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Fetal Alcohol Spectrum Disorders (FASDs)Behavior & Sensory Support

What you need to know

The effects of FASD can include mental and behavioral effects. Individuals may have FASD or FAS as well as other diagnoses (i.e. autism, depression).   It is important to diagnosis all conditions an individual has and treat each appropriately. 

  • Individuals may also be diagnosed with
    • ADHD
    • ODD
    • Anxiety
Additional issues

Individuals may also have:

  •  Judgment problems
    •  Failure to learn from experience or develop a logical approach to problems
  • Lack of safety awareness
    • Lack of impulse control
    • Lack of behavioral inhibition
    • Poor judgment
    • Difficulty generalizing skills across contexts

Having FASDs can also cause individuals to have psychosocial stress. Individuals with FASDs often lack social skills.  Making friends and maintaining friendships is challenging.

Social difficulties

Individuals with FASDs may have difficulty socially with:

  • Listening
  • Asking for help
  • Waiting their turn and sharing
  • Understanding social cues          
  • Processing social information
  • Communicating in social contexts
  • Following directions
  • Participating in treatment that requires receptive language skills like group therapy
  • Processing info and applying info
  • Using reward systems because time is abstract

Behavioral and sensory issues in adolescence

This is a time of physical and emotional change.  Behavioral and mental health problems stemming from pre-natal alcohol exposure can become more pronounced. Depression and anxiety are common as is alcohol and drug use.

Vocational and transitional services are important during adolescence. Adolescents must be given instructions as well as lifestyle support early on.  Individuals with FASDs need help with life skills such as:

  • Basic maturity
  • Observational learning
  • Punctuality

Other issues that may arise:

  • Anxiety and depression
  • Victimization
  • Lying, stealing or antisocial behavior
  • Sexual behavior also becomes an issue at this age
    • Individuals with FASD are often unaware of the boundaries for appropriate interaction, the subtle social cues, and impulse issues
Behavioral and sensory issues in adulthood
  • Many daily obstacles can occur in general living:
    • Affordable and appropriate housing
    • Transportation
    • Employment and money handling

What you can do

To address attention problems
  • Medication may be helpful
  • Keep the child’s environment as simple as possible, and structure time with brief activities
  • Provide activities that are short and fun
To address social problems
  • Teach basic rules of social behavior
  • Model, rehearse, and practice and provide feedback
  • Pair the child with another who is one or two years younger
  • Teach safety rules and skills
  • Need help with daily skills and life skills
  • Help them learn community based skills
  • Learn how to tell when child is getting frustrated and help out early
  • Tell the child about what will happen if he or she has acceptable behavior or inappropriate behavior at school
  • Let child know when he or she has acceptable behavior
  • Teach self-talk to help child develop self-control. Use specific, short phrases such as “stop and think.”
  • Repeat everything you say and give the child many chances to do what you ask
  • Be patient
  • Give directions one-step at a time. Wait for the child to do the first step in the directions before telling the child the second step
  • Be sure child understands rules, and be firm and consistent with them
  • If easily frustrated or tantrums occur:
    • Remove the child from the situation and use calming techniques such as sitting in a rocker or playing quiet music
    • Consider a functional behavioral assessment if issues impact quality of life
To address issues in adolescence
  • Anxiety and depression:
    • Medication and or counseling may be helpful
      • Find out what activities are meaningful to the child and help them join in. For example, encourage child to participate in sports, clubs or other structured activities
  • Victimization
    • Monitor the activities of the child and discuss dealing with strangers
  • Lying, stealing, or antisocial behavior
    • Family counseling may be helpful
    • Set simple and consistent rules with immediate consequences
  • Sexual behavior may also become an issue at this age
    • Individuals with FASD are often unaware of the boundaries for appropriate interaction, the subtle social cues, and impulse issues
    • Close supervision and open lines of communication are important
To address issues in adulthood
  • Housing
    • Finding appropriate housing for adults affected by FAS/FASDs is extremely challenging
    • Contact your state’s department of disabilities to pursue funding if appropriate
  • Poor peer or social relations
    • Encourage/help the person develop meaningful friendships and relationships
      • e.g., enroll in classes or social clubs with other adults
  • Mental health issues
    • Provide structure, routine and plenty of interesting and meaningful activities
    • Investigate medication options and counseling if needed
  • Handling money
    • Many adults need the support of their family to handle financial matters
  • Difficulty obtaining or keeping jobs
    • Investigate trade schools
    • Job training programs or job coaches
    • Be sure to select jobs that offer structured, routine activities that won’t cause overload or stress

See "The Fetal Alcohol Spectrum Disorders Handbook", University of South Dakota Medical School.