You Suspect a Student is Living with FASD

Fetal Alcohol Spectrum Disorder (FASD) refers to a range of physical, neurodevelopmental, and behavioural impairments resulting from damage to the fetus caused by maternal alcohol use during pregnancy. These impairments may include growth retardation, malformations of the face, neurological disorders, and deficiencies such as problems with memory, learning, attention and social communication. The physical abnormalities associated with prenatal alcohol exposure are not always present; therefore, FASD is frequently invisible and often goes undiagnosed.

FASD as a diagnostic term… Prior to the new diagnostic guidelines being published by the Canadian Medical Association Journal in early 2016, FASD was described as an umbrella term for impairments associated with prenatal alcohol exposure. Diagnoses could have included: Fetal Alcohol Syndrome (FAS), Partial Fetal Alcohol Syndrome (pFAS), Alcohol Related Neurodevelopmental Disorder (ARND), or Alcohol Related Birth Defects (ARBD). Such diagnoses are no longer made. Based on these new guidelines for diagnosis, FASD itself, is the diagnostic term.

An invisible disability… FASD is very often an invisible disability, meaning that most people with FASD do not necessarily show any physical signs of having FASD. So, if we can’t see FASD, what are some symptoms or clues that a student may be living with FASD? Often, the brain-based struggles can be noticed in the behaviour of the student. When working with students suspected or diagnosed with FASD, it can be helpful to reframe behaviour as functional or serving a purpose, asking ourselves “What is the goal?” Behaviour offers hints to how the student is functioning in the environment and responding to expectations and various stimuli. It is crucial to remember that all behaviour is functional and communicates a need.


 

BRAIN-BASED STRUGGLES

OBSERVABLE BEHAVIOURS

Executive Functioning

The student may struggle with planning, sequencing, task initiation, and/or goal setting

Memory

The student may have difficulty with learning from past experiences, inconsistent retrieval and forming of associations with information

Abstract Concepts

The student may have difficulty understanding concepts such as ownership, money, time and/or math

Judgment

The student may struggle with decision making, impulse control and understanding safety and/or danger

Language and Communication

The student may have difficulty with organizing and comprehending information, social communication, verbally expressing ideas, and/or understand abstract language such as sarcasm, jokes, idioms, and metaphors

Processing Speed

The student may have difficulty taking in and processing information, and/or keeping up with instructions or directions (10 second kids in a 1 second world)

Preservation

The student may struggle with transitions to a new activity or subject and can get stuck more easily

Generalizing

The student may have difficulty generalizing information and rules in unfamiliar setting or situations

Dysmaturity

The student may experience a mismatch between chronological and developmental age, functioning younger socially, emotionally, or cognitively than their chronological age

Impulsivity

The student may struggle with impulse control, leaving class without permission, taking items from others, and/or blurting out in class

Attention

The student may have difficulty with focus and/or attending to information presented

Sensory Integration

The student may have difficulty integrating sensory information and filtering stimuli they can see, smell or hear, and/or under or over react to pain or temperature

 

Brain Based Behaviours PDF

Although schools may observe several behaviour clues that a student may be living with FASD, the student may or may not meet the criteria for a diagnosis of FASD. An FASD assessment can be a great way to get a strengths-based understanding of IF or HOW the student’s brain has been impacted by prenatal alcohol use. This can be a sensitive topic to discuss with families or caregivers, so it is important to first focus on building supportive relationships which are grounded in positive regard and rapport. Building a strong school support team is essential for supporting success for students who are suspected to be living with FASD and can begin at any point, regardless of a diagnosis.