What Works Best for Babies with FAS?

Sleep disturbances: Dark, quiet room. Avoid chaos and sensory stimulation. Accept that the child might not require as much sleep as typical babies. Avoid unnecessary visits and visitors. Swaddle or use a Snugli carrier. Benadryl or Dramamine in children’s doses is okay when needed, but check with the doctor first.

Poor sucking response: Use preemie nipple. Avoid tube feeding, as this could delay eating development and may lead to more serious nutritional problems. Small meals, ever hour if necessary. Avoid fatigue, limit feeding time.

Prolonged crying: In a darkened, quiet room (other than the screaming of the baby), and with the baby swaddled, put the baby against your chest with his or her ear just under your neck. Breathe at the same rate as the baby for about 30 seconds, then slowly reduce your breathing rate, making sure to wait until the baby is at your rate until you slow down more. Within a few minutes, you'll both be calm, and you will have encouraged bonding as well.

Failure to thrive: Try not to worry about the weight charts. It is normal for the child with FAS to be in the 5% percentile. Trying to feed the child rich fatty foods could cause stomach upset. Trying to feed the child more sugar foods could spur added hyperactivity (from colorings in candy and sugar drinks more than from the sugar). Sometimes the extra calories just get turned into extra energy. They will have different reactions to different textures, so experiment and let them eat whatever they want. Be careful of vitamins that might have coloring agents or cause constipation (iron) or stomach upset. Give vitamins at bedtime. Eventually they will grow. Let the mothers be the judge of what and how much to feed the child.

Developmental delays: Employment of speech therapy, occupational therapy, and physical therapy might be helpful. Learning simple sign language is fun and easy. OT should include Sensory Integration therapy. One-to-one play time stimulates development and promotes healthier bonding. Normal milestones for FAS are: walking at age 2, talking around age 3. IQ tests for preschoolers tend to show higher scores than in the school years. The delays in social and emotional development might not be really obvious until around age ten.

Toilet training: It is common for the child with FAS to still be having issues around toilet training at age 6 or even later. The less concern about this, the better. The neural pathways are not yet well-formed, and when the brain development progresses, there will be progress. Sensory input is sometimes not functioning properly, and the message does not get from the body to the brain in time to act. Also, some sleep-aid medications (like Clonidine) may increase night-time bed wetting. A parent can sometimes pick up on the signs before the child even knows it’s time to go. Absolutely avoid punishment for accidents, no matter how old the child is. This is almost always a neurological issue, rather than a psychological one.

Difficulty following directions, distractibility: Careful monitoring, close supervision at all times. Safety-proof the house. Don’t visit anyone’s house that is not child-proof. The five-year-old child with FAS may be closer in psychosocial development to a child of two or three. Lots of reminders, using different modalities. Picture signs. Simple instructions. Break down task into small steps. Repeat directions several times. Factors that influence the ability to follow directions: Poor impulse control, faulty short-term memory, attention deficits, and CAPD – Central Auditory Processing Disorder, where the child might hear only part of what is said, it doesn’t all register with the brain. Showing the child what to do is more effective than just telling the child. Make up songs and rhymes for important tasks to remember.

Tempter tantrums and disobedience: The same factors listed above will interfere with the child’s ability to control temper, expression of feelings, cooperating in social interactions, etc. Alter your expectations: A child of four might only be able to act like a two-year-old. A child going into Kindergarten might not be able to cope socially with the pressures and expectations. Waiting for a turn, getting in line, sitting quietly in a circle - these concepts may be difficult for the child with FAS, who may react either by withdrawal or aggression. Calming time (not "time out") in an area the child feels comfortable (in the closet, under a desk, in a sleeping bag) for whatever time the child needs. Show child how to self-calm, using songs, practicing on dolls or stuffed toys. Note: Some children with FAS also suffer from RAD – Reactive Attachment Disorder, or childhood Bi-Polar disorder, for which special treatment is required. Avoid physical and emotional punishment of any kind. Prevention is the best medicine. Give positive examples with healthy role models.

By Teresa Kellerman, Coordinator, FAS Community Resource Center