04/29 17:08



The Medicine Wheel tools and interventions were developed in an aboriginal community with help from elders and other community members as well as educational and service agency professionals. They reflect a holistic but practical approach to understanding the needs and nurturing the strengths of youth and families in a small community in order to prepare the ground for further growth and development.

An aboriginal elder Murdena Marshall once spoke about two eyed seeing: one eye looking through a traditional lens and one eye looking through a scientific lens. If we use two eyes for seeing, instead of one, our vision changes and there is more depth in our perspective. In this approach the ‘wisdom of the elders’ informs the scientific perspective of professionals working in the school and community systems


These tools were developed to provide a culturally sensitive assessment or screening tool with a broad enough lens to take in the broad range of needs and strengths that exist in an aboriginal school and community system. At the present time there is no culturally sensitive school screening tool to determine which children should be referred for assessment of conditions that seriously impair behavior and learning such as trauma or pre-natal exposures to alcohol and/or drugs. There are also few pedagogical models or interventions appropriate to a modern aboriginal school and community system. These tools were developed to help educators and other service professionals determine individual and collective ‘needs and strengths’ in an indigenous school and community system.

The Medicine Wheel Tools Consist Of:

The Medicine Wheel Tools have not been normed to large population samples. They are useful for screening, referral, needs assessment and goal setting in a community setting. They should not be used, however, as the sole criteria for determination of specific disabilities. Individuals with high level of needs should be referred to appropriate service professionals and if possible connected to community elders.  

In the Medicine Wheel approach screening leads to referral for assessment and diagnosis if necessary. The purpose of the screening process is an intervention that will help the individual grow and heal and reconnect to their own possibilities.


An Indigenous Approach: Focus on Relationships

The guiding principles of this approach to education are grounded in the concept of honoring all of the many circles of relationships within a system--respectful and balanced relationships to self, family, community, to creator and all of the creation.

Children learn through the relationships they have in their family, school and community systems. This approach seeks to balance and strengthen relationships within the school and community systems so that individuals can grow and heal.

This is a ‘need and strength based approach’. It assumes a wellness rather than a deficit model of learning. If children’s needs are met and strength’s are nurtured they will grow and learn.

Effectiveness Screening for FASD

These tools have proven to be very effective in Elsipogtog, the First Nations community where they were developed. In the first two years of using the tools 237 children were screened and 23% of these proceeded to diagnostic clinic.  65% of these were diagnosed with FASD. In a grade 1-8 Aboriginal community school population of 187 children approximately 20% were diagnosed with FASD by the end of the 1999-2000 school year.

Children in the community who were diagnosed with FASD were able to receive appropriate support in school. With this support diagnosed youth have been able to attend and graduate high school. A few have gone on to college and post-secondary training.

New Directions

Based on the success of the Medicine Wheel tools in Elsipogtog members from communities across Canada were brought together to assess the applicability of the Tools to other First Nations and also Inuit communities.  As a result an Inuit version, the Medicine Wheel Tools, was developed with the help of members of Inuit communities in the North.

Speaker Bio:

Lori Vitale Cox 

Dr. Lori Vitale Cox works in Elsipogtog First Nation where she is clinical coordinator of the Eastern Door Diagnostic Team, an indigenous multi-disciplinary diagnostic team for FASD and related conditions. She also works with school age youth and their families through the Education Division and is acting director of the Nogemag Healing Lodge Program for youth and families. She has been active in FASD research, diagnosis, and intervention for many years. She designed the Medicine Wheel Screening Tools for Screening of FASD and related conditions and the Medicine Wheel Difference Game Cards for Intervention with mothers at high risk of drinking or drugging during pregnancy. She is presently working on the development of a culturally safe diagnostic wheel for neurobehavioral disorders like FASD that is uses the 4-Digit process within the context and framework of community culture ---broadening the diagnostic lens to also take into account pre and post natal effects of historical trauma. It has been in use by the Eastern Door team for the last year.

On a national level Dr. Cox was one of the primary authors of the recent SOGC Clinical practice guidelines for Ob-GYN’s for the screening women of childbearing years about alcohol use. She has also been on the teaching faculty of PRIMA, a train-the trainer approach to teaching physicians, nurses and other health professionals about Pregnancy Related Issues In the Management of Pregnancy. Currently she is involved in the piloting of the MW tools and the Northern Circle Tools, the Inuit version, in a few indigenous communities across Canada.

On a provincial level she has been a member of the NB FASD Advisory Committee that worked through a series of provincial consultations to develop a model of FASD service delivery that the NB Health Minister recently announced will be implemented by an NGO as the NB FASD Centre of Excellence.

She has traveled throughout the country giving training workshops on FASD to diverse groups such as physicians and provincial judges in NB, Innu elders in Labrador and teachers and social service professionals in the Yukon. A few years ago in a James Bay Cree First Nation in northern Quebec, community members attempted to teach her how to clean and take the feathers off of a partridge as part of an informal knowledge exchange. Although Lori attended Dalhousie University
in Halifax obtaining her PhD in 1996 and her Masters in 1984 — she recognizes that she hasn’t yet mastered the art of plucking partridge.


This webinar was made possible through a contribution agreement between the Public Health Agency of Canada (PHAC) and the Canadian Association of Paediatric Health Centres.

Created by Doug Maynard on 2011/05/31 13:21