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Fetal Alcohol Spectrum Disorders: Tips for Parents

By Lynne R. Frigaard, Fetal Alcohol Specialist, Arc Northland, Duluth, MN

Finally, in growing numbers, women are coming to understand that alcohol use during pregnancy can be harmful to the developing baby. The Surgeon General of the United States now agrees that there is no safe amount of alcohol for use by pregnant women.

Still, we are seeing what seems to be increasing numbers of children affected by prenatal alcohol consumption. Some women are addicted and have not had treatment. Others don’t know that they are pregnant, and though they stop drinking when they find out, it is already be too late. For other women, their physicians are telling them that it is all right to have an occasional alcoholic beverage. Some live in a culture where the elders dictate behavior, maybe tout the virtues of alcohol without understanding its power to harm.

Whatever the reason, women are still drinking during pregnancy and children with Fetal Alcohol Spectrum Disorders are still being born.

So why should we care? The list is long.

We are creating children with brain damage that is not fixable.

Children with FASD can have significant emotional, behavioral, and learning problems and other difficulties that last a lifetime.

People with FASD are filling our prisons, CD treatment centers and mental health facilities.

FASD is contributing to homelessness and poverty.

FASD is costing us millions, maybe billions, of dollars.

Fetal Alcohol damage is TOTALLY PREVENTIBLE.

Many children and teens with FASD end up in foster care or adoptive homes, taken in by parents ready and willing to give them the love and support they so desperately need and deserve. But then things can start to get difficult. Would you recognize the signs and symptoms that might indicate the possibility of FASD? Some of the most common include:

ADHD
Tantrums
Immaturity
Impulsivity
Lying
Stealing
Sensory problems
Lack of generalized learning
No action/consequence thought process
Can’t learn from experience
Poor memory
Slow processing of information

And, sadly the list goes on. Because these are spectrum disorders, the symptoms in each individual can be very different and determining what the person really has can be like assembling a puzzle.

On one end of the spectrum, a person could simply be disorganized and forgetful.

On the other end, they could actually have mental retardation, meaning an I.Q. of 70 or lower.

Most children and teens fall somewhere in the middle. They have normal intelligence but are lacking age appropriate common sense. They tend to be “concrete” people trying to live in an “abstract” world. Their higher-level executive function skills such as predicting, decision-making, reading environments and understanding relationships may be impaired. They may “act” much younger than their chronological age and their intelligence would indicate.

So, what is to be done? If you live in Wisconsin, Minnesota, Michigan or another mid-west state, you need to understand that there are many kids with undiagnosed FASD in the foster and adoptive system. This is due to our pattern of binge drinking, the most harmful type of drinking for the unborn fetus. If you suspect that a child you care for may have FASD, try to get an assessment. You can call the Arc Northland office in Duluth, MN at 1-800-317-6475 and we will try to direct you to diagnostic resources.

The most important thing in raising children with FASD is that they have brain damage that cannot be fixed, so efforts to change them internally are likely to fail. However, we can change the way we parent, teach, and manage them to improve their futures. In 1997, Deb Evenson and Jan Lutke developed a guide that identified the 8 most important concepts to apply to any situation involving a child/teen with FASD. They called it The Eight Magic Keys and the following has been adapted from the original.

Concrete – Use concrete language, not words with double meanings or idioms, etc. Make things visible and touchable; use pictures to help with routines, etc. “Think younger” when developing expectations for freedom and responsibility.
Consistency – With the inability to generalize learning from environment to environment, those with FASD do best when little changes. All caregivers, teachers, etc. should use a common language, common expectations and responses.
Repetition – Due to poor short-term memory, children and teens with FASD need rote, repetitive teaching. Think of it as “habit building” through direct training.
Routine – Stable routines from day to day help those with FASD know what to expect. As they may not manage “change” well, routines are user friendly for them.
Simplicity – Kids with FASD can be very distractible and easily over stimulated. Creating “Zen” environments can help them stay on task and avoid the “shut-down” response to too much stimulation.
Specific – Say exactly what you mean. Children and teens with FASD can be very literal in their understanding of words so the phrase “raining cats and dogs” may have them looking for the fur to fly.
Structure – Structure is the “glue” that holds the world together for those with FASD. Structure can result in success. The lack of can result in failure.
Supervision – Children and teens with FASD can be very vulnerable because of their naiveté. They can have trouble reading environments and adapting behavior to suit. For safety, they may need to be supervised at the level of a much younger child.

In conclusion, kids with FASD need structured and stable homes with loving families who can be patient and are willing to “build habits” through rote, repetitive teaching. They need predictable routines, concrete reminders and less stimulating environments. In addition, all environments should be purged of any sexual and/or violent content. Sex and violence have a lot of “energy”, which can draw those with FASD like a moth to flame, and because they tend to act out what they see, sexual or violent movies, cartoons, video games, etc. should be avoided at all costs.

Lynne R. Frigaard presented the workshop “Living with Children with Fetal Alcohol Spectrum Disorder (FASD)” at the Friends of Adoption Fall Adoption Retreat in Chetek on October 22nd, 2005.