What is it Really Like to Raise a Child with FASD?

What is it really like to parent a child with Fetal Alcohol Spectrum Disorders? Prenatal exposure causes brain damage and this damage causes specific behaviors that can make parenting challenging. What works to help these kids? Host Dawn Davenport, Executive Director of Creating a Family, the national infertility, adoption, & foster care education and support nonprofit, interviews Suzanne Emery, a Program Director with FASCETS, a nonprofit focused on helping parents raise children with Fetal Alcohol Spectrum Disorders. She is also the mom of a son with FASD.

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How does alcohol affect the brain of a developing fetus?
What are the primary behaviors most characteristic of the brain damage associated with FASD?
- Significant memory problems – short and long term
- Gaps in the thinking process including difficulty forming associations, predicting, abstract reasoning, cause and effect reasoning, and generalizations
- Slower pace of thinking, understanding and listening
- Impulsivity and distractibility
- Different responses to stimuli including sensitivity to lights, sounds, temperature, taste and touch
- Difficulty understanding cause and effect
- Challenges in managing free time
- Difficulty weighing and evaluating, resulting in possible difficulty understanding safety and danger and possible heightened risk for victimization and exploitation
- Difficulty managing time, money, and schedules
- Dysmaturity (wide variation between developmental and chronological age)
Do children with FASD generally have more behavioral problems than a child without fetal alcohol exposure?
Secondary behaviors develop from constant exposure to failure, frustration, and not being understood.
- Fatigue and frustration
- Anxiety
- Anger and aggression
- Withdrawing and avoidance
- Poor self esteem
- Difficulty making friends
- Depression and other mental health concerns including
- Opposition and defiance
- Self aggrandizement
FASD is sometimes called an invisible disability. Children and adults with FASD can have strong areas, such as expressive language, but this often makes others respond to the child as if they are on that level. What type of problems does this cause?
Do children outgrow the affects of FASD?
Individuals with FASD are literal, concrete learners who tend to grasp pieces, rather than concepts. This means:
- Slower thinking and hearing speed
- Problems storing and retrieving information
- Difficulty forming links, associations
- Difficulty generalizing
- Difficulty with abstract concepts
- Difficulty seeing next steps/outcomes
- Disconnections: says one thing and does another
- Highly suggestible and thus at risk for exploitation
- Do not experience risk and rewards the way a non brain injured person would
Parenting tips:
- Focus on strengths
- Consider developmental age over chronological age.
- Distinguish, if possible, between what behaviors are a direct result of the brain damage, and what behaviors are the result of the frustration with living with this brain damage.
Provide structure: Lists, schedules, timers, and supportive technology can be very helpful. Assistance in managing these aids. Set up a system of reminders and consider using visual reminders/lists if child learns better by sight. As the child ages, involve them in setting up the reminders and system.
Language processing if often impaired so:
- Use fewer words,
- Slow down your speech,
- Give time for the person to answer one thing at a time
- Avoid conditional words such as however, instead of, provided that, probably, likely
- Be specific and concrete
- Keep it simple. Give only one or two directions at a time
- If possible, give visual cues
- Check for understanding frequently in your conversation.
- Include child in problem solving.
- Don’t expect-immediate obedience-give time
- Don’t over-explain things. Avoid the why behind your statement. Stick with black and white, yes and no, bad and good. “Walk home without stopping.” “Be home by 5:00.” “No TV until homework has been checked by Dad.”
- Limit choices. Too many choices may cause confusion about what to do. When giving a choice keep it simple: “Do you want to clean your room now or in 30 minutes.”
- Help child put their feelings into words and give them something they can do to make it better (take a break, count to 10)
Sleep issues, especially as child ages, are common because of time management, lack of structure, and difficulties with self-regulation. Set up a simple to maintain bedtime routine.
Teach the child how to ask for help and that asking is a strength not a weakness.
What is the prognosis for a child with significant prenatal alcohol exposure?