Prenatal exposure to alcohol can result in an almost limitless combination of physical and functional birth defects. While there are specific criteria for diagnosing Fetal Alcohol Syndrome and other disorders under the FASD umbrella, the full range of physical and developmental disabilities for any one affected individual may become evident at irregular times through childhood, adolescence and into adulthood. Preventing the disabilities through early diagnosis and intervention—if possible—and coping with the symptoms or consequences of the disabilities becomes the challenge for families and caregivers.
Described below are practical solutions and brief recommendations for some of the most common challenges, including learning and behavioral problems across the lifespan. Often, more specialized information and resources are needed by families to adequately meet the needs of a loved one with FASD. Search the NOFAS Resource Directory, visit the Strategies for FASD Parents and Caregivers and Adults Living with FASD pages, or contact NOFAS for more information.
FAS/FASD through the Lifespan
FAS/FASD has lifelong implications. There is a broad range of characteristics to watch for at different ages.
- Infants: low birth weight; irritability; sensitivity to light, noises and touch; poor sucking; slow development; poor sleep-wake cycles; increased ear infections.
- Toddlers: poor memory capability, hyperactivity, lack of fear, no sense of boundaries and a need for excessive physical contact.
- Grade-school years: short attention span, poor coordination and difficulty with both fine and gross motor skills.
- Older children: trouble keeping up with school, low self-esteem from recognizing that they are different from their peers.
- Teenagers: poor impulse control, cannot distinguish between public and private behaviors, must be reminded of concepts on a daily basis.
- Adults: need to deal with many daily obstacles, such as affordable and appropriate housing, transportation, employment and money handling.
Strategies for Living
Establish a relationship with a pediatrician and consult him or her with any problems or questions. Here are some other helpful tips—
- Poor sleep-wake cycles/irritability: Play soft music and sing to your baby. Rocking, frequent holding, low lights, automatic swings and wrapping them snugly in a soft blanket also can be helpful.
- Poor weight gain: Consult a nutritionist to develop a food plan or discuss supplement use.
- Chronic ear infections: Speak to a specialist about evaluating your child’s hearing and effectively treating infections.
- Delays in rolling over, crawling, walking: See an occupational therapist for assistance. Also help your baby in crawling, grabbing and pulling.
- Speech delays: Consult a speech therapist and purchase tapes or toys that are specifically designed for children with delays. Speak and read aloud expressively to your baby.
- Continued motor skill delays: Work with an occupational or physical therapist. Use toys that focus on manipulating joints and muscles.
- Distracted easily: Establish a routine and use structure. Simplify rooms in the home and reduce noises or other stimulation.
- Dental problems: Consult a pediatric dentist. Your child may not be able to sit still, so be sure to prepare your child for the exam and allow more time for the appointment.
- Small appetites or sensitivity to food texture: Serve small portions that are lukewarm or cool and have some texture. Allow plenty of time during meals and decrease distractions such as television, radio or multiple conversations.
- Bedtime: If your child cannot sleep at night, shorten naps or cut them out completely.
- Making and keeping friends: Pair your child with another who is one or two years younger. Provide activities that are short and fun.
- Boundary issues: Create a stable, structured home with clear routines and plenty of repetition.
- Attention problems: Medication may be helpful. Keep the child’s environment as simple as possible, and structure time with brief activities.
- Easily frustrated/tantrums: Remove your child from the situation and use calming techniques such as sitting in a rocker, giving a warm bath or playing quiet music.
- Difficulty understanding cause and effect: Repetition, consistency and clear consequences for behavior are important.
- Anxiety and depression: Medication may be helpful, as well as counseling or encouraging your child to participate in sports, clubs or other structured activities.
- Victimization: Monitor the activities of your child and discuss dealing with strangers.
- Lying, stealing or antisocial behavior: Family counseling is helpful, as well as setting simple and consistent rules with immediate consequences.
- Housing: Finding appropriate housing for adults affected by FAS/FASD is extremely challenging. Contact your state’s department of disabilities to pursue residential funding and get on every waiting list you can find that offers housing options.
- Poor peer or social relations: Enroll your child in classes or social clubs for adults with disabilities.
- Mental health issues: Provide structure, routine and plenty of activities. Investigate medication options and counseling.
- Handling money: Many FAS adults need the family to handle all 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.
- Keep your family’s routine as consistent as possible.
- If the family’s routine or schedule changes, remind your child about changes.
- Learn how to tell when your child is getting frustrated, and help out early.
- Make sure your child understands the rules at home.
- Tell your child about what will happen if he or she has good behavior or bad behavior at home.
- Let your child know when he or she has good behavior.
- Teach self-talk to help your child develop self-control. Use specific, short phrases such as “stop and think.”
- Repeat everything you say and give your child many chances to do what you ask.
- Be patient.
- Give directions one step at a time. Wait for your child to do the first step in the directions before telling your child the second step.
- Tell your child before you touch him or her.
- Be sure your child understands your rules, and be firm and consistent with them.