Once a diagnosis is made, the management of a child or adult with FASD requires an interdisciplinary approach by the healthcare team and families. While there is no cure for FASDs, several strategies may be beneficial for individuals and their families from infancy and continue through adulthood.
Developmental and behavioral problems reflect alcohol's effect on the central nervous system (CNS). Deficits can range from a borderline low IQ to profound intellectual disability, from subtle effects on memory, maturity and executive functioning to severe behavioral disturbances.
There are lifelong challenges for individuals exposed to alcohol in utero that significantly affect the individual's social and emotional functioning. It is important for families to be aware of the neurobehavioral profile of the child; this includes is how the child's thinking process, language skills, and brain function influence his/her behavior on a day-to-day basis. This awareness enables families to nurture a child's strengths while accommodating or intervening in areas of weaknesses.
Families may be better prepared for and able to cope with abnormal behavior that is related to the diagnosis, rather than becoming frustrated if they interpret the behavior as the child's ill-intentions. Furthermore, such awareness also enables professionals to acknowledge that these behaviors are not the result of poor parenting skills.
Individuals with FASDs have lifelong problems with learning and behavior. If disabilities are not addressed early, they may result in more severe problems over time (e.g. school dropout, legal problems, and substance use disorders).
Individuals with FASDs may have delays in meeting expected developmental milestones or may have uneven development in the various domains. Some affected individuals may have significant cognitive disability, with the most extreme cases meeting criteria for intellectual disability. Others may have borderline, low average or even normal IQ, and yet have poor life skills (e.g., self- care, community functioning, and social skills).
Several protective factors have been shown to improve functioning for individuals with prenatal alcohol exposure. These factors include:
- A stable and nurturing environment
- Early diagnosis
- Absence of violence
- Stable home placements and
- Eligibility and access to social, developmental and educational services
Conversely, risk factors that may lead to poor outcomes for individuals with FASDs include:
- Multiple care giving placements
- Early or continued exposure to violence, and
- Failure to qualify for disability services
Management Strategies by Age
The management of individuals with FASDs depends on an understanding of their neurocognitive and developmental abilities as they apply to daily life. Parenting children with FASDs requires a lot of patience, structure, and consistency. It is important to recognize and nurture the individual’s strength while helping him/her navigate the world in the face of their behavioral difficulties. Individuals with FASDs have disabilities that affect the way they behave at home, in school, and throughout the community. Just as we as a society provide ramps, glasses, and hearing aids for those with physical disabilities, we must also advocate for appropriate accommodations for individuals with FASDs. Parents, teachers, and care providers can and should play an active role in such advocacy efforts.