FAS Issues At All Ages

PSYCHOSOCIAL NEEDS ASSOCIATED WITH FAS & FAE
Prepared by Robin LaDue, Ph.D.
Fetal Alcohol & Drug Unit, Dept.of Psychiatry & Behavioral Sciences
University of Washington School of Medicine, Seattle, Washington
(Reprinted with permission)

General Issues

Early and adequate identification and diagnosis
Safe, stable and structured home or residential placement
Unrealistic expectations of persons with FAS/E due to the outward appearance and verbal, gregarious manner
Appropriate academics, vocational and living skills training programs

Infancy & Early childhood:
Ages 0-5 Years

Problems and Concerns
Poor habituation
Sleep disturbances; poor sleep/wake cycle
Poor sucking responses
Failure to thrive
Delays in walking and talking
Delayed toilet training
Difficulty following directions
Temper tantrums and disobedience
Distractibility

Recommendations
Early identification
Intervention with birth and/or foster parents
Education of parents regarding physical and psychosocial needs of as infant or child with FAS/E
Careful monitoring of physical development and health
Safe, stable and structured home
Assignment of a case manager for coordination of services and support to parents
Placement of the child in preschool
Respite care for caretakers

Latency Period:
Age 6-11 YEARS

Problems and Concerns
Easily influenced and difficulty predicting and/or understanding consequences
Give an appearance of capability without actual abilities
Difficulty separating fact from fiction
Temper tantrums, lying stealing, disobedience and defiance of authority
Delayed physical and cognitive development
Poor comprehension of social rules and expectations

Recommendations
Safe, stable and structured home or residential placement
Careful and continued monitoring of health issues and existing problems
Appropriate education and daily living skills placement
Help caretakers establish realistic expectations and goals
Caretakers establish realistic expectations and goals
Caretaker support group
Psychological, educational and adaptive evaluations on a regular basis
Use of clear, concrete and immediate consequences for behavior
Respite care for caretakers
Case manager role expands to include liaison between parents, school, health care providers and social service agents

Adolescence:
Ages 12-17 Years

Problems and Concerns
Lying, stealing and passivity in responding to requests
Faulty logic
Egocentric; has difficulty comprehending and/or responding appropriately to other people's feelings,, needs, and desires
Low motivation
Low self-esteem
Academic ceiling, which is usually around grade 4 for reading and grade 3 for spelling and arithmetic

Recommendations
Education of caretakers and patients regarding sexual development, birth control options and protection from sexually transmitted diseases
Planning and implementation of adult residential and vocational training and placement
Appropriate and mental health interventions as needed
Respite care for caretakers
Caretakers support group
Safe, stable and structured home or other residential placement
Shifting of focus from academic skills to daily living and vocational skills
Careful monitoring of social activities and structuring of leisure time
Working towards increased independence by teaching to make healthy choices (taught at the child's level)

Adulthood:
Ages 18+ Years

Problems and Concerns
Residential placement
Economic support and protection
Job training and placement
Depression and suicidal ideation
Pregnancy or fathering of a child
Social and sexual exploitation, or inappropriate behavior
Increased expectations of the patient by other people
Increased dissatisfaction towards the patient by others
Withdrawal and isolation
Unpredictable behavior

Recommendations
Guardianship for funds
Specialized residential and/or subsidized living
Specialized vocational and job placements
Medical coupons
Acceptance of the patient's "world"
Acknowledgement of the patient's skills limitations
Patient advocates to ensure the above occurs


FAS Community Resource Center