FASD Treatment

Children with prenatal exposure to alcohol can present families with a unique set of challenges. Fetal Alcohol Spectrum Disorders (FASD) involve permanent neurological damage that can result in cognitive deficits, academic difficulties, and psychosocial behavioral problems persisting into adulthood[1]. Most treatments are compensatory, and involve strategies to help affected children and their families cope better with the disorder. Specific interventions with children and adolescents should be based on their individual needs. The following form includes challenges commonly associated with FASD, and specific strategies to address them.

 

Cognitive manifestations. The neurodevelopmental deficits associated with FASDs range from global intellectual impairments to specific processing deficits, and learning disabilities that can hinder academic performance and adaptive functioning[2]. Specific areas of cognitive dysfunction may include short-term memory deficits, inadequate processing of information, inflexible approaches to problem-solving, and difficulties with planning and organization.

 

Cognitive intervention recommendations include:

  

  • Present instruction and directions that are broken down into manageable parts (i.e., one step at a time). Visual schedules and picture cues will provide children with consistent exposure to information to support their memory.
  • Review previously learned skills and provide opportunities for repeated practice of new skills. Modeling should be provided for all new tasks. Frequent check-ins with the child ensures understanding and accurate completion of tasks.
  • Graphic organizers and systems for organizing belongings offers support for the child to effectively manage their ideas and materials.
  • Provide specific and labeled praise when desired behaviors are exhibited.
  • Children with FASD who have significant cognitive impairments and demonstrate academic deficits in the classroom setting may require specialized educational interventions.

 

Behavioral manifestations.  In addition to problems with processing and organizing information, children with FASD often have difficulties modulating their physical and/or emotional reactions to their environment as it changes[3]. Self-regulation difficulties may interfere with the ability to transition smoothly to new activities and to maintain a consistent state of mental alertness and attention, particularly in group settings.

 

Recommended interventions supporting behavior regulation are as follows:

  

  • Provide clear expectations for behavior in different settings. Include modeling of examples and non-examples of appropriate behavior.
  • Create a structured learning environment with reduced distractions and predictable routines. Visual schedules displayed will support the child’s memory of routines and expectations.
  • Alternate between preferred and non-preferred tasks. Allotting “brain breaks” and regular exercise will likely support the child in sustaining motivation and maintaining attention during non-preferred activities.
  •  Provide persistence coaching and encouragement while the child engages in non-preferred tasks (i.e., “You’re working hard and really sticking with it. You’re not giving up!”).
  • Medical intervention, such as the use of psychostimulants, may be necessary to mitigate the symptoms of hyperactivity for some children.

Social manifestations.  Children with prenatal alcohol exposure can have difficulty with peer relations and maintaining friendships.  Problems in this domain will likely show up as being unable to appropriately interpret social cues, becoming inappropriately affectionate towards others, and/or having difficulty observing appropriate personal boundaries[4]. Regulating emotional reactions may also be significantly challenging.

 

The following are strategies to support children socially and in regulating their emotions:

  

  • Provide direct instruction in expected and unexpected behaviors, including coping strategies in how to regulate emotional reactions.
  •  Provide coaching and support in social interactions. Coaching in how to manage strong emotions may be particularly important during frustrating situations and non-preferred activities.
  • Offer the child frequent positive feedback and praise for demonstrating positive social behaviors.




 

[1] Phelps, L. (1995). Psycheducational outcomes of fetal alcohol syndrome. School Psychology Review, 24(2), 200. Retrieved from http://search.ebscohost.com

[2] Kable, J.A. & Coles, C.D. (2004). Teratology of alcohol: Implications for school settings. Handbook of Pediatric Psychology in School Settings (pp. 379-404). New Jersey: Lawrence Erlbaum Associates, Inc.

[3] Schonfeld, A., Paley, B., Frankel, F., O’Connor, M. (2006). Executive functioning predicts social skills following prenatal alcohol exposure. Child Neuropsychology, 12(6), 439-52.

[4] Coggins, T., Timler, G., Olswang, L. (2007). A state of double jeopardy: Impact of prenatal alcohol exposure and adverse environments on the social communicative abilities of school-age children with fetal alcohol spectrum disorder. Lang Speech Hear Serv Sch, 38, 117-27.

 

 

 

 

Information presented on this website is for educational purposes only. Website content is not meant as a substitute for clinical advice or professional guidance. Images are used with permission. Images may not represent particular individuals or situations discussed in articles. All rights reserved. No part of this website may be reproduced, distributed, or transmitted in any form or by any means, except when used by a trained FMF Specialist or by special arrangement with the FMF Program Developer.

Please note:

Information presented on this website is for educational purposes only. Website content is not meant as a substitute for clinical advice or professional guidance. For clinical care and advice, it is best to consult a mental health provider or primary care provider. This site does not provide clinical advice or connections with care.

Images are used with permission. Images may not represent particular individuals or situations discussed in articles.

This site is primarily for health care providers and systems to learn about training in the Families Moving Forward (FMF) Program intervention.  The FMF Program is a behavioral consultation treatment designed for families raising preschool and school-aged children with fetal alcohol spectrum disorder (FASD) or prenatal alcohol exposure.