There can be a lot of misinterpretation that goes along with understanding and working with individuals who have a Fetal Alcohol Spectrum Disorder. FASD is an invisible disability; its physical characteristics can be subtle or non-existent and may go unrecognized. We cannot see brain damage so instead we see behaviours that can easily be misinterpreted.

Infants

Every child is unique, but infants with FASD may show signs of some or many of the following. They may:

• Be born too soon/ be small at birth.
• Have problems sucking and swallowing
• Be fussy – often cry, tremble and shake
• Be prone to infections and illnesses – especially ear infections
• Either under or over react to pain, cold or touch
• Have trouble sleeping
• Have jerky movements
• Have slow development/ growth
• Have cleft palate/ cleft lip or other birth defects

 

Toddlers

Toddlers and preschoolers with FASD may also have some or many of the following. They may:

• Be very active
• Be slow to speak and then mimic others
• Be unaware of the consequences of their actions
• Have no fear of strangers
• Not understand what others are saying
• Be too affectionate sometimes
• Have trouble sleeping and eating
• Be able to say what could happen to them if they would do something dangerous, but will still do it
• Have trouble playing with others
• Have no fear of danger
• Have a short attention span
• Need to touch others
• Not learn from mistakes
• Have trouble making choices
• Be clumsy and rough

Great things about children with FASD

Children with FASD have many strengths. Here are just a few:

• Happy
• Artistic
• Great speaker
• Great storyteller
• Friendly
• Loyal
• Committed
• Affectionate
• Creative
• Have lots of energy
• Musical
• Care about younger children
• Hard worker
• Spontaneous
• Funny
• Don’t give up easily
• Caring
• Curious
• Innocent

*Adapted from Characteristics of Fetal Alcohol Syndrome/ Fetal Alcohol Effects, Patricia Tanner Halverson, Ph.D.

 

Young Adult

When thinking about “problem” behavior and young adults with FASD, it is essential to remember that the individual has

Brain Damage and / or Neurological Dysfunction.

Some reasons for “problem” behaviors are that the young adult:

• Does not understand what is expected
• Feels anxious or frantic when changes or transitions happen
• Has significant memory, perceptual and / or attention problems
• Is required to enter an environment which he experiences as painful or chaotic
• Do not know how to ask for help
• Is seeking attention (due to being socially isolated)
• Is having an anxiety attack
• Is depressed and acts out his depression, becoming confrontational or aggressive
• Mood disorder – depression, anxiety or both
• Sleep disorder – poor quantity or quality of sleep
• Neurological Regulation problems with sensory and emotional overload
• Side effects of medication – tiredness, agitations, sleep disruption, or nausea
• Mirrors the behavior of the support staff or parent who has responded to a problem with alarm or anger
• Is feeling backed into a cornered and attacked.
• Experiences self-hatred and wishes to punish himself
• Has developed secondary mental illness
• Has lost hope and becomes suicidal

The brain and neurological system operates differently in these young adults and all aspects of their lives may be affected. They experience the world differently in the following kinds of ways: how they see, hear, touch, taste and smell; how they learn; how they experience emotions; and how they understand the behavior, language and emotions of other people.

These differences have major impact on the day to day lives of the young adults It may limit their ability to understand the social world; to anticipate the consequences of their actions; to problem solve and to deal with the challenges of everyday life.

 

Understanding behavior

Assumptions – Our assumptions about why behavior is occurring directly influence how we respond to the behavior. Support workers and parents may find that they need to rethink their assumptions:

AVOID assuming that the behavior is intentionally defiant, annoying or disrespectful.

ASSUME INSTEAD the following possibilities – that the young adult:

• Is confused and doesn’t understand what is expected
• Is somehow distracted or forgetful
• Is able but somehow inadequately supported or motivated to participate
• Is able but somehow inadequately trained to perform the expected behavior
• Is unable to learn at the present time

Young adults with FASD often have difficulty expressing their feelings, thoughts and needs.

A good way to look at the behavior of the young adult is to think of it as a puzzle that needs to be solved.

For caregivers:

An important part of your job as a caregiver is to work toward understanding how the young adult experiences and understands the world. This may be quite different from how you experience and understand the world.

 Babies don’t grow out of alcohol related birth defects. They have them for life

Sources:

• Asperger syndrome Fetal Alcohol Spectrum Disorder The Adult Years Help for Front Line Staff and Parents By Karen Phillips and Meredith Porter
• FASD The Basics The prevention Conversation