Overview of F.A.S.D.(Fetal Alcohol Spectrum Disorder)

ByBrenda McCreight Ph.D.

http://www.theadoptioncounselor.comhttp://www.hazardousparenting.com

brendamccreight@gmail.com

What the name means

• Fetal alcohol spectrum disorder is the diagnostic term used to identify the permanent impact of alcohol on the formation of the embryonic and fetal brain.

• It is called a Disorder because it alters the way the brain forms which results in permanent long term challenges in learning, in behaviour, in relationship formation and in emotional regulation.

• It is considered to be part of a spectrum of disorders because every brain is unique and the damage done to the brain can be different in different people.

• Brenda McCreight PH.D., workshops 2013

Other terms used for fasd

• Alcohol-related neurodevelopmental disorder (ARND)

• Partial FAS (pFAS)

• Fetal alcohol effects (FAE)

• Alcohol-related birth defects (ARBD)

• Static encephalopathy (an unchanging injury to the brain)

• Brenda McCreight Ph.D. workshops 2013

This is what alcohol does to a fetal brain – the brain will not recover

Behavioural Challenges of People with FASD

  

Learning disabilities People with fasd have trouble learning some things that might be easier for you to learn. They often need help at school and often can’t meet many academic expectations. They run into the same problems with learning when they reach adulthood and try to work Short impulse control People with fasd might do things on impulse – that is, she doesn’t think about things before she does them. Inability to relate behaviour to consequences The individual may do things and get into trouble, but he doesn’t understand why everyone is mad at him. Or, you may notice that he makes choices that you both know will lead to problems, but he just does it anyway.  Brenda McCreight Ph.D. workshops 2013

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  Very forgetful  You tell her the same thing over and over again but she just doesn’t remember it, even if it’s written down and she is reminded several times.  Sometimes he knows the rules, sometimes he doesn’t You think everything will be okay because he understands the rules, or he knows how to play the game, but then he does something totally different and acts like he never knew the rule at all.  Can get in your space and not understand why you are mad

You ask her and ask her to stop, or to leave your room, or to quit jumping in your space, but she just won’t.

Brenda McCreight Ph.D. workshops 2013

 

He lies He lies all the time, or least it seems like that to you. Even when the lie will get him into more trouble, he still tells it and expects you to believe him Has trouble understanding time and the value of money She spends all of her money as soon as he gets it and always steals or tries to borrow money from you. She’s late for everything and can’t understand why you get frustrated when you have to take her places and you can’t even find her.  Makes the same bad decisions over and over again You learn from doing things wrong, but he seems to do the same wrong things repeatedly and is then surprised when things don’t work out or he’s in trouble again.

Brenda McCreight Ph.D. workshops 2013

Inconsistent knowledge baseHe knows something one day, and then appears to have nevereven heard of it the next. He can spell easily one day, and can’t spell at all the following week.

Can’t generalize What she learns in one setting isn’t transferred to the next setting. She learns not to yell out loud in math class, but she doesn’t take that learning or knowledge to socials class.

Can’t process information adequatelyHe can’t decide what to do in a situation and can’t use the information that is available to evaluate what would be the best action to take. Brenda McCreight Ph.D. workshops 2013

And a few more challenges…• Has trouble completing tasks• Has problems with following or repeating a sequence• May appear non-compliant because she doesn’t understand or remember what was expected

of her

Decline in cognitive skills over time• Research shows that there is a significant drop in cognitive skills as

the children reach adulthood• Particularly – there is a drop in the hugely important skills of

information processing and working memory. • That means that a person with fasd loses some of his capacity to

understand information as well as losing some capacity to learn, to reason, and to remember

• Since people with fasd start out with impairments in these areas, it’s very important that the rest of us understand that not only will their abilities not improve, they will get worse as they transition from adolescence to adulthood.

• Re-testing of IQ and adaptive skills is vital near the middle or end of adolescence!

Facial Characteristics

• There are distinct facial characteristics in some children and adults – not all people who have fasd will have the facial characteristics.

As if that wasn’t enough…• Most babies born to moms who drank during the pregnancy are also neglected – they don’t receive

adequate pre-natal care and nurturing, and they don’t receive adequate post natal care and nurturing - and that brings in a whole new set of problems.

• This is discussed in depth in some of my other courses – but to give you an overview of the impact of neglect….

• Neglect causes the young brain to be under stimulated, under nurtured, and over stressed. • The neglected brain doesn’t get an opportunity to develop appropriate stress management systems so

whenever the child feels stress from anything ie lonlieness, fear, change, the unfamiliar, anger, frustration, abuse, hunger, confusion etc – he will not be able to process the feelings or manage the cortisol that the stress creates – and so will act out in negative behaviors - most often it will be through anger and non-compliance.

The brain of a person with fasd is smaller than the typical brain The brain of a person who has been neglected is also smaller than a typical brainIt’s crucially important that the people who love, or work with, an individual who has fasd and has been neglected, remember always that while there are many strategies and supports that can enhance the capacity of the individual, there is nothing that will make the brain work the way it should have. The individual can have a good life, but it will never be the life she would have had without fasd and neglect. Therefore, don’t aim for what might have been – aim for what the person can truly achieve.

This is the brain of a child who was neglected but was not pre-natally exposed to drugs or alcohol

• The combination of pre-natal exposure to alcohol and the experience of neglect has a profound impact on the child’s brain.

• This impact is life long.• The impact of neglect can be mitigated by

effective parenting, nurturing, stability etc, but the brain will never become what it would have if the child was born to, and lived in, a healthy and nurturing environment for the first years of his or her life.

• Brenda McCreight Ph.D. workshops 2013

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Secondary Disabilities

• When this many issues exist, they are going to create even more problems as the person reaches adolescence and adulthood – these are called secondary disabilities.

• Ann Streissguth studied secondary disabilities in people with fasd and she found that many of them often developed some of the following secondary disablities:

• trouble with the law• sexual victimization• financial victimization• Brenda McCreight Ph.D. workshops 2013

disrupted school experience problems with parenting their own children problems getting or keeping a job addictions problems maintaining independent living problems getting and keeping jobs

Brenda McCreight Ph.D. workshops 2013

Home Based Strategies for parents or caregivers

• Keep to a routine when possible – but be aware that the person with fasd

may not follow it or even recognize that you have a routine • Prepare for transitions ie getting in and out of the car or bathtub, waking up,

going to sleep, settling for dinner, change in television program • Keep complex carbohydrates and proteins around for regular snacks • Break all tasks down to one step at a time • Use learning aids ie Hooked on Math, and Hooked on Phonics • Brenda McCreight Ph.D. workshops 2013

• Don’t do homework assigned from school unless it is a special group assignment • Create some fun in every day • Lots of cuddling and hugging • Use individual sports such as swimming – lots of exercise!! • Learn to distinguish between flexibility and chaos • Re teach everything • Use lots of picture prompts around the house• Brenda McCreight Ph.D. workshops 2013

Issues for Adolescents/Young Adults with FASD•  

     Why They Can’t Risk Following Your Good Advice•

• They can’t picture/grasp consequences • They have little or no experience with positive outcomes • They have a familiar history of negative outcomes • Their current life with you is not permanent due to their age or life stage so there is no point in changing or accepting your way of living • They don’t believe they need your love or approval due to their age or life stage • They need the love and approval of their peers • They have no investment in your home, your life, or your plans for them – the brain issues make them very self centered • The only permanent factor in their life is the “opt out” clause • Brenda McCreight Ph.D. workshops 2013

     

Supports for Adults with FASDAs a parent, you may be limited in what you can offer by the person’s rejection of your help or by the lack of resources in your area – here are some suggestions for how you might be able to help:• Get the person linked up with whatever resources provide support and help in your

community. The person with fasd may resist this, or may be compliant, but do whatever you have to in order to get him linked to every possible resource.

• Be aware that you, as the parent, will have to bail her out from time to time, with rent money, food money, caring for her children.

• You may not have the financial or other capacities to do this – if that is the case – make your limits clear and get the appropriate services involved.

• Plan to provide or access support for housing, income, work, and parenting – these needs will be lifelong – the person may function well for a few years but one major change and it can all fall apart.

• Make the quality of your relationship the priority – not compliance or a positive lifestyle – the love your adult child feels from you may, at times, be the only consistently good thing in his life.

• Brenda McCreight Ph.D. workshops 2013

Online Resources

• http://www.fasdoutreach.ca/• http://www.fasd-cmc.alberta.ca/• http://www.cnc.bc.ca/Campuses/Lakes_District_Campus/FASD_Programs__Services___

Training/Advanced_Diploma_in_FASD.htm• http://www.torontocas.ca/wp-content/uploads/2008/09/FASD.pdf• http://fasdcenter.samhsa.gov/educationTraining/EducationTraining.aspx• http://www.nofas-uk.org/ http://www.mofas.org/ai1ec_event/free-online-training-fasd-the-basics/?instance_id=