Characteristics

• Problems with cause and affect relationships and impulse control
• Problems with the ability to generalise information
• Problems with understanding concepts and abstract thought
• Problems with perseverative behaviour
• Problems with the ability to conceptualise, internalise and structure time
• Problems with short term memory
• Problems with all areas of accessing information, especially auditory
• Unable, not unwilling to take responsibility for their actions
• Volatility – rage and strong emotions
• Still in need of limits and protection because of their deficits in reasoning, judgement and memory.

Intervention & Management

Set the environment

Adjust expectations to developmental age not chronological age

• Keep a daily schedule of things to do and appointments to keep.
• Daily reminders may be necessary – maintain sense of humour
• Develop a variety of supports – friends, neighbours, relatives, professionals – educate them
• Reminders about hygiene and basic safety issues will still be needed
• Try to reduce the number and complexity of decisions
• Free time is dangerous time – try to keep days structured and planned - 24/7 supervision is still necessary.
• A locked room may be necessary to keep your personal items safe – eg money, jewellery, alcohol etc

Sleep/Getting Up

• Ensure they get enough rest – 11 hours may be needed
• Start each day as a new day – give up on what happened yesterday
• Avoid conflicts or rushing in the morning as this will have negative affect on whole day
• Use same morning routine ever day - get things ready for next day before going to bed –

General

• Any person who has dealings with your adolescent ie. teachers counsellors etc must have experience, be flexible, compassionate and know about FASD
• Advocate for school programmes designed to meet their needs - FASD is a disability not bad behaviour – they will probably require a Negotiated Education Plan
• Parents and school staff need to work as a team
• Encourage exercise as part of their day
• Work on ways to identify and cope with sensory overload
• Set concrete rules – be consistent – consequences must be immediate
• Don’t get into a power struggle – model calm, rational behaviour
• If there is bad behaviour talk about what happened but avoid asking why it happened
• Identify strengths, skills and interests and build on those
• Monitor friendships – they are very vulnerable to getting mixed up with the wrong crowd
• Your alternative care worker must have an understanding of FASD and must have appropriate plans for transition – these children are NOT ready for independent living at 18 and most will never be without intensive support